CurrentsIn Emergency Cardiovascular Care

BREATHING CHECKOLD

Present or absence of breathing checkNEW

Check 5-10 second No Normal breath 2 rescue breaths CPRXWhy ?

GASPING is NO BREATHING !Reason

AIRWAY PERFORMOLD

Jaw thrustNEW

Head tilt or Chin liftXWhy ?

ReasonJaw thrust is difficult and can produce movement of an injured spine like others technicque

OLD

Breath were to be delivered over 1 to 2 secondNEW

Breath given over 1 second see chest riseAvoid too large and forcefullXWhy ?

During CPR, blood flow to the lung decrease need ventilation decreaseRescue breath increase pressure in the chest decrease refill the heart decrease blood flow next compressionCPR more interupted Reason

OLD

Emphasized just quality and rate of chest compressionsNEW

push hard and push fast except newbornRecoil chestLimited interruption (100 kali/menit)XWhy ?

Rate, depth, recoil adequate more blood flow

CPR interrupted blood flow stop first few compression are not as effective as the later compressions Reason

Compression-to-Ventilation RatioOLD

15 : 2NEW

30 : 2 excluding newbornXWhy ?

The higher the C-to-V ratio the more chest compressions are given in a series during CPR increase blood flowReason

OLDShockable rhytm 3 shocks without any CPR between the shocksCheck the rhytm before and after shocksNEW1 shock following by immediate CPR 5 cycles and than check rhytmXWhy ?

In cases first shock fails, resumption of CPR is likely to confer a greater value than another shockShock eliminates VFseveral minutes for a normal heart rhytm to return and to create blood flow. There is no evidence that CPR immediately after defib will provoke recurrent VF.ReasonThe rhytm analysis result in delays of 37 second even longer after each shock

Conclusion