Intensive Care Medicine

Day 3: Cardiac Arrest, CPR, Defibrilation

Learning Objectives

  • The student will recognize circulatory arrest. 
  • The student performs high-quality CPR.
  • The student analyzes rhythm during ALS - incl. palpation of central pulses.
  • The student will recognize shockable and nonshockable rhythms.
  • The student can perform safe defibrillation.
  • The student knows the pharmacotherapy during CPR for shockable rhythms, incl. dosage (amiodarone and epinephrine).
  • The student can provide Bag-mask ventilation during CPR.
  • The student knows the reversible causes of circulatory arrest.
  • The student knows the specifics of CPR in a child (PALS algorithm).
  • The student knows the specific dosages for CPR in a child: epinephrine, amiodarone and shock energy.

ATTENTION
  • For practice participation is required to fill in the ROPOT form
  • Please, fill in the ROPOT form no later than midnight of the previous day

ROPOT - CPR

Sudden cardiac arrest

Sudden cardiac arrest (SCA) is a condition in which there is an unexpected interruption of blood circulation in the bloodstream for any reason.

The causes can be divided into:

  • Cardiac - primary
    • The cause of the circulatory arrest is heart disease

  • Non-cardiac – secondary
    • The cause of circulatory arrest is other than cardiac.
      The most common etiology is hypoxia.

Chain of survival

To ensure the highest chance of survival for SCA patients, it is crucial to ensure the so-called chain of survival. These are the downstream and interrelated steps that we try to accomplish during out-of-hospital as well as in-hospital cardiac arrest.

1. Recognising SCA and calling for help (Early access to emergency care)

  • Calling for help – emergency medical services (EMS) outside of the hospital,
    MET call/ resuscitation team (ACLS – advanced life support team) in the hospital

2. Immediate initiation of Cardiopulmonary resuscitation (Early CPR)

  • Trained rescuers provide CPR, including artificial respiration if circumstances permit

3. Early defibrillation

  • Possible to perform during Basic Life Support (BLS) using Automated external defibrillator (AED)

4. Early advanced care, post-resuscitation care

Chain of Survival

It is clear from the individual steps of the chain of survival that the extended resuscitation provided by a specialized team (EMS, resuscitation team in the hospital) is only a piece of care for the SCA patient. Early initiation of basic CPR and calling for help is critical. The different steps of the chain will be described in more detail in the following subsections.

ECR guidelines

Recommendations for providing resuscitation care are developed at the European level and updated at regular five-year intervals by the European Resuscitation Council (ERC). The last update was in 2021. These recommendations are adopted by regional societies in the Czech Republic by the Czech Resuscitation Council.

The recommended practices are shown schematically and can be found in the individual chapters.

A full Summary of Recommendations is also available (found in the Bonus materials for those interested in the field). Please note that this is a fairly complex technical text. We recommend combining it with e-learning or a textbook.


Cardiac Arrest in Adults
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Cardiac Arrest in Children
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BONUS materials
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Následující
Operace
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