CPR 2010 changes : CPR 2010 changes MODERATOR: DR. SUDARSHAN
PRESENTER: LOKESH 50 years of CPR : 50 years of CPR Cardoipulmonary resuscitation is a series of life saving actions that improve the chances of survival following cardiac arrest.
1960, Kouwenhoven, Knickerbocker and Jude documented 14 patients who survived cardiac arrest with the application of closed cardiac massage.
Maryland medical society introduced chest compressions and rescue breathing.
First monophasic waveform defibrillation 1962
First CPR guidelines 1966 ethics : ethics Terminating resuscitative efforts BLS Slide 4: Termination of cpr ALS Chain of survival : Chain of survival 2005 2010 Basic life support : Basic life support No look, listen, feel
Chest compressions – atleast 2 inches
Rescuer specific cpr strategy
Untrained: Hands only cpr CAB sequence : CAB sequence Emphasis on chest compressions over ventilations
Rescue breathing takes time whereas chest compressions can be started immediately.
Beginning with 30 compressions rather than 2 ventilations l/t shorter delays. Slide 9: High quality cpr
Focus on high quality cpr
Depth to atleast 2 inches
Integrated team of trained rescuers
Building of team
Assigning work to every member
Perform work simultaneously rather rhan sequentially. Hands only cpr : Hands only cpr Only chest compressions for lay persons
Outcomes similar to conventional cpr
Can overcome panic and hesitation to act
Interval to which hands only cpr is acceptable is not known at present
In pediatric patients (arrest d/t asphyxia) conventional cpr is better. Advanced airway : Advanced airway Earlier time to advanced airway associated with longer survival.(<12 min of arrest preferable)
Endotracheal intubation or supraglottic airway
Less (<10 sec) or no interruption of chest compression while placing advanced airway
Conformation of placement with EtCO2 or esophageal detector device.
Continuous waveform capnography is preferable Advanced cardiac life support : Advanced cardiac life support Continuous waveform capnography is recommended
Atropine no longer recommended in PEA
Chronotrophic drug infusions used as alternative to pacing.
Advanced airway: includes supraglottic airway devices, capnography. Slide 13: No Atropine Slide 17: Thank you