CARDIAC ARREST

RISK FACTORS:

      abnormal heart rhythm

               - birth defects of the heart or blood vessels

      previous myocardial infraction

               - coronary artery disease

       family history of sudden cardiac death

               - cardiomyopathy

       long QT syndrome

               - excessive alcoholism

       smoking 

                - high blood pressure

       pulmonary embolism

                - high blood cholesterol level

       high blood pressure

                 - diabetic mellitus

        increased aged

                 - overweight and obesity

CLINICAL MANIFESTATIONS:

            The most reliable sign is absence of pulse

             Unconsciousness or Unresponsiveness

             No respiratory movement

             No blood pressure

             Pupils begin dilating within 45 sec

             Death like appearance

             Lips and nail beds turn blue and skin turn pale

DIAGNOSTIC EVALUATION:

              1. History collection and physical examination

              2. Electrocardiography 

              3. Cardiac catheterization 

              4. Echocardiography

              5. Exercise and stress test

              6. MRI -studies

              7. Blood studies ( which includes cardiac enzyme level, serum electrolyte level, hormonal level)

 MANAGEMENT:

            In pharmacological management of cardiac arrest the drug in ACE inhibitors, beta- blocker, calcium channel blocker.

            Antiarrhythmic drugs can control abnormal heart rhythm.

            Drug therapy alone will not be effective or reducing cardiac arrest.

CPR:

       circulation- restore the circulation by external cardiac massage

          airway- ensure the open airway by preventing the falling back of tongue, tracheal intubation

           breathing- start artificial respiration of lungs

WHY CPR IS IMPORTANT?

        Keeping the blood flow activity- even partially- extends the opportunity for the successful resuscitation once trained medical staff arrive on site.

  HANDS - ONLY CPR CONSITS OF TWO EASY STEPS : 
        1. Call 9-1-1 ( or send someone to do that )

            2. Push hard and fast in the center of the chest.
 ADVANCED CARDIAC LIFE SUPPORT ;

       Advanced life support refers to the use of specialized techniques ,in an attempt to rapidly restore an effective rhythm to the heart. the most important components of ALS techniques are direct current defibrillation and efficient BLS.

ADULT CARDIAC ARREST ALGORITHM

   
PEDIACTRIC CARDIAC ARREST ALGORITHM            

HOW TO USE DEFIBRILLATOR:

         Turn on defibrillator

         Select the energy level

         Apply gel to pads

         Position the paddles

         Press charge button 

         When defibrillator fully charged state firmly in a forceful voice ,

         " I am going to shock....

           One I'm clear....

           Two your  clear....

           Three everybody clear....

           Press the 2 paddle discharge button simultaneously."

COMPLICATION OF DEFIBRILLATOR :)

        Damage to myocardium due to repeated high energy electrical shocks.

         Chest burns due to repeated high - energy discharges and poor contract between the paddles and the skin.

         Electrocution of the by-standers.

         Formation of short circuits between paddles due to excessive amount of conduction jelly applied on the paddles. this causes loss of electrical energy.  

SURGICAL MANAGEMENT:)

   Coronary angioplasty

    Coronary artery bypass graft

    Heart transplantation

    Corrective heart surgery.