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Cardiopulmonary Resuscitation (CPR) : Treatment & Medication Multimedia

Cardiopulmonary resuscitation (CPR) involves chest compressions and artificial ventilation to maintain circulation and oxygenation during cardiac arrest. Survival rates for out-of-hospital cardiac arrests are typically less than 10% while in-hospital rates are less than 20%. Bystander CPR within minutes of arrest can improve survival 2-3 times. CPR should be immediately performed on anyone found unconscious and pulseless until a defibrillator can be used or a pulse is detected.

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9 views2 pages

Cardiopulmonary Resuscitation (CPR) : Treatment & Medication Multimedia

Cardiopulmonary resuscitation (CPR) involves chest compressions and artificial ventilation to maintain circulation and oxygenation during cardiac arrest. Survival rates for out-of-hospital cardiac arrests are typically less than 10% while in-hospital rates are less than 20%. Bystander CPR within minutes of arrest can improve survival 2-3 times. CPR should be immediately performed on anyone found unconscious and pulseless until a defibrillator can be used or a pulse is detected.

Uploaded by

preet kaur
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd

Cardiopulmonary Resuscitation (CPR)

 Overview
 Treatment & Medication
 Multimedia

Introduction

Cardiopulmonary resuscitation (CPR) consists of chest compressions and artificial ventilation used to
maintain circulatory flow and oxygenation during cardiac arrest.

Of the more than 300,000 cardiac arrests that occur annually in the United States, survival rates are
typically less than 10% for out-of-hospital events and less than 20% for in-hospital events. 1,2,3,4,5
Additionally, studies have shown that survival falls by 10-15% for each minute of cardiac arrest without
CPR delivery.6,7 Bystander CPR initiated within minutes of the onset of arrest has been shown to
improve survival rates 2- to 3-fold.8

This article focuses on CPR, which is just one aspect of resuscitation care. Other interventions, such
as the administration of pharmacologic agents, cardiac defibrillation, invasive airway procedures, and
various diagnostic maneuvers9,10 are beyond the scope of this article. For more information, visit
Medscape's Resuscitation Resource Center. For specific information on the resuscitation of neonates,
see eMedicine article Neonatal Resuscitation.

Indications

CPR should be performed immediately on any person who has become unconscious and is found to
be pulseless. Assessment of cardiac electrical activity via rapid "rhythm strip" recording can provide a
more detailed analysis of the type of cardiac arrest as well as indicate additional treatment options.

Loss of effective cardiac activity is generally due to the spontaneous initiation of a nonperfusing
arrhythmia, sometimes referred to as a "malignant arrhythmia." The most common nonperfusing
arrhythmias include the following:

 Ventricular fibrillation (VF)


 Pulseless ventricular tachycardia (VT)
 Pulseless electrical activity (PEA)
 Asystole
 Pulseless bradycardia

Although prompt defibrillation has been shown to improve survival for VF and pulseless VT rhythms, 11
CPR should be started prior to rhythm identification and should be continued while the defibrillator is
being applied and charged. Additionally, CPR should be resumed immediately following a defibrillatory
shock until a pulsatile state is established. This is supported by studies showing that "pre-shock
pauses" in CPR result in lower defibrillation success and patient recovery. 12 In one study involving out-
of-hospital cardiac arrests in Seattle, 84% of patients regained a pulse when defibrillated during VF. 13
Defibrillation is generally most effective the faster it is deployed.
Contraindications

The only absolute contraindication for CPR is a Do Not Resuscitate (DNR) order or other
advanced directive indicating a person’s desire to not be resuscitated in the event of cardiac
arrest.

A relative contraindication for performing CPR is if a clinician justifiably feels that the
intervention would be medically futile, although this is clearly a complex issue that is an active
area of research.14,15

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