CARDIAC ARREST

Cardiovascular Disease Over 1,000,000 Americans die from diseases of the heart & blood vessels annually.

High Blood Pressure 65 million Americans have high blood pressure.

Heart Attack Risk Factors

Sudden Cardiac Death Sudden loss of heart function Most commonly due to cardiovascular disease. 50% of deaths due to CVD are sudden, unexpected & will occur out-of-hospital.

Causes Most cardiac arrests are due to ventricular fibrillation (VF). Arrests due to extreme slowing of heart are arrhythmias which are life-threatening. Most arrests occur at home.

Factors Contributing to Survival Two Critical Elements of Survival (before arrival of EMS responders) Time elapsed from collapse to initiation of CPR Time elapsed from collapse to application of AED

Effects of Location 75% of cardiac arrests occur in home. Males 40 - 70 years of age 60% are witnessed by family member. Spouses & family most likely to do CPR: However, this group least likely to be trained in CPR. Research shows arresting in public increases survival by 50%!

Dispatcher-Assisted CPR Initiation of CPR within the first minute or so after collapse is critical. Therefore, dispatcher-assisted CPR must be provided.

Ventricular Fibrillation 80% of adults with sudden (non-traumatic) cardiac arrest are found in VF. Why is this a critical point?

Causes of Cardiac Arrest Myocardial Infarction (MI) Arrhythmias Respiratory arrest Trauma Drowning Overdose Severe allergic reaction continues

Causes, cont’d Electrical impulse malfunction (as in severe reaction to cocaine) Terminal disease or infection Hypothermia

CVD 80% of cardiac arrests are caused by CVD. Myocardial infarction is the most common cause of cardiac arrest & the most common cause of death in developed countries.

Signs of Cardiac Arrest Sudden collapse Unconsciousness ;body goes limp, reflexive movement in extremities. NO sign of life Hypoxic seizure due to lack of oxygen to brain continues

Signs, cont’d Agonal respirations, which are usually short-term. Body will turn blue/purplish & cool. Loss of urinary or bowel control.

Cardiac Arrest is a critical, life-threatening emergency! Brain death occurs w/in 4-6 minutes following collapse.

Sudden Infant Death Syndrome The most common cause of death for infants from 1 month to 1 year old. 7,000 infants die of SIDS per year. Most common age is 2-4 months. Most common during winter months.

SIDS One of the most difficult/distressing calls for the telecommunicator. Most infants cannot be saved. The benefit of dispatcher-assisted CPR is for the parents (or rescuer).

Recognition/Physical Appearance of SIDS Usually found unresponsive & not breathing after nap or in the morning. Infant said to be well when put to sleep. No external signs of injury. Lividity.

Recognition/Physical Appearance of SIDS Frothy pink drainage from nose/mouth. Generalized flushing of skin. Cooling/rigor mortis. Other siblings appear normal.

Dead on Arrival (DOA) Clues Timing: unwitnessed; not seen for hours/days. Temperature (of trunk). Color: pale/grayish. Lividity: normally occurs between 8-12 hrs Flexibility: stiff; after 48 hrs rigidity may cease.

Vital Points Interrogation If unsure about consciousness, use any of the below to probe further: Does the patient respond to you? Does the patient respond when you speak to them? Does the patient respond when you try to wake them?

Vital Points If unsure about breathing normally, interrogate further: Does the patient’s chest rise & fall? – sometimes people breathe from the belly Describe the patient’s breathing. Listen for sounds & frequency of breaths:

Vital Points Agonals might be described as snoring •every once in awhile snorting •weak or heavy gasping •barely breathing moaning •takes breath every now & then

Cardiac/Respiratory Arrest Instructions Does anyone there know CPR? (Trained bystanders may still need instructions. Ask!) Get the phone next to the person if you can. Listen carefully. I’ll tell you what to do. Get the phone to the patient whenever possible Follow the Emergency Instructions

Obstacles Nose Bleeds Nasal Canula – what do you do with it? Hear “bones crushing” False Teeth Can’t get patient to the floor Can you think of any others?

LET’S DO SOME PRACTICING WITH OUR CPR AND AED’S IN OUR GROUPS 