Currents

In Emergency Cardiovascular Care

BREATHING CHECK
OLD

NEW
Check 5-10 second No Normal breath 2 rescue breaths CPR

Present or absence of breathing check

GASPING is NO BREATHING !

AIRWAY PERFORM
OLD Jaw thrust NEW Head tilt or Chin lift

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

OLD Breath were to be delivered over 1 to 2 second

NEW Breath given over 1 second see chest rise Avoid too large and forcefull

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

OLD

NEW
push hard and push fast except newborn Recoil chest Limited interruption (100 kali/menit)

Emphasized just quality and rate of chest compressions

Rate, depth, recoil adequate more blood flow CPR interrupted blood flow stop first few compression are not as effective as the later compressions

Compression-to-Ventilation Ratio
OLD 15 : 2

NEW

30 : 2 excluding newborn

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

OLD Shockable rhytm 3 shocks without any CPR between the shocks Check the rhytm before and after shocks

NEW 1 shock following by immediate CPR 5 cycles and than check rhytm

The rhytm analysis result in delays of 37 second even longer after each shock In cases first shock fails, resumption of CPR is likely to confer a greater value than another shock Shock 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.

Conclusion