1. CARDIAC ARREST

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

3. High Blood Pressure
65 million Americans have high blood pressure.

4. Heart Attack Risk Factors

5. 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.

6. 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.

7. 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

8. Effects of Location 75% of cardiac arrests occur in home.
Males 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%!

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

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

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

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

13. 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.

14. 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

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

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

17. 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.

18. 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).

19. 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.

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

21. 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.

22. 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?

23. 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:

24. 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

25. 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

26. 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?

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