sudden cardiac arrest

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Post on 07-May-2015

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Sudden cardiac arrest (SCA) is an event caused by a problem with the heart's "electrical" system. SCA occurs when the heart suddenly stops beating. The heart’s electrical system sends signals to the heart to beat much too fast. The heart cannot beat that fast, so the heart muscle just quivers. Blood and oxygen do not reach vital organs like the brain. Then it stops altogether. The heart needs immediate treatment from an electrical shock (defibrillation) to restart the electrical system. If SCA is not treated within 7-10 minutes, it leads to sudden cardiac death.

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  • 1.HANDLINGSUDDEN CARDIAC ARRESTDR. D. B. PAHLAJANI Consultant Cardiologist & Chief of Cardiac Catherization Laboratory, Breach Candy Hospital

2. Sudden Cardiac Arrest (SCA)Statistics

  • Every two minutes someone suffers a sudden cardiac
  • arrest (SCA).

3. Major killer worldwide

  • Over 250,000 deaths a year in the U.S. alone*.
  • Only 5 10 % of its victims survive.

* American Heart Association 2002 Heart & Stroke statistical Update, Dallas, Texas : AHA 2000. He died so suddenly and we didnt even know he had heart disease Sudden Cardiac Arrest (SCA) 4. Source:American Heart Association2002 Heart & Stroke statistical Update , Dallas, Texas : AHA 2000.Sudden Cardiac Arrest (SCA)Incidence of SCA Vs Other Main causes of death 5.

  • Heart Attack (Myocardial infarction)occurs
  • when the coronary artery becomes blocked
  • and the blood supply to heart muscle is
  • interrupted.
  • If the blockage is not reversed in a matter
  • of hours, permanent damage occurs.

Sudden Cardiac ArrestvsHeart Attack 6.

  • Sudden Cardiac Arrestoccurs when the heart
  • starts beating chaotically and is unable to
  • pump blood to the body (no pulse or breathing).
  • It is the result of an electrical malfunction of
  • the heart.

Sudden Cardiac ArrestvsHeart Attack 7.

  • The heart muscle contracts
  • in response to electrical
  • stimulus generated bythe
  • hearts pacemaker Cells
  • withtheresultofapulse,
  • blood pressure, breathing
  • & other signs of circulation.

Cardiac Electrical Conduction 8. Sinoatrial Node Normal Sinus Rhythm 9. 10. Ventricular TachycardiaSudden Cardiac Arrest (SCA) 11. Ventricular Fibrillation

  • Causes :
  • Coronary artery disease
  • Acute coronary syndromes
  • Electrocution.
  • Drug toxicity and sensitivity
  • Asphyxia
  • Drowning
  • Blunt force trauma to the chest.

Sudden Cardiac Arrest (SCA) 12.

  • 150 Sudden Cardiac Deaths per 100,000 persons
  • annually in industrialised world.
  • 40% of SCDs occur in people with no prior history of
  • heart disease.
  • SCD accounts for more than 50% of cardiac mortality.
  • Autospies revealed 90% victims have CAD.
  • Age above 40 yrs.

Incidence of Sudden Cardiac Death (SCD) 13.

  • Prior Episode ofV.TACH
  • Low LVEF.
  • Previous Myocardial Infarction.
  • Coronary Artery Disease
  • Family History of SCD.
  • Cardiomyopathy
  • Congestive Heart Failure
  • Long QT Syndrome.
  • Right Ventricular Dysplasia.

Risk Factors of Sudden Cardiac Death (SCD) 14. Treatment Chain of Survival

  • Early access.
  • Early CPR.
  • Early defibrillation.
  • Early advanced life support.

Sudden Cardiac Arrest (SCA) 15. Chain of SurvivalFirst link Early access

  • Call for Help !
  • Patient evaluation
  • Determine if conscious or not, by placing
  • one hand on patients forehead and
  • shaking shoulders gently with another
  • hand.
  • In case of SCA patient will not respond.

Sudden Cardiac Arrest (SCA) 16. Chain of SurvivalSecond link Early CPR

  • Steps preceding Cardiopulmonary Resuscitation (CPR)
  • Determine A,B,C of Basic Cardiac Life Support (BCLS).
  • *A for Airway.
  • *B for Breathing.
  • *C for Circulation.

Sudden Cardiac Arrest (SCA) 17.

  • Airway
  • *Head tilt
  • *Finger sweep.
  • *Jaw Thrust.

Sudden Cardiac Arrest (SCA) Chain of SurvivalSecond link Early CPR 18.

  • Breathing
  • *Look Down the line of chest to
  • to see it rise and fall.
  • *Listen at mouth and nose for
  • breathing sounds.
  • *Feel for expired air at patients
  • mouth and nose.

Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 19.

  • Circulation
  • *Feel - carotids

Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 20.

  • Once SCA is confirmed
  • Patient should be placed on hard surface.
  • Start CPR.
  • Give 2 expired breaths, followed by 15 compressions.
  • Continue 2:15 cycles for CPRboth for 1- & 2 - rescuers
  • Compression rate -100 per minute

Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 21.

  • Mouth to mouth ventilation
  • Remove any obvious obstruction.
  • Open airway.
  • Pinch victims nose.
  • Give mouth to mouth ventilation.
  • Repeat breaths.

Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 22.

  • Cardiac compressions
  • Locate correct chest compression site,
  • 2 - fingers above xiphoid.
  • Place heel of other hand on the lower end
  • of breast bone.
  • Fingers off the chest wall.
  • Continue till AED is available.

Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 23. 24. Chain of SurvivalSecond link Early CPR Sudden Cardiac Arrest (SCA) 25. Chain of SurvivalThird link Early Defibrillation

  • CPR saves time
  • The most common cause of SCA is VF, a lethal rhythm
  • The only effective treatment is defibrillation

Sudden Cardiac Arrest (SCA) 26. Chain of SurvivalThird link Early Defibrillation

  • Over 10 years ago, AHA expanded its early defibrillation standard of care to include
  • AEDs for in-hospital first responders (1990).
  • Resuscitation committees often inappropriately emphasize the arrival of core team
  • rather than the delivery of the first shock.
  • Treatment goal defibrillation within 3 min. anywhere in the hospital.

AHA/ERC Standards & Guidelines VF DefibrillationNSR Defibrillation Electrical Current Stops VF Sudden Cardiac Arrest (SCA) 27. Chain of SurvivalThird link Early Defibrillation Defibrillation Electrode Placement

  • Anterior lateral placement

Sudden Cardiac Arrest (SCA) 28. 29. Chain of SurvivalThird link Early Defibrillation

  • Guidelines 2000
  • For communities :
  • 3-5 minutes, preferably less than 3 minutes.
  • For hospitals :
  • less than 3 minutes.

The Importance of TIME : Sudden Cardiac Arrest (SCA) 30. Time is the enemy : %SuccessTime (minutes) Resuscitation Successvs. Time Success rates decrease7-10% each minute Sudden Cardiac Arrest (SCA) Chain of SurvivalThird link Early Defibrillation

  • Survival rates plunge 7 10 %
  • every minute defibrillation is
  • delayed.
  • Quick action by first responder on
  • scene can save a life.
  • Solution : Public Access Defibrillation
  • Recognize SCA (1 to 2 mins)
  • Locate AED & deliver shock (2 mins).

0 1 2 3 4 5 6 7 8 9 31.

  • % Witnessed VF Patients Surviving to Hospital Discharge

Sudden Cardiac Arrest (SCA) Chain of SurvivalThird link Early Defibrillation 32.

  • Safety First
  • Attach AED only to someone not
  • breathing and without a pulse or signs
  • of circulation.
  • Make sure no one is touching the victim.
  • Be sure the electrodes are firmly
  • adhered to victims chest.
  • Move oxygen away from the rescue
  • effort before defibrillation.

Sudden Cardiac Arrest (SCA) Chain of SurvivalThird link Early Defibrillation 33.

  • TodaysAEDs are more practical for use in the work place
  • and public places
  • *Voice prompts are more intuitive.
  • *AEDs do self tests and are virtually maintenance free.

Sudden Cardiac Arrest (SCA) Chain of SurvivalThird link Early Defibrillation AEDs are WELL SUITED for USE by NON-TRADITIONAL RESPONDERS 34.

  • Who is Using AEDs Today ?
  • Flight Attendants
  • Firefighters.
  • Paramedics
  • Corporate Emergency Response Teams
  • Security Officers
  • Factories/ Industries
  • Shopping Malls
  • Corporate Offices
  • Police force
  • Golf Pros
  • Health club employees

Automated external defibrillators (AEDs) are safe for trained lay rescuers to use, to treat sudden cardiac arrest.The devices analyze a vict