CARDIO - RESPIRATORY RESUSCITATION

Cardio-respiratory arrest

• Respiratory arrest = stopping spontaneous, physiological breathing (apnea)

• Cardiac arrest = stopping the contractions and pumping activity of the heart

• Cardio-respiratory arrest = Respiratory arrest + Cardiac arrest

 Cardiorespiratory resuscitation consists of using chest compressions and
artificial ventilation to maintain circulatory flow and tissue oxygenation
during cardiac arrest.

 — early defibrillation when needed—and appropriate implementation of

post-cardiac arrest care can improve survival and neurologic outcomes .
Cardio-respiratory arrest

• Respiratory arrest = stopping spontaneous, physiological breathing (apnea)

• Cardiac arrest = stopping the contractions and pumping activity of the heart

• Cardio-respiratory arrest = Respiratory arrest + Cardiac arrest

 - Sudden cardiac arrest - is one of the leading causes of
death in Europe.

 - On an initial analysis of the heart rhythm, approximately 25-

50% of those with SCR (cardiorespiratory arrest) have
ventricular fibrillation (VF), but when the rhythm is recorded
immediately after the collapse, especially with the help of an
AED (automatic external defibrillator) , the proportion of
victims with VF can be higher than 76%.

 - The recommended treatment for cardiac arrest with VF is
the immediate start of CPR by the people present and
external defibrillation as quickly as possible.

 Rescue breaths , as well as chest compressions, are
essential for the successful resuscitation of these patients.
- The annual incidence of OHCA (out - of-hospital cardiac arrest ) in
Europe is between 67 and 170 per 100,000 inhabitants Epidemiology
- Annual incidence of IHCA ( in- hospital cardiac arrest) in Europe is
between 1.5 and 2.8 per 1,000 hospital admissions

- The rate of involvement of witnesses in the CPR algorithm varies

between European countries (on average 58%, range from 13% to
83%)

- Use of automated external defibrillators (AEDs) in Europe remains

low (mean 28%, range 3.8% to 59%)

- Survival rates at hospital discharge are on average 8%,

ranging from 0% to 18%

initial rhythm , the place where cardiac arrest occurs and the degree
of monitoring at the time of collapse
  Early recognition of SCR/premonitory
Algorithm - Chain of Survival i
signs SCR+ request for help
 Rapid initiation of resuscitation
measures ( BLS) – time is gained
 Restarting the heart (Defibrillation) +
restoring spontaneous circulation
 Post-resuscitation care - restoring the
quality of life
1 . Early recognition and seeking help. Recognizing the cardiac origin of chest pain and
calling emergency services before the victim collapses allows emergency medical services
to arrive early. After a cardiac arrest has occurred, early recognition is essential to enable
rapid notification of the emergency services and prompt initiation of CPR by bystanders.
The diagnostic elements are the lack of response to stimuli and the absence of normal
breathing.

2 . Initiation of CPR by bystanders: Immediate initiation of CPR can double survival after a
CPR. If able, bystanders who have undergone CPR training can perform chest
compressions along with ventilations. When a bystander has not been trained in CPR, the
emergency medical dispatcher should guide him/her to perform only chest compressions
until specialized medical help arrives.

3 . Early defibrillation: Early defibrillation within 3-5 minutes of collapse can result in a
survival rate greater than 50-70%. This can be achieved through public access to the DEA.

4 . Early advanced life support and post-resuscitation care: Advanced life support with
airway management, medication and correction causative factors may be necessary if
initial resuscitation attempts are unsuccessful .
Cardio-respiratory resuscitation
basic life support
Basic life support
Basic life support
Basic life support
Basic life support
Cardio-respiratory resuscitation
advanced life support
advanced life support
advanced life support
advanced life support
Cardio-respiratory resuscitation
postresuscitation care
 Successful return of spontaneous circulation (ROSC) is the first step towards
the goal of achieving full recovery after cardiac arrest.

 The complex pathophysiological processes that occur as a result of global

ischemia during cardiac arrest and the subsequent response to re-perfusion
during Cardio- Respiratory Resuscitation (CPR ) have been termed Post
Cardiac Arrest Syndrome.
 Post-cardiac arrest syndrome consists of cerebral injury,
myocardial dysfunction, systemic ischemia - reperfusion
response and persistence of the triggering pathology.

 The severity of this syndrome varies depending on the duration

and cause of the cardiac arrest. It may not occur at all if the
cardiac arrest is of short duration.

 Post-cardiac arrest brain injury is manifested by : coma,

convulsions, myoclonus, various degrees of neuro-cognitive
dysfunction and brain death.