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UPDATES OF
ESTABLISHED
BREAKTROUGH

Aquino, Roman S.
Bacani, Crisencia
Battaong, Jefferson A.
Buslig, Dariel
Unciano, Nympha C.
Unday, Jofel T.

Saint Louis University


2014-2015

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Cardiopulmonary resuscitation (CPR) is a series of lifesaving actions that improve the


chance of survival following cardiac arrest.
UPDATES on Adult CPR
(Nursing Management)
BEFORE (2005 AHA

NOW (2010 AHA

Guideline)
A-B-C (Airway -Breathing

Guideline)
C-A-B (Chest

Chest Compression)

Compression-Airway-

compressions

Breathing)

are often delayed while

REASONS FOR REVISING

The sequence of adult CPR

In A-B-C sequence, chest

the responder opens the

began with opening of

Initiate chest compressions

airway to give mouth-to-

the airway, checking for

before ventilations.

mouth breaths, retrieves a

normal breathing, and then

barrier device, or gathers

delivery of 2 rescue breaths

and assembles ventilation

followed by cycles of 30

equipment. Changing the

chest compressions and 2

sequence to C-A-B, chest

breaths.

compressions will be
initiated sooner and the
delay in ventilation
should be minimal.

Oxygenation to the vital


organs like brain and
heart through early chest
compression when
cardiac arrest occurs will
increase victims

Chest Compressions to 11/2

Chest Compression at least

to 2 inches depth.

2 inches depth.

survival.
Science suggests that
compressions of
at least 2 inches are more

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effective than
compressions of
11/2inches.

Increasing intrathoracic
pressure and directly
compressing the heart
will generate critical
blood flow and oxygen
and energy delivery to
the heart and brain.
Breathing is briefly

Look, listen, and feel for

Look, listen, and feel for

breathing after the delivery

breathing has been

checked already as part

of 30 chest compressions

removed from the

of a check for cardiac

and before giving 2 breaths.

algorithm, and goes directly

arrest, after the first set of

in opening the victims

chest compressions, the

airway and delivers 2

airway is opened, and the

breaths.

rescuer delivers 2

AHA Guidelines for CPR

Chest compressions are

breaths.
Hands-Only

and ECC did not provide

emphasized for both trained

(compression-only) CPR

different recommendations

and untrained rescuers:

is easier for untrained

for trained and untrained

rescuers to perform and

rescuers and did not

Trained/Healthcare

can be more readily

emphasize differences in

Provider

guided by dispatchers

instructions provided to lay

-Conventional CPR (with

over the telephone.

rescuers versus healthcare

Ventilation)

providers.
Untrained/Bystanders:
Untrained/Bystanders:

-Hands-only(Compression-

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- Compression-only CPR

only) CPR until an


Advanced External
Defibrillator (AED) arrives
and is ready for use or
Emergency Medical
Services (EMS) providers
take over care of the victim.

Compress at a rate of about

Chest compressions at a

100/min.

rate of at least

associated with higher

100/min.

survival rates

More compressions are

Updates on the Use of MRI and CT Scan


(Diagnostic)
Reason
The amount of

Update(2010)
An experimental 3-

information they have

imaging (MRI) is a

dimensional printed model

before a surgery is

technique that uses a

of the heart may help

critical to the success

magnetic field and

surgeons treat patients

of the operation.

radio waves to create

born with complicated

It provides a new

detailed images of

heart disorders, according

dimension of

the organs and tissues

to research presented at

understanding that

within your body.

the American Heart

cannot be attained by
2D or even 3D
images.

Before
Magnetic resonance

Radiological

Association's Scientific

The MRI machine

Sessions 2014.

can also be used to


produce 3-D images

3D objects can be

that may be viewed

produced based on CT or

diagnosis has become

from many different

MRI medical images.

less invasive and

angles.

Using the model a surgeon

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more informative

Most heart surgeons

is able to perform a

however, we are

use 2D images taken

"mock"surgery prior to

limited by the use of

by X-ray,

ever entering the operating

flat screens for the

ultrasoundand

room. Some surgeons find

visualization of

MRIfor surgical

that minutes or hours of

imaging data.

planning. However,

operating time can be

these images may not

saved by careful

reveal complex

preparation using the

structural

model.

complications in the
heart's chambers that
occur when heart
diseaseis present at
birth (congenital
heart defects), as
opposed to
developing later in
life within a
structurally normal
heart.

Using Computed
Tomography (CT) to
diagnose
cardiovascular
disease gives
physicians the ability
to project a patients
future risk for heart

3D printing is holding the


exact model of the heart in
hands. It provides a new
dimension of
understanding that cannot
be attained by 2D or even
3D images.

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attack or stroke
before symptoms
occur

MRI gives different


information about
structures in the body
than can be seen with
an X-ray, ultrasound,
or computed
tomography (CT)
scan.

Urine MS Proteomic Analysis


Reasons of Updates
Before
Most of the procedures
Urinalysis is used to

Update
Plasma proteomics

conducted to patient with

detect and assess a

using various MS-

suspected CAD is invasive

wide range of

bassed technologies

such as blood analysis, Urine

disorders, such as

has recently been

MS Proteomic Analysis

urinary tract infection,

applied to identify

promises convenience without

kidney disease and

protein biomarkers

sacrificing efficiency.

diabetes.

associated with CAD,

Increased levels of

peripheral artery

protein in urine can be

disease(PAD) and acute

a sign of kidney

coronary syndrome

disease.

(ACS)

Urinalysis is the
physical, chemical, and

Urine MS proteomic
analysis revealed

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microscopic

protein signatures

examination of urine. It

specific for CAD.

involves a number of

Several markers of

tests to detect and

CAD are fragments of

measure various

collagens,

compounds that pass

fibrinogen,-2

through the urine.

antiplasmin,apolipoprot
eins, and complement
factors.

Plasma proteomic
approach has been
applied to identify new
biomarkers in acute
myocardial infarction
(AMI)

Updates on the medications related to Cardiovascular diseases


(MEDICINE AND ITS ADMINISTRATION)
Reason

Sacubitril +

Before

Valsartan and

valsartan
reduced

Now (September 2014)

The combined

Sacubitril are

medicines Valsartan

used and taken

and Sacubitril is now

separately.

taken unified

primary
outcome of

making patients

convenient in taking

cardiovascular
mortality and
hospitalization

it.

It has shown a
striking efficacy in

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for heart

prolonging the lives

failure

of people with heart


failure.

compared to
the proven ace
inhibitor
Enalapril.
Sacubitril +
valsartan
group has
higher rates of
hypotension
and no serious
angio-edema
but lower rates
of renal
impairment,
hyperkalemia
and cough
compared to
the Enalapril
group.
The two in one
medication is
cost effective

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REFERENCES:
1. Field JM, Hazinski MF, Sayre M, et al. Part 1: Executive Summary of
2010 AHA Guidelines for CPR and ECC. Circulation. In press.

2. Hazinski MF, Nolan JP, Billi JE, et al. Part 1: Executive Summary:
2010 International Consensus on Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care Science With Treatment
Recommendations. Circulation. In press.

3. Nolan JP, Hazinski MF, Billi JE, et al. Part 1: Executive Summary:
2010 International Consensus on Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care Science With Treatment
Recommendations. Resuscitation. In press.

4. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac


massage. JAMA. 1960;173:1064-1067.

5. Kilgannon JH, Jones AE, Shapiro NI, et al. Association between arterial
hyperoxia following resuscitation from cardiac arrest and in-hospital
mortality. JAMA. 2010;303:2165-2171.

6. Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS


Recommendations for the Standardization and Interpretation of the
Electrocardiogram, Part III: Intraventricular Conduction Disturbances.
Circulation. 2009;119:e235-e240.
7. Garcia,J.M.(2014). The path to personalized cardiovascular medicine.UK.:Academic Press

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