CPR - WILCOX

2 shockable heart rhythms

V tach and V fib

what is V tach

ventricles are contracting faster than it could fully refill, causing no pulse

what is V fib

irregular and rapid beating of the heart’s chambers (quivering, can’t pump blood effectively)

what are 2 unshockable heart rhythms

PEA and asystole

what is PEA

no pulse despite there being electrical activity in the heart

why could PEA happen?

hypovolemia, cardiac tamponade, hypoxia

what is asystole

no electrical activity in the heart, rendering defib ineffective

what is the AHA out of hospital cardiac chain of survival

activation of emergency response (ALS + AED), high-quality CPR, defibrillation, advanced resuscitation, post cardiac care, recovery

describe the CAB algorithm

COMPRESSIONS - prioritize compressions (push any residual oxygen in the blood to the tissue as other equipment is set up)

AIRWAY - establish a path for ventilation

BREATHING - provide artificial ventilation and supplemental O2 w/ BVM

what to do when patient obtains ROSC

deliver supplemental O2 and continue rescue breaths if patient regains a pulse without adequate breathing

take a set of vitals + BGL

acquire a 12-lead EKG

full assessment

5 reasons to stop or not start CPR

ROSC, obvious signs of death

Scene becomes unsafe, DNR/MOLST/eMOLST is found

after 20 mins of CPR, call med control for termination of resuscitation

what are your obvious signs of death

Transection, Rigor Mortis, Incineration, Evisceration, Massive Crush Injury to vital area, Submersion for over an hour, Decapitation, Decomposition, Dependent Lividity

possible mechanisms of a traumatic arrest

falls, MVAs, blunt trauma

COMMOTIO CORDIS: blunt trauma to the chest on the uprise of the T-wave, causing instant v-fib

try to maintain spinal stability when CPR-ing

Use Jaw thrust w/ 2 providers

what are your H’s and T’s

Hypoxia, Hypovolemia, Hydrogen Ion (Acidosis), Hypoglycemia, Hypo/HyperKalemia

Tension pneumothorax, Tamponade, Toxins, Thrombosis

what to do when patient is conscious and can breathe, cough, or speak

encourage PT to cough, transport into sitting position, administer supplemental oxygen, watch for progression to complete obstruction

what to do when patient is conscious and cannot breathe, cough, or speak

5 back slaps and 5 abdominal thrusts (or 5 chest thrusts)

place one leg between their leg

wrap your arms around their body

place fist just above the naval

thrust upwards in a J-shaped motion

what to do when parents go unresponsive

gently lower them to the ground and initiate CPR