Basic pathophysiology of sudden cardiac arrest Tereza Prokopová Zápatí prezentace2 Learning objectives ̶ Student will learn what are the causes of primary circulatory arrest. ̶ Student will learn what are the causes of secondary circulatory arrest. ̶ Student will learn the basic facts about the role of oxygen in the sudden cardiac arrest. Basic pathophysiology of SCA3 What is essential for human? Basic pathophysiology of SCA4 Cycle of oxygen ̶ Lungs oxygenate blood ̶ Oxygenated blood goes to heart ̶ Heart pumps oxygenated blood to whole body ̶ Deoxygenated blood goes to heart through veins ̶ Heart pumps deoxygenated blood to lungs IDEAL STATE Basic pathophysiology of SCA5 SCA ̶ Sudden cardiac arrest ̶ Sudden interruption in blood flow in systemic bloodstream ̶ Heart does not pump blood ̶ Leads to death without help Basic pathophysiology of SCA6 Types of cardiac arrest ̶ Primary (Cardiac) ̶ Secondary (Not cardiac) Basic pathophysiology of SCA7 Primary SCA ̶ Problem with bloodstream ̶ Heart failure (heart attack, arrhythmias,…) → heart cannot pump blood ̶ Insufficient intravascular volume (bleeding,…) → nothing to pump ̶ → both cases lead to SCA Basic pathophysiology of SCA8 Secondary SCA ̶ Problem with ventilation ̶ For example: suffocation, drowning, asphyxia ̶ Heart pumps blood to lungs, but blood is not oxygenated over there ̶ Level of oxygen in blood is dropping ̶ Not enough oxygen for heart ̶ Leads to heart failure ̶ Heart stops → SCA Basic pathophysiology of SCA9 Secondary SCA – what follows? ̶ More often in childhood ̶ The blood oxygen level is lower than in case of primary SCA in time when heart stops ̶ Higher importance of rescue breaths ̶ Higher emphasis on rescue breaths in child CPR algorithm ̶ Do not palpate the pulse in BLS ̶ If the victim is not breathing, the heart stops working very soon Basic pathophysiology of SCA10 What is the short term goal during CPR? ̶ Provide heart with enough oxygen → chance for restoration of spontaneous circulation (ROSC) ̶ Blood oxygenation – rescue breaths ̶ Oxygen distribution – chest compression Basic pathophysiology of SCA11 What is the long term goal during CPR? ̶ Oxygen for brain - good quality of life Zápatí prezentace12 Learning outcomes ̶ Student knows the differences between primary and secondary cardiac arrest. ̶ Student is able to explain the importance of uninterrupted chest compressions. Basic pathophysiology of SCA13 Thank you for your attention Basic pathophysiology of SCA14 Sources ̶ www.erc.edu ̶ Pictures: ̶ https://rebelem.com/epinephrine-in-out-of-hospital-cardiac-arrest-poll/ ̶ www.erc.edu Simulation Centre, Faculty of Medicine, Masaryk University 2020