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First Aids of Cardiac Arrest  

2013-08-03 14:42:36|  分类: Reading notes |  标签: |举报 |字号 订阅

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Cardiac arrest 1

----What is cardiac arrest?. 1

----What are the major differences between heart attacks and cardiac arrest?. 1

----The immediate actions required to restore blood flow: 2

----3 phases of cardiac arrest 2

CPR. 2

----What’s CPR? 

----High Quality CPR. 4

Defibrillation. 5

----What’s defibrillation?  5

Cardiac arrest

What is cardiac arrest?

When the heart stops beating abruptly, leading to falling blood pressure and consequently insufficient blood flow to the body. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes.

What are the major differences between heart attacks and cardiac arrest?

A heart attack (“myocardial infarction” or “MI”) is from blockages in the coronary arteries, blood vessels that feed the heart. These blockages grow over years, related to genetic factors, smoking, hypertension, and other risk factors

In a heart attack a portion of heart muscle dies from lack of blood flow, whereas in cardiac arrest the heart suddenly stops beating. In a heart attack a patient may experience chest pain, nausea, or trouble breathing, whereas in cardiac arrest they suddenly collapse. In a heart attack the heart continues to beat, whereas in cardiac arrest it does not.

The immediate actions required to restore blood flow:

1: Cardiopulmonary resuscitation (CPR)

2: Electrical defibrillation

3 phases of cardiac arrest

There are 3 phases of cardiac arrest during which we should take different emergency actions(JAMA 2002, Weisfeldt & Becker): electrical phase of VF during which defibrillation should be applied as soon as possible(0-4 minutes); circulatory phase during which chest compression should be done before defibrillation(4-10 minutes); metabolic phase during which injury has occur and new therapies are needed(>10 minutes). 

CPR

What’s CPR? 

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions. Victims receiving high quality CPR were FOUR TIMES more likely to be resuscitated(Gallagher et al, 1995)

The American Heart Association uses the acronym of CAB — circulation, airway, breathing — to help people remember the order to perform the steps of CPR.

But some recent research shows that breathing is not necessary for CPR. Survival rate could be better with hands-only CPR.

High Quality CPR

What is a high quality CPR?

1)      Push at a rate of about 80 – 100 compressions per minute

2)      compress the chest at least 2 inches (approximately 5 centimeters) deep

And it is reported that in Arizona, with some intervention without any new drugs or new devices, the survival to hospital discharge could be tripled.

The inventions are:

1.  Delay intubation

2.  200 compressions before first shock

3.  Minimize pre and post shock pauses

Defibrillation

What is defibrillation?

Defibrillation is a process in which an electronic device gives an electric shock to the heart. This helps reestablish normal contraction rhythms in a heart having dangerous arrhythmia or in cardiac arrest. In recent years small portable defibrillators have become available. These are called automated external defibrillators or AEDs.

During cardiac arrest, your brain and other vital organs quickly become starved of blood and the life-sustaining oxygen and nutrients it carries. If you survive, you may have permanent damage to your brain and other organs. The sooner your heart's rhythm is restored the better, since each minute is critical to determining your chance of survival and how much damage you might have.

Cardiopulmonary resuscitation (CPR) is a vital step in the lifesaving process and can keep some blood flowing to your heart and brain for a short time. But often only defibrillation can restore the heart's normal rhythm and ultimately save your life. This is especially true if you experience a type of abnormal heart rhythm known as ventricular fibrillation.


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