Cardiac Arrest Incidents February 2013 EMS Continuing Education 1 When do we not start CPR? • Patient with no pulse or respirations exhibiting Dependent Lividity and/or Rigor Mortis • Obvious Mortal Injuries • An approved "Do Not Resuscitate" order or signed "Living Will“ • ALS Units on the scene have assumed responsibility off patients care. 2 Patient with no pulse or respirations exhibiting Dependent Lividity and/or Rigor Mortis 3 Obviously Mortal Injuries 4 DNR or Living Will 5 Chain of survival consist of : 1. Immediate recognition of cardiac arrest and activate of emergency response system. 2. Early CPR that emphasizes chest compressions 3. Rapid defibrillation if indicated. 4. Effective advanced life support. 5. Integrated post-cardiac arrest care. Sequence of events: 1. Don your PPE. 2. Determine responsiveness and breathing 3. Call for HELP 4. Check for a pulse, if none present 5. Start Chest Compressions Hand positioning for Compressions and Ratio Ages : ? To Puberty Rate: Depth: Puberty to 1 year at least 100 per minute at least 2 inches Ratio: 30:2 with 1 or 2 rescuer at least 100 per minute 1 year to Birth at least 100 per minute at least 2 inches at least 1.5 inches 30:2 with 1 or 15:2 with 2 rescuer 30:2 with 1 or 15:2 with 2 rescuer 8 Open the Airway Ventilations Pocket Mask Bag-Valve -Mask Each breath should be 1 second in duration 10 Cardiac Science G3 Pro 11 Cardiac Science G3 Pro 1. Use as Soon as Possible!! 2. Turn it on by opening the lid. 3. Apply the pads to chest. 4. Stand back and let it analyze. 5. “STAND CLEAR” If shock advised press the red button. 6. Start CPR immediately after the shock is delivered. Trauma Codes Are we as BLS responders going to treat the trauma arrest patient any differently? NO! They Need CPR The need no delay in getting to the Trauma center After the Cardiac Arrest 1. Ensure the patient and their family are cared for. 2. Ensure all sharps and bio waste are properly disposed of. 3. IF a coroner is to be requested that must be done by Law Enforcement 4. Plug in a new set of pads in the AED and ensure it is “Rescue Ready”. Put it back in service, download will occur later. 5. Ensure EMS Bag is restocked and operationally ready. 6. Notify the Duty Chief that the AED has be deployed on a cardiac arrest patient. They will facilitate getting the data downloaded. QUESTIONS?? Then Let’s Play!