A brief about Cardiac arrest...!!

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1. PREPARED BY: Sharmin Susiwala CARDIAC ARREST

2. introduction Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest , is the end of normal circulation of the blood due to failure of the heart to contract effectively. Also referred as a sudden cardiac arrest (SCA ). Cardiac arrest is a medical emergency that, in certain situations, is potentially reversible if treated early. Unexpected cardiac arrest sometimes leads to death almost immediately; this is called sudden cardiac death (SCD).

3. CLASSIFICATION Based upon the ECG rhythm SHOCKABLE The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia NON-SHOCKABLE The two non– shockable rhythms are asystole and pulseless electrical activity This refers to whether a particular class of cardiac dysrhythmia is treatable using defibrillation

4. CAUSES Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure . Coronary artery abnormalities Myocarditis Hypertrophic cardiomyopathy Long QT syndrome

5. Non-cardiac The most common non-cardiac causes: Trauma non-trauma related bleeding (such as gastrointestinal bleeding, aortic rupture, andintracranial hemorrhage) Overdose Drowning pulmonary embolism

6. Hs Hypovolemia - A lack of blood volume Hypoxia - A lack of oxygen Hydrogen ions (Acidosis) - An abnormal pH in the body Hyperkalemia or Hypokalemia - Both excess and inadequate potassium can be life-threatening. Hypothermia - A low core body temperature Hypoglycemia or Hyperglycemia Ts Tablets or Toxins Cardiac Tamponade - Fluid building around the heart Tension pneumothorax - A collapsed lung Thrombosis (Myocardial infarction) - Heart attack Thromboembolism (Pulmonary embolism) - A blood clot in the lung Traumatic cardiac arrest

7. RISK FACTORS The risk factors for SCD are similar to those seen with coronary heart disease including: Smoking Lack of physical exercise Obesity Diabetes Family history

8. SIGNS AND SYMPTOMS Cardiac arrest is synonymous with clinical death . Absence of palpable pulse. Lack of conciousness . Abnormal or absent breathing. Death. “silent chest”

9. DIAGNOSIS The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation. Lack of carotid pulse is the gold standard for diagnosing cardiac arrest. Various other methods for detecting circulation have been proposed. Look for "signs of circulation“ These signs include: Coughing Gasping Colour Twitching Movement

10. management Cardiopulmonary resuscitation: CPR is a critical part of the management of cardiac arrest. It should be started as soon as possible and interrupted as little as possible. The component of CPR which seems to make the greatest difference is the chest compressions. Tracheal intubation has not been found to improve survival rates in cardiac arrest cases .

11. Defibrillation: Shockable and non– shockable causes of cardiac arrest is based on the presence or absence of ventricular fibrillation or pulseless ventricular tachycardia. The shockable rhythms are treated with CPR and defibrillation. This involves placing automated external defibrillators in public places, and training staff in these areas how to use them. This allows defibrillation to take place prior to the arrival of emergency services, and has been shown to lead to increased chances of survival. Some defibrillators even provide feedback on the quality of CPR compressions, encouraging the lay rescuer to press the patient's chest hard enough to circulate blood.

12. Medications: Epinephrie Atropine Amiodarone Vasopressin Therapeutic hypothermia: Cooling a person after cardiac arrest with return of spontaneous circulation (ROSC) but without return of consciousness improves outcomes . This procedure is called therapeutic hypothermia. People are cooled over a 24 hour period, with a target temperature of 32–34 °C (90–93 °F). Death rates in the hypothermia group were 35% lower.

13. Others: Precordial thump may be considered in those with witnessed, monitored, unstable ventricular tachycardia (including pulseless VT) Resuscitation with extracorporeal membrane oxygenation devices . Open cardiac massage.