TAKDIR MUSBA
CPCR Principle
4 6 minutes
CPCR
During respiratory and cardiac arrest, CPCR may be
successful
if performed before biological death
A. Cardiac asystole.
B. Ventricular fibrillation or Pulseless VT
Electrical defibrillation is required to
reestablish spontaneous and effective
cardiac electrical activity.
C. Electromechanical dissociation
circulatory collapse that occurs despite
satisfactory electrical complexes on the ECG
Flail chest
Pneumothorax
Massive atelectasis
Acute pulmonary embolism
Congestive heart failure
Overwhelming pneumonia
Gram-negative septicemia
Lung burns
Carbon monoxide poisoning
Massive blood loss.
ABCD steps
A, airway.
B, breathing.
C, circulation.
D, drugs and definitive therapy.
In a witnessed cardiac arrest (when treatment
can be initiated within 1 min of the onset of
arrest), the ABCD sequence should include
use of a precordial thump.
Precordial Thumb
CHECK
RESPONSIVENESS
OPEN AIRWAY
If breathing:
recovery position
CHECK BREATHING
BREATHE
2 effective breaths
ASSESS
10 secs only
CIRCULATION PRESENT
Continue Rescue Breathing
Check circulation
Every minute
Signs of a circulation
NO CIRCULATION
Compress Chest
1.
2.
3.
4.
Cardiac Compression
Defibrillate up to 3
Ventricular fibrillation
times
Epinephrine several
dose options
Antiarrhythmic agents
Lidocaine
Bretylium
Magnesium
Procainamide
Epinephrine
Atropine
Consider transcutaneous
pacing
Search for reversible causes
Atropine
Dopamine
Epinephrine
Transcutaneous pacing
Transvenous pacing
Immediate cardioversion
Premedicate when possible
Synchronized setting
Narrow-complex
Adenosine
Verapamil
Diltiazem
-blockers
Digoxin
Synchronized
cardioversion
Wide-complex
Lidocaine
Procainamide
Bretylium
Consider adenosine
Synchronized
cardioversion
Ventricular tachycardia
Ventricular tachycardia with a pulse
Electrode Position
Indications
Adrenaline is the first drug used in cardiac arrest of
Indications.
refractory VF/VT
haemodynamically stable ventricular tachycardia
(VT) and other resistant tachyarrhythmias
Dose. Consider an initial intravenous dose of
the parasympathetic
neurotransmitter acetylcholine at
muscarinic receptors.
Blocks the effect of the vagus nerve
on both the sinoatrial (SA) node and
the atrioventricular (AV) node,
increasing sinus automaticity and
facilitating AV node conduction.
is indicated in:
asystole
pulseless electrical activity (PEA) with a
rate <60/min.
sinus, atrial, or nodal bradycardia when
the haemodynamic condition of the
patient is unstable.
The recommended adult dose of atropine
for asystole or PEA with a rate <60 /min
is
3 mg i.v. in a single bolus.
stabilized
The patient is pronounced death
Alone rescuer is physically unable
to continue