Cardiac and Respiratory Arrest

Introduction

Cardiac and respiratory arrest are life-threatening emergencies where the heart and/or breathing stop abruptly. Immediate recognition and intervention are critical to prevent death or severe brain damage. In this lecture, we will cover the causes, symptoms, emergency response, and possible outcomes of cardiac and respiratory arrest.

Causes

Cardiac and respiratory arrest can occur due to various conditions, including: - Cardiac causes: Myocardial infarction (heart attack), arrhythmias, heart failure - Respiratory causes: Severe asthma attack, choking, drowning, drug overdose - Neurological causes: Stroke, traumatic brain injury - Metabolic causes: Severe electrolyte imbalance, hypoglycemia

Symptoms and Recognition

Early signs of an impending cardiac or respiratory arrest may include: - Sudden loss of consciousness - Absence of breathing or abnormal gasping (agonal breaths) - No detectable pulse - Cyanosis (bluish discoloration of the skin due to lack of oxygen)

Emergency Response (Basic Life Support — BLS)

1. Check Responsiveness – Tap the person and ask loudly if they are okay.
2. Call for Help – Activate emergency medical services (EMS) immediately.
3. Assess Breathing and Pulse – If absent, start chest compressions.
4. Provide High-Quality CPR (Cardiopulmonary Resuscitation)
   • Chest compressions: Press hard and fast (100–120/min) in the center of the chest.
   • Rescue breaths: Give 2 breaths after every 30 compressions if trained.
5. Use an Automated External Defibrillator (AED) if available.
6. Continue CPR Until Help Arrives – Do not stop unless the person regains circulation or professional help takes over.

Advanced Life Support (ALS)

• Advanced airway management (intubation or ventilation support)
• Administration of medications such as epinephrine or antiarrhythmics
• Defibrillation (if necessary) for shockable arrhythmias like ventricular fibrillation

Prognosis and Outcomes

• Early CPR and defibrillation within minutes significantly improve survival rates.
• Delayed response leads to poor neurological outcomes or death.
• Patients who regain circulation require intensive post-resuscitation care to prevent complications.

Conclusion

Cardiac and respiratory arrest require immediate action. Learning basic CPR and recognizing early warning signs can save lives. If in doubt, always call emergency services and start chest compressions immediately.

Source recommendations

1. American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC)

1. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines
2. https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
3. https://cpr.heart.org/en/resources/about-cpr-and-ecc
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000916
5. https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf

2. European Resuscitation Council Guidelines

1. https://cprguidelines.eu/guidelines-2021
2. https://www.erc.edu/
3. https://cprguidelines.eu/
4. https://www.sciencedirect.com/science/article/pii/S0300957221000551
5. https://www.resuscitationjournal.com/article/S0300-9572(21)00064-2/fulltext