Cardiac Arrest PDF

Cardiac Arrest Cardiac Arrest Cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action and causes blood to stop flowing to the rest of your body....

Cardiac Arrest Cardiac Arrest Cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action and causes blood to stop flowing to the rest of your body. Causes Ventricular Fibrillation The most common cause of cardiac arrest is an arrhythmia called ventricular fibrillation — when rapid, erratic electrical impulses cause your ventricles to quiver uselessly instead of pumping blood. Without an effective heartbeat, your blood pressure plummets, cutting off blood supply to your vital organs. Ventricular Tachycardia Electromechanical Dissociation  Symptoms Sudden cardiac arrest symptoms are sudden and drastic: Sudden collapse No pulse No breathing Loss of consciousness Pallor-ashen gray Cyanosis Dilated pupils Absence of BP Pathophysiology Cardiac arrest produces global ischemia with consequences at the cellular level that adversely affect patients following resuscitation. The main consequences involve direct cellular damage and edema formation. Edema is particularly harmful in the brain, which has no room to expand, resulting in increased intracranial pressure and corresponding decrease in cerebral perfusion post-resuscitation. A number of successfully resuscitated patients have short- or long-term cerebral dysfunction. Decreased ATP production leads to loss of membrane integrity with efflux of K and influx of Na and Ca. Excess Na produces cellular edema. Excess Ca damages mitochondria (depressing ATP production), increases nitric oxide production (leading to formation of damaging free radicals), and in certain circumstances, activates proteases that damage cellular contents.  Diagnostic Tests and Procedures EKG (Electrocardiogram) An EKG is a simple, painless test that records the heart's electrical activity. This test is used to detect and locate the source of several heart problems. An EKG shows how fast the heart is beating and the heart's rhythm (steady or irregular). It also records the strength and timing of electrical signals as they pass through each part of the heart. An EKG may show whether you've had a heart attack. Echocardiography a painless test that uses sound waves to create pictures of your heart. It provides your doctor with information about the size and shape of your heart and how well your heart's chambers and valves are working. The test also can find areas of heart muscle that aren't contracting normally due to poor blood flow or injury from a previous heart attack. Stress echocardiography shows whether you have decreased blood flow to your heart  Cardiac Magnetic Resonance Imaging Cardiac magnetic resonance imaging (MRI) is a safe procedure that uses radio waves and magnets to create detailed pictures of your heart. The test creates images of your heart as it is beating, producing both still and moving pictures of your heart and major blood vessels. Doctors use cardiac MRI to get images of the beating heart and to look at the structure and function of the heart.  Cardiac Catheterization is a procedure used to diagnose and treat certain heart conditions. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, your doctor can do diagnostic tests and treatments on your heart. Sometimes a special dye is put into the catheter to make the inside of your heart and blood vessels show up on x rays. The dye can show whether plaque has narrowed or blocked any of your coronary arteries.  Medical Management Cardiopulmonary Resuscitation Airway(look,listen,feel) Breathing (mouth-to-mouth) Circulation (chest compression)  Drug Therapy Lidocaine, procainamide, verapamil Dopamine, isoproterenol, norepinephrine Epinephrine to enhance myocardial automaticity, excitability, conductivity, and contractility Atrophine sulfate to reduce vagus nerve’s control over the heart, thus increasing the heart rate Sodium bicarbonate is administered during first few moments of cardiac arrest to correct respiratory and metabolic acidosis Calcium chloride: calcium ions help the heart beat more effectively by enhancing the myocardium’s contractile force Defibrillation  For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're at high risk of having it again. Research shows that an implantable cardioverter defibrillator (ICD) reduces the chances of dying from a second SCA. An ICD is surgically placed under the skin in your chest or abdomen. The device has wires with electrodes on the ends that connect to your heart's chambers. The ICD monitors your heartbeat. If the ICD detects a dangerous heart rhythm, it gives an electric shock to restore the heart's normal rhythm. Your doctor may give you medicine to limit irregular heartbeats that can trigger the ICD.  Nursing Intervention Monitored arrest caused by ventricular fibrillation Begin precordial thump and if successful, administer lidocaine If unsuccessful defibrillate If defibrillation unsuccessful, initiate CPR immediately Assist with administration of and monitor effects of additional emergency drugs TAPOS…. THE END…. AHHHHH UMMMM!