arrest) occurs when the heart ceases to produce an effective pulse and blood
circulation. Maybe caused by a cardiac electrical event, heart rate is too fast
(ventricular tachycardia or ventricular fibrillation) or too slow (bradycardia or AV
block) or no heart rate at all (asystole).Pulseless Electrical Activity (PEA)-
Electrical activity is prevent but theirs is ineffective cardiac contraction or
circulating volume. Can be caused by hypovolemia, cardiac tamponade,
hypothermia, massive pulmonary embolism, medication overdoses, significant
acidosis and massive acute myocardial infarction.
Causes
Unlike other muscles in your body, which rely on nerve connections to receive
the electrical stimulation they need to function, your heart has its own electrical
stimulator — a specialized group of cells called the sinus node, located in the
upper right chamber (right atrium) of your heart. The sinus node generates
electrical impulses that flow in an orderly manner through your heart to
synchronize heart rate and coordinate the pumping of blood from your heart to
the rest of your body.
If something goes wrong with the sinus node or the flow of electric impulses
through your heart, an arrhythmia can result, causing your heart to beat too fast,
too slow or in an irregular fashion. Often, these interruptions in rhythm are
momentary and harmless. But some types of arrhythmia can be serious and lead
to a sudden stop in heart function (sudden cardiac arrest).
1. Smoking
2. Sedentary lifestyle
3. Obesity
4. DM
5. Family History
Clinical Manifestation
• Consciousness, pulse, blood pressure are lost immediately.
• Ineffective Respiratory gasping occur.
• Dilation of pupils within 45 seconds.
• Seizures
• Risk for irreversible brain damage and death.
Emergency Management:
Cardiopulmornary Resuscitation
CPR
Immediate cardiopulmonary resuscitation (CPR) is critical to treating sudden
cardiac arrest. By maintaining a flow of oxygen-rich blood to the body's vital
organs, CPR can provide a vital link until more advanced emergency care is
available. A quick primer on CPR follows below.
If you don't know CPR but someone collapses unconscious near you, call
emergency medical help. Then, if the person isn't breathing normally,
immediately begin pushing hard and fast on the person's chest — about
two compressions a second (100 per minute), allowing the chest to fully
rise between compressions. Do this until an automated external
defibrillator (AED) becomes available or emergency personnel arrive.
To perform CPR:
Defibrillation
Advanced care for ventricular fibrillation, a type of arrhythmia that can cause
sudden cardiac arrest, typically includes delivery of an electrical shock through
the chest wall to the heart. The procedure, called defibrillation, momentarily stops
the heart and the chaotic rhythm. This often allows the normal heart rhythm to
resume.
Defibrillators are available in a small, portable form and come with built-in
automated instructions to ensure proper use. They're programmed to recognize
ventricular fibrillation and send a shock only when it's appropriate. These
portable defibrillators are available in an increasing number of public places,
including airports, shopping malls, casinos, health clubs, and community and
senior citizen centers.
Prevention
There's no sure way to know your risk of cardiac arrest, so reducing your risk is
the best strategy. Steps to take include regular checkups, screening for heart
disease, and living a heart-healthy lifestyle with the following approaches:
• Don't smoke, and use alcohol in moderation (no more than one to two
drinks a day).
• Eat a nutritious, balanced diet.
• Stay physically active.
If you know you have heart disease or conditions that make you more vulnerable
to an unhealthy heart, your doctor may recommend that you take appropriate
steps to improve your health, such as taking medications for high cholesterol or
carefully managing diabetes.
In some people with a known high risk of cardiac arrest — such as those with a
heart condition — doctors may recommend anti-arrhythmic drugs or an
implantable cardioverter-defibrillator (ICD) as primary prevention.
If you have a high risk of cardiac arrest, you may also wish to consider
purchasing an automated external defibrillator (AED) for home use. Before
purchasing one, discuss the decision with your doctor; the devices can be
expensive and aren't always covered by health insurance.
Cardiac arrest in children
Cardiac arrest is rare in children and usually happens because breathing has
been cut off rather than because of heart problems. Health professionals need to
be especially careful when reviving children in cardiac arrest because the
medication used to revive them can also cause problems.
In children, cardiac causes of sudden cardiac arrest are much less common.
Instead, predominant causes include trauma, poisoning, and various respiratory
disorders (eg, airway obstruction, smoke inhalation, drowning, infection, sudden
infant death syndrome).
Anatomy
Airway: Upper airway anatomy is different in children. The head is large with a
small face, mandible, and the neck is relatively short. The tongue is large relative
to the mouth, and the larynx lies higher in the neck and is angled more anteriorly.
The epiglottis is long, and the narrowest portion of the trachea is inferior to the
vocal cords at the cricoid ring, allowing the use of uncuffed endotracheal tubes.
In younger children, a straight laryngoscope blade generally allows better
visualization of the vocal cords than a curved blade, since the larynx is more
anterior and the epiglottis is more floppy and redundant.