Cardio-Respiratory Emergencies/Cardio Pulmonary Arrest

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June 13, 2024

What Is Cardio Pulmonary Arrest

Cardiopulmonary arrest is a sudden cessation of spontaneous effective breathing and circulation, which may lead to death in few minutes.

Immediate recognition and activation of the emergency.
Early cardiopulmonary resuscitation (CPR) with emphasis on chest compression (action must be taken within 4 to 6 minutes) at least 100/min chest compressions.
Rapid defibrillation if no response to CPR
Effective life support
Integrated post-cardiopulmonary arrest care CPR procedures in Adults.

ABC changed to CABD ( Ref AHA 2010 guidelines )

C: Circulation
Shout for help
Start chest compression without delay
30 chest compression first to precede 2 positive.
Pressure ventilations.
A: Airways
Clear airway immediately
Aspirate vomitus and secretions if applicable
B: Breathing
Ventilation via mask with 100% O2 saturation delivery and bag ventilation if available or mouth-to-mouth resuscitation until intubation is possible.
Ensure chest movement and give 2 rescue breaths followed by 30 chest compressions, keep doing this until a portable defibrillator is available or emergency personnel arrives.
D: Drugs
IV line and maintain circulation
IV fluid
Inotropic support; Adrenaline 1mg IV every 2-5min or 3mg in endotracheal tube if no IV line
Atropine 0.5mg every 3-5min in case of bradycardia (< 40)
Sodium bicarbonate 1mEq/kg in case of metabolic acidosis, or prolonged CPR (>15min), and hyperkalemia for known cases of renal failure, crash injury
In case of Ventricular Tachycardia and Ventricular; For fibrillation give Amiodarone 300mg IV, if reoccurrence give 150mg IV, alternatively give lidocaine 1.5mg/kg.

Correct the immediate underlying problem with appropriate management.

Refer to ICU to maintain ventilation
Pacing if indicated.
Any other required management