What to do in case of cardiac arrest?

What to do in case of cardiac arrest?

If we all knew how to identify this situation early, ask for help and perform basic cardiopulmonary resuscitation maneuvers, we would be able to greatly reduce the number of people who die or the risk of neurological sequelae that occur as a consequence of the lack of cerebral oxygenation.

The vast majority of cardiac arrests occur far from a hospital, especially in our own homes or in public places, with an incidence that is between 67 and 170/100.000 inhabitants. Generally, in these places there are no health personnel who can direct resuscitation. Therefore, the objective of those who witness an episode of this type is to begin cardiopulmonary resuscitation (CPR) as soon as possible, so that the patient's organs, especially the brain, are not so damaged when the ambulance arrives.

Half of the adult population admits that they do not know how to correctly identify cardiorespiratory arrest. But, if you are afraid to do CPR or are not sure how to do CPR correctly, you should know that it is always better to try than to do nothing, the worst resuscitation is not doing it and the difference between doing something and doing nothing can be life. of a person.

In this post we are going to review CPR so that you have some basic knowledge.

Initial evaluation:

  1. SAFETY: Make sure you, the victim, and other witnesses to the incident are safe.
  2. RESPONSE SEEKING: Gently shake the victim by the shoulders, asking out loud “are you okay?”
  3. CHECK AIRWAY: If there is no response, place victim face up. With one hand on the forehead and the fingers of the other at the base of the chin, gently tilt the victim's head back by lifting the chin to open the airway. Look, listen, and feel your breathing for no more than 10 seconds.
    1. If you are sure the victim is breathing normally but still does not respond, place her in the recovery position described below.
      1. RECOVERY POSITION: To put the victim in the recovery position, hold the victim with one hand by the leg and the other by the shoulder and turn him or her toward the rescuer until they are on their side. The top leg is adjusted so that both the hip and knee are bent at right angles, the head is tilted gently backward to maintain a patent airway. The person should be kept warm until medical help is obtained. If breathing or circulation stops at any time, the victim should be turned back onto their back and CPR should be initiated.
      2. If you are not breathing normally (barely breathing or gasping infrequently and loudly), call Emergency Services (112) and send a witness to look for an AED, you must begin CPR maneuvers.

Basic cardiopulmonary resuscitation

If you have not received CPR training or are not sure if you can give rescue breaths, only do continuous chest compressions until paramedics arrive. You do not need to try rescue breathing. The steps to follow are:

  1. Kneel next to the victim.
    • Place the bottom of the palm of one of your hands on the lower half of the victim's breastbone (or center of the chest).
    • Place the palm of your other hand on top of your first hand and interlace your fingers.
    • Keep your arms straight.
    • Stand vertically above the victim and press the sternum to compress it by about 5 cm (no more than 6).
    • After each compression, release all pressure on the chest, without losing contact between your hands and the breastbone.
    • Repeat at a rate of 100-120 compressions per minute.

DEA

  • As soon as the AED arrives, turn it on and place the electrodes on the victim's bare chest.
  • If there is more than one rescuer, CPR should be continued while the electrodes are placed on the chest.
  • Follow the spoken and visual instructions given by the AED.
  • If shock is advised, make sure no one is touching the victim and press the shock button, then immediately resume CPR and continue as directed by the AED.
  • If no shock is advised, immediately resume CPR and continue as directed by the AED.

Special situation due to the Covid-19 pandemic

The European Resuscitation Council guidelines promote the continuation of resuscitation attempts in cardiac arrests, while seeking to minimize the risk to the person or persons acting as rescuers and providing treatment. If there is uncertainty about the presence of COVID-19, people performing CPR should perform a dynamic risk assessment considering:

  • the current prevalence of COVID-19,
  • the clinic and presentation of the victim (for example, history of risk contact, symptoms compatible with COVID-19...),
  • the probability that the treatment will be effective or futile,
  • the availability of personal protective equipment and the personal and occupational risks for the people providing the treatment.

Resuscitation of low-risk people or those with confirmed negative results for COVID-19 has been addressed in this post.

Do not stop CPR until…

  • You may be told not to continue by a healthcare professional, or the victim is definitely waking up, moving, opening their eyes, and breathing normally, or you are becoming exhausted.
  • CPR alone is unlikely to restart spontaneous heartbeat; so unless you are sure the victim has recovered, continue CPR.
  • Signs that the victim has recovered: waking up, movements, eye opening, normal breathing.

Dr. Ana Casado,

General cardiologist and hemodynamic specialist