Cardiac Emergencies

(Cardiac arrest)
Mohammed A. Al-Soud
 Cardiac Emergencies
(Cardiac arrest )
• Cardiac arrest : is the cessation of normal circulation of the
blood due to failure of the heart to contract effectively.

• Cardiac arrest is classified based upon the ECG rhythm into:

1.Shockable (Ventricular fibrillation and Pulseless ventricular
tachycardia )
2. Non–shockable (Asystole and Pulseless electrical activity).
Non-shockable(Asystole)
Shockable Rhythms
 Shockable Rhythms
Ventricular Tachycardia(VT)

VT (Monomorphic)
- Broad complex regular rhythm
- Rapid rate
- Constant QRS morphology
 Signs & symptoms
1.The most reliable sign is absence of pulse.
2.Unconsciousness
3.No breathing
4. No Blood Pressure
5.Pupils begin dilating within 45 seconds
6. Seizures may/may not occur
7.Death – like appearance
8. Lips & nail buds turn blue
➢ Cardiac arrest most often is associated with cardiovascular disease and is
precipitated by VF or ventricular asystole.
➢ Cardiac arrest also may result from non cardiac causes, such :
➢ poisoning, drug overdose, toxic inhalation, trauma, and foreign body airway
obstruction, For adult cardiac arrest in these cases, the standard 30:2 CPR is
indicated
➢ Techniques, and types of equipment used to manage
cardiac emergencies, these include :
1. basic cardiac life support (BCLS)
2. mechanical CPR devices
3. monitor-defibrillators
 Basic Cardiac Life Support
❖High-quality chest compressions is increasingly recognized as a key element
influencing survival from sudden cardiac arrest.
❖Early CPR can double or triple survival from cardiac arrest.
Cardiopulmonary resuscitation (CPR) is an emergency
procedure that combines chest compressions often with
artificial ventilation in an effort to manually preserve intact
brain function until further measures are taken to restore
spontaneous blood circulation and breathing in a person who
is in cardiac arrest.
➢ Elements of high-quality CPR include the following:
1. Beginning CPR with chest compressions
2. Providing chest compressions at a rate of 100 to 120 compressions/min
3. Providing chest compressions at a depth of at least 2 inches (5 cm)
4. Ensuring full chest recoil between chest compressions
5. Minimizing interruptions in chest compressions (maintaining a high
compression fraction)
6. Avoiding excessive ventilation
 Hand Position
- Hand in the center of the chest
- Lower half of breastbone
- Second hand on top of the first hand
- Not on the lowest part of the breastbone
- Applies to both lay and healthcare providers
• Several studies showed better survival with good
neurologic outcome when continuous compressions
without ventilation was performed for the first few
minutes in patients with witnessed arrest or
shockable rhythm.
1 2 3

4 5 6
 Monitor-Defibrillators
➢Cardiac monitor-defibrillators are: classified as manual defibrillators or
AEDs
• Automated External Defibrillators (AEDs)
• analyze the ECG signal. They evaluate the frequency, amplitude, and
shape of the ECG waves. They are designed to be used by people with
little training. They increase the number of people who are able to use a
defibrillator in a cardiac arrest emergency. AEDs are available for adult
and pediatric patients
• All AEDs are attached to the patient by two adhesive monitor-
defibrillator pads
 AEDs have four safety features:
1. They can analyze ECG waves.
2. They have built-in filters that check for QRS-like signals, radio
transmission waves, 60- cycle interference, and loose or poor electrode
contact.
3. Most are programmed to detect spontaneous patient movements,
continued heartbeat and blood flow, and movement of the patient by
others.
4. They make multiple evaluations of the rhythm before making a shock
advisory or delivering a shock.
 AED pads placement

In children and infants, one pad must be placed in the middle front of
their chest,
And the other one must be placed on the posterior middle.

In the adults, both pads must be placed on the chest as shown in AED
instructions.
Make sure no one is, including you, is touching the person. Tell
everyone to "stand clear.“