Cardiopulmonary Resuscitation (CPR) in Cardiac Arrest

Introduction

Cardiac arrest is a life-threatening emergency where the heart suddenly stops beating. Immediate cardiopulmonary resuscitation (CPR) is crucial to maintain blood circulation and oxygen delivery to vital organs, increasing the chances of survival and preventing permanent damage.

Causes of Cardiac Arrest

Cardiac arrest can be caused by several conditions, including: - Heart attack (myocardial infarction) – A blockage in the coronary arteries depriving the heart muscle of oxygen. - Arrhythmias – Abnormal heart rhythms, such as ventricular fibrillation or tachycardia. - Severe electrolyte imbalances – Especially involving potassium or calcium. - Drug overdose or poisoning – Certain medications or substances affecting heart function. - Severe trauma – Such as a car accident or a significant blow to the chest.

The Importance of Immediate CPR

When the heart stops, oxygen-rich blood stops flowing to the brain and other organs. Brain damage can occur within minutes. Performing CPR helps restore blood circulation and increases survival chances until medical professionals arrive.

Steps to Perform CPR

1. Check responsiveness – Tap the person and shout their name. If there is no response, call for emergency assistance (911 or local emergency number).
2. Check for breathing – Look, listen, and feel for breathing for no more than 10 seconds.
3. Start chest compressions:
   • Place your hands in the center of the chest.
   • Push hard and fast, at a rate of 100-120 compressions per minute.
   • Allow full chest recoil between compressions.
4. Provide rescue breaths (if trained):
   • Give 2 breaths after every 30 compressions.
   • Ensure breaths make the chest rise.
5. Use an Automated External Defibrillator (AED) (if available):
   • Follow voice instructions from the device.
   • Deliver a shock if advised.
6. Continue CPR until medical help arrives or the person regains consciousness.

Special Considerations

• CPR in an Out-of-Hospital Setting: Immediate action by bystanders significantly increases survival chances.
• Hands-Only CPR: If unwilling or untrained in mouth-to-mouth ventilation, performing only chest compressions is still highly effective.
• CPR in Children and Infants: Uses different techniques, such as gentler compressions and different compression-to-breath ratios.

Conclusion

Cardiac arrest requires swift action, and CPR is an essential life-saving measure. Knowing how to perform CPR increases the likelihood of survival and recovery. Training in CPR and the use of AEDs can make a significant difference in emergencies.

Source recommendations

1. American Heart Association 2020 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

1. https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
2. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000918
4. https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf
5. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194

2. European Resuscitation Council Guidelines 2021

1. https://cprguidelines.eu/guidelines-2021
2. https://www.sciencedirect.com/science/article/pii/S0300957221000551
3. https://cprguidelines.eu/
4. https://pubmed.ncbi.nlm.nih.gov/33773835/
5. https://www.resuscitationjournal.com/article/S0300-9572(21)00063-0/fulltext