Adult Cardiac Arrest - PMD Refresher - Video Transcript PDF

Adult Cardiac Arrest \| PMD Refresher \| Video Transcript Our objectives for part one of adult cardiac arrest management are to discuss the chain of survival, current techniques of one and two-rescuer CPR, and airway management issues during cardiac arrest. When we talk about the chain of survival...

Adult Cardiac Arrest \| PMD Refresher \| Video Transcript Our objectives for part one of adult cardiac arrest management are to discuss the chain of survival, current techniques of one and two-rescuer CPR, and airway management issues during cardiac arrest. When we talk about the chain of survival, we identify and order the elements of out-of-hospital cardiac arrest management, emphasizing actions with the highest impact when done early. Activating emergency response is the first step---this is where we come in. Once on the scene, initiating high-quality CPR is essential, beginning with dispatcher instructions to bystanders. Early defibrillation of shockable rhythms is critical, as delivering shocks promptly improves patient outcomes. After stabilizing the patient, transport to the ER for definitive care is vital for identifying the cause of arrest and recovery. The most significant factor in improving outcomes for out-of-hospital cardiac arrest is high-quality bystander CPR. Research shows that patients receiving bystander CPR have a 23% chance of achieving ROSC before hospital arrival and a 12% chance of being discharged alive and cognitively intact. In contrast, patients without prior CPR have only a 14% chance of ROSC and a 4.7% chance of a good outcome. A notable example involved a community outreach initiative in underserved areas with low bystander CPR rates. EMS clinicians partnered with firefighters to teach hands-only CPR during home visits and community events, increasing bystander CPR rates from 20% to 55%, exceeding the national average of 40%. The history of CPR dates back to the 1500s, with significant milestones such as mouth-to-mouth resuscitation in the 1740s and external chest compressions in the 1870s. The development of portable defibrillators and CPR mannequins in the mid-20th century shaped modern practices, with ongoing advancements in education and technology to improve outcomes. Chest compressions remain a cornerstone of resuscitation. Maintain a rate of 100-120 compressions per minute and a depth of one-third of the chest's AP diameter, ensuring complete recoil to allow ventricular refilling and coronary perfusion during diastole. Minimize interruptions to maintain effective perfusion pressure, as every minute without compressions decreases survival by 10%. In single-rescuer CPR, perform 30 compressions followed by two breaths. With multiple rescuers, roles can be optimized to reduce interruptions. Two-thumb techniques or supraglottic airway devices can enhance efficiency. Avoid hyperventilation and provide breaths only until visible chest rise. Part two of this module will cover ALS skills during cardiac arrest, including airway management, vascular access, pharmacology, and termination criteria.