Download Free Medical In-hospital Cardiac Arrest-First and foremost Chest Compressions PowerPoint Presentation

In-hospital Cardiac Arrest-First and foremost Chest Compressions PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "In-hospital Cardiac Arrest: First and foremost, Chest Compressions", to know about In-hospital Cardiac Arrest and Chest Compressions.

Tags : Emergency Medical Services, EMS, In-hospital Cardiac Arrest, Chest Compressions

Published on : Aug 06, 2021 | Views : 1352 | Downloads : 6

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

In-hospital Cardiac Arrest: First and foremost, Chest Compressions Charles L Campbell MS MD Associate Professor of Medicine University of Kentucky College of Medicine
Slide 2-

No Disclosures
Slide 3-

Outline IHCA Hospitals Vary in Outcome Why What is recommended How should it be done Does it really matter
Slide 4-

IHCA is pretty common… ˜200,000 in the US Survival is 18-20% There is tremendous variability among hospitals Get with the Guidelines 135,896 20% with Ventricular fibrillation or Ventricular tachycardia 64% occur in an ICU Median Survival Varies 8.3% at the lowest Decile 31.4 at the highest JAHA. 2014;3:e000400
Slide 5-

JAHA. 2014;3:e000400
Slide 6-

JAHA. 2014;3:e000400
Slide 7-

JAHA. 2014;3:e000400
Slide 8-

What seems to work? Performing ACLS correctly is associated with an improvement in outcome MUSC study Compared guideline adherence for survivors vs. non-survivors 75 survivors 75 non-survivors Survivors older and with more cormorbidities Resuscitation. 2013;85:82-87
Slide 9-

Resuscitation. 2013;85:82-87
Slide 10-

Resuscitation. 2013;85:82-87
Slide 11-

Resuscitation. 2013;85:82-87
Slide 12-

Resuscitation. 2013;85:82-87
Slide 13-

Each 10% improvement in adherance results in a ˜30% increase in ROSC. Resuscitation. 2013;85:82-87
Slide 14-

What is Happening Weisfeldt and Becker Electrical Phase 4 min Defibrillation alone may be effective Circulator Phase Chest compressions are necessary Metabolic Phase Stone Heart JAMA.2002;288:3035-3038
Slide 15-

Time course of VF
Slide 16-

Circulation. 2005;111:1136-1140 and e294
Slide 17-

J Cardiovascular Magnetic Resonance. 2011;13:17 Hypothermia during VT/VF
Slide 18-

What is Recommended Defibrillation Chest Compressions Oxygenation Medications Procedures
Slide 19-

NEJM 2008;358:9-17
Slide 20-

Chest Compressions Place patient on a firm surface Backboard Deflation of air mattress Had in the middle of the chest 5 cm of depression Allow complete recoil Lifting the hand completely of the chest can improve recoil Circulation. 2010;122:S685-705
Slide 21-

How Fast Rate 100-120 cpm Deliver >80 per minute That means minimal interruption Duty Cycle Time between the start of one compression and the start of the next Target is 50% As much time relaxing as compressing Circulation. 2010;122:S685-705
Slide 22-

Circulation. 2005;428-434
Slide 23-

Circulation. 2005;428-434
Slide 24-

Circulation. 2005;428-434
Slide 25-

Circulation. 2012;125:3004-12 ROC consortium (9 sites) OHCA in which monitors/defib measured chest compression rates 3098 cases analyzed
Slide 26-

Circulation. 2012;125:3004-12
Slide 27-

Circulation. 2012;125:3004-12 Compression rate vs Compressions Delivered
Slide 28-

Circulation Qual Outcomes.2013;6:148-156
Slide 29-

Compression Depth
Slide 30-

Resuscitation. 2005;64:363-372
Slide 31-

Circulation Qual Outcomes.2013;6:148-156
Slide 32-

Recoil Matters…
Slide 33-

Resuscitation. 2006;71:341-351
Slide 34-

Resuscitation. 2006;71:341-351
Slide 35-

Resuscitation. 2006;64:353-362
Slide 36-

Circulation Qual Outcomes.2013;6:148-156
Slide 37-

Resuscitation, 2007;73:54-61
Slide 38-

Resuscitation, 2007;73:54-61
Slide 39-

Resuscitation, 2007;73:54-61
Slide 40-

Resuscitation. 2009;80:743-751
Slide 41-

Non-Shockable Rhythms
Slide 42-

Circulation. 2012;125:1787-94
Slide 43-

Circulation. 2012;125:1787-94
Slide 44-

Chest Compressions and Defibrillation
Slide 45-

Resuscitation. 2006;71:137-145
Slide 46-

Resuscitation. 2006;71:137-145
Slide 47-

Survival from OHCA improved after the implementation of a protocol that required 90 seconds of CPR prior to the delivery of a shock via an AED 24% to 30% Particularly in those in whom the intial response interval was > 4 min. JAMA. 1999;281:1182-1188
Slide 48-

Resuscitation. 2008;77:10-15
Slide 49-

Resuscitation. 2008;77:10-15
Slide 50-

Resuscitation. 2008;77:10-15
Slide 51-

Mechanical CPR?
Slide 52-

ppt slide no 52 content not found
Slide 53-

ppt slide no 53 content not found
Slide 54-

Conclusions Chest Compressions are the cornerstone of resuscitation Rate Depth Recoil Minimizing Interruptions Feedback is probably helpful In some cases chest compressions aid defibrillation Mechanical chest compressors have not been demonstrated to be helpful