CARDIAC ARREST ALGORITHMS

DR. MONIKA SHARMA

B.Sc., M.Sc., Ph.D. (Nursing) RN

Associate Professor
Medical Surgical Nursing Department
AIIMS, Bhatinda
&
Faculty Instructor
American Heart Association BLS & ACLS Course
at DMC & H, Ludhiana
C-A-B
CRITICAL CONCEPTS OF CPR FOR ADULTS
High-quality CPR improves a victim’s chances of survival. The
critical characteristics of high-quality CPR include the following:
•Start compressions within 10 seconds of recognition of cardiac
arrest.
•Push hard: Compress with a depth of at least 5cm
•Push fast: Compress at a rate of 100 to 120/min
•Allow complete chest recoil after each compression.
•Minimize interruptions in compressions (try to limit interruptions
to less than 10 seconds).
•Give effective breaths that make the visible chest rise.
•Avoid excessive ventilation
CARDIAC ARREST ALGORITHMS
Verify Scene Make sure the
environment is safe for
Safety rescuers and victim

Check for
BE
Responsiveness Victim is Responsive
HAPPY

If Victim is unresponsive
Shout for nearby help
Activate emergency response system
via mobile device (if appropriate).
Get AED and emergency equipment
(or send some one to do so)
Pulse-
•Locate trachea (2 fingers)
•Slide into groove between
Breath-
trachea and muscles of
•Scan for victims chest rise
neck
•Feel or palpate carotid Assess for breathing and pulse with
pulse
in 5 to 10 seconds simultaneously.

No normal
Normal breathing,
breathing,
has pulse
has pulse

No breathing or
only gasping,
No pulse

Sign of Cardiac Arrest

 No normal
Normal breathing,
breathing,
has pulse
has pulse

Provide rescue breathing:

1 breath every 5-6 seconds, or
about 10-12 breaths/min.
Monitor until
•Continue rescue breathing
emergency responders
•Check pulse about every 2
arrive.
minutes If no pulse, begin CPR
( go to CPR box)
 No breathing or
By this time in all scenarios,
Sign of only gasping, emergency response system or backup
Cardiac No pulse is activated, and AED and emergency
Arrest equipment are retrieved or someone is
retrieving them

Cardio Pulmonary Resuscitation

(CPR)
Begin Cycles of
30 compressions and 2 breaths.
Use AED as soon as it is available
 Cardio Pulmonary Resuscitation(CPR)
Begin Cycles of 30 compressions and 2 breaths.
Use AED as soon as it is available

COPRESSIONS AIRWAY BREATHS

(30) •Opening of Airway with (2)
Head Tilt Chin Lift •Give effective breaths that
•Start compressions within 10 Jaw Thrust
seconds of recognition of make the visible chest rise
cardiac arrest. with
•Push Hard, Push Fast Mouth to mouth
•Compress at a rate of 100 to Pocket mask if available
120/min with a depth of •Avoid excessive
Compress at least 5cm for ventilation.
adults •Deliver each breath over 1
•Allow complete chest recoil
after each compression
second
•Minimize interruptions in
compressions (try to limit
interruptions to less than 10
seconds)
 If no AED
• Continue CPR till
another person take
over, may be ACLS
Team
Use when reached
• Single rescuer
•On power
extremely tired
•Listen audiovisual
• Pulse and Breathing If AED prompts
Present after a set of
CPR(2 minutes) i.e. 5 arrives •Apply pads
•Insert connection of
cycles of 30
lines of pads
compressions and 2
•Analyze Heart Rhythm
breaths

Check Rhythm.
Shockable Rhythm?
 Check Rhythm.
Shockable Rhythm?
Yes, No,
Shockable Non-Shockable
VF/pVT Asystole/PEA

Give 1 shock .
Resume CPR
Resume CPR
immediately for about
immediately for about 2
2 minutes (until
minutes
prompted by AED to
(until prompted by AED
allow rhythm check).
to allow rhythm check).
Continue until ALS
Continue until ALS
Providers take over or
providers take over or
victim starts to move
victim starts to move
 REVIEW
OF
ALGORITHM
CARDIAC ARREST ALGORITHMS
Verify Scene Make sure the
environment is safe for
Safety rescuers and victim

Check for
BE
Responsiveness Victim is Responsive
HAPPY

If Victim is unresponsive
Shout for nearby help
Activate emergency response system
via mobile device (if appropriate).
Get AED and emergency equipment
(or send some one to do so)
Pulse-
•Locate trachea (2 fingers)
•Slide into groove between
Breath-
trachea and muscles of
•Scan for victims chest rise
neck
•Feel or palpate carotid Assess for breathing and pulse with
pulse
in 5 to 10 seconds simultaneously.

No normal
Normal breathing,
breathing,
has pulse
has pulse

No breathing or
only gasping,
No pulse

Sign of Cardiac Arrest

 No normal
Normal breathing,
breathing,
has pulse
has pulse

Provide rescue breathing:

1 breath every 5-6 seconds, or
about 10-12 breaths/min.
Monitor until
•Continue rescue breathing
emergency responders
•Check pulse about every 2
arrive.
minutes If no pulse, begin CPR
( go to CPR box)
 No breathing or
By this time in all scenarios,
Sign of only gasping, emergency response system or backup
Cardiac No pulse is activated, and AED and emergency
Arrest equipment are retrieved or someone is
retrieving them

Cardio Pulmonary Resuscitation

(CPR)
Begin Cycles of
30 compressions and 2 breaths.
Use AED as soon as it is available
 Cardio Pulmonary Resuscitation(CPR)
Begin Cycles of 30 compressions and 2 breaths.
Use AED as soon as it is available

COPRESSIONS AIRWAY BREATHS

(30) •Opening of Airway with (2)
Head Tilt Chin Lift •Give effective breaths that
•Start compressions within 10 Jaw Thrust
seconds of recognition of make the visible chest rise
cardiac arrest. with
•Push Hard, Push Fast Mouth to mouth
•Compress at a rate of 100 to Pocket mask if available
120/min with a depth of •Avoid excessive
Compress at least 5cm for ventilation.
adults •Deliver each breath over 1
•Allow complete chest recoil
after each compression
second
•Minimize interruptions in
compressions (try to limit
interruptions to less than 10
seconds)
 If no AED
• Continue CPR till
another person take
over, may be ACLS
Team
Use when reached
• Single rescuer
•On power
extremely tired
•Listen audiovisual
• Pulse and Breathing If AED prompts
Present after a set of
CPR(2 minutes) i.e. 5 arrives •Apply pads
•Insert connection of
cycles of 30
lines of pads
compressions and 2
•Analyze Heart Rhythm
breaths

Check Rhythm.
Shockable Rhythm?
 Check Rhythm.
Shockable Rhythm?
Yes, No,
Shockable Non-Shockable
VF/pVT Asystole/PEA

Give 1 shock .
Resume CPR
Resume CPR
immediately for about
immediately for about 2
2 minutes (until
minutes
prompted by AED to
(until prompted by AED
allow rhythm check).
to allow rhythm check).
Continue until ALS
Continue until ALS
Providers take over or
providers take over or
victim starts to move
victim starts to move
THANKS