SUDDEN CARDIAC

ARREST

dr. Rien Afrianti. SpPD, SpJP, FIHA

 DEFINITION

Sudden cardiac arrest:

‘Abrupt cessation of cardiac mechanical function,
which may be reversible with prompt intervention
but will lead to death in its absence’
• The most sudden cardiac arrest in adults → cardiac cause (MI & electric
disturbances)
• Arrests without a primary cardiac origin (respiratory failure, toxic ingestion,
pulmonary embolism [PE], or drowning) are also common, however, and in
such cases, treatment for reversible underlying causes is important for the
rescuer to consider.
• Opioid overdose, increased markedly outside the hospital

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 MECHANISM
• Ventricular fibrillation
• Ventricular tachycardia
• Asystole
• Bradycardia
• Pulseless electrical activity
• Mechanical factors
The main focus in adult cardiac arrest events:
• rapid recognition
• prompt provision of CPR
• defibrillation of malignant shockable rhythms
• post-ROSC supportive care
• treatment of underlying causes.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 AHA Chains of Survival for adult IHCA
(In-hospital of Cardiac Arrest)

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Recognition of Cardiac Arrest

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
• Chest compressions are the most critical component of CPR
• Maintaining a patent airway → adequate ventilation and oxygenation are
priorities during CPR.
• If a jaw thrust and/or insertion of an airway adjunct are ineffective in
opening the airway and allowing ventilation to occur, a head tilt–chin lift may
be the only way to open the airway → this maneuver should be used even in
cases of potential spinal injury because the need to open the airway
outweighs the risk of further spinal damage in the cardiac arrest patient.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Adult BLS
Algorithm for
Healthcare
Providers.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Opioid Overdose
People who suffer cardiac arrest due to an opioid overdose:
• Younger
• fewer chronic medical conditions
• may be more likely to be to receive bystander CPR

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Adult Post–Cardiac Arrest Care
• Post–cardiac arrest care is a critical component of the Chain of Survival.
• The systemic impact of the ischemia-reperfusion injury caused by cardiac
arrest and subsequent resuscitation requires post–cardiac arrest care to simul-
taneously support the multiple organ systems that are affected.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Adult Post–Cardiac Arrest Care Algorithm.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 Cardiac Arrest in
Pregnancy
In-Hospital ACLS
Algorithm.

2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
2020 AHA Guidelines for Cardiopulmonary Resuscitation & Emergency Cardiovascular Care
 CONCLUSION
• Cardiac arrest remains a condition with considerable morbidity and mortality
• The main focus in adult cardiac arrest events: rapid recognition, prompt
provision of CPR, defibrillation of malignant shockable rhythms, post-
ROSC supportive care, treatment of underlying causes.
• CPR has long been the hallmark of cardiac arrest management
• Post–cardiac arrest care is a critical component of the Chain of Survival.