What is a Cardiac Arrest
A cardiac arrest, a. K. A cardiopulmonary arrest or circulatory arrest, is the sudden conclusion of normal circulation of the blood due to failure of the heart to contract effectively during systole.
A cardiac arrest isn’t like ( but may be caused be due to ) a coronary or myocardial infarction, where blood flow to the still-beating heart, is interrupted ( as in cardiogenic shock).”Arrested” blood circulation stops bits of oxygen to all elements of the body. Cerebral hypoxia, or lack of oxygen supply to the brain, causes victims to lose consciousness and to stop standard respiring, though agonal breathing may still occur. Brain injury is likely if cardiac arrest is untreated for over five mins, though new treatments like prompted hypothermia have started to extend this time. To enhance survival and neurological recovery immediate response is paramount. That being said did you hear about the latest news on Michael Jackson (this is related to cardiac arrest)? (Michael Jackson Death)
Cardiac arrest is a medical emergency that, in certain groups of patients, is probably reversible if treated early enough (See “reversible causes” below ). When unexpected cardiac arrest leads to death this is named unexpected cardiac death (SCD). The first first-aid treatment for cardiac arrest is cardiopulmonary resuscitation (commonly known as CPR) which provides circulatory support till availability of decisive medical treatment, which will vary reliant on the rhythm the heart is exhibiting, but frequently needs defibrillation.
Characteristics and diagnosis
Cardiac Arrest is a sudden conclusion of pump function (evidenced by lack of a palpable heart beat ) of the heart that with prompt intervention may be reversed, but without it will lead to death. In certain cases, it is an expected outcome to a major illness.
However, due to inadequate cerebral perfusion, the patient will be unconscious and will have stopped respiring. The main diagnostic criterion to diagnose a cardiac arrest ( vs breathing arrest, which shares many of the same features) is lack of circulation, however there are a number of ways of determining this.
In many cases, absence of carotid pulse is the gold standard for diagnosing cardiac arrest, but absence of a pulse (particularly in the peripheral pulses) may be a result of other conditions ( e.g. Shock ), or simply an error on the part of the rescuer. Research has shown that rescuers frequently screw up when checking the carotid pulse in an emergency, whether they are healthcare professionals or lay persons.
Owing to the inaccuracy in this method of diagnosis, some bodies like the European Resuscitation Council (ERC) have de-emphasised its importance. The Resuscitation Council ( UK ), in line with the ERC’s suggestions and those of the Yankee Heart Association, have suggested that the strategy should be used only by healthcare executives with explicit coaching and expertise, and even then that it should be viewed in association with other indicators like agonal respiration.
Various other strategies for detecting circulation have been proposed. Guidelines following the 2k Global Liaison Committee on Resuscitation ( ILCOR ) suggestions were for rescuers to go looking for “signs of circulation”, but not specifically the pulse. These signs included coughing, gasping, colour, twitching and movement. However, in the face of proof that these guidelines were ineffective, the current advice of ILCOR is that cardiac arrest should be diagnosed in all casualties who are unconscious and not breathing normally.
Following initial diagnosis of cardiac arrest, healthcare professionals further categorise the diagnosis based on the ECG/EKG rhythm. There are four rhythms which result in a cardiac arrest. Ventricular fibrillation ( VF/VFib ) and pulseless ventricular tachycardia (VT) are both responsive to a defibrillator and so are colloquially called “shockable” rhythms, while asystole and pulseless electrical activity (PEA) are non-shockable. The nature of the presenting heart rhythm recommends different causes and treatment, and is used to guide the rescuer as to what treatment might be suitable ( see complicated life support and sophisticated cardiac life support, as well as the causes of arrest below).
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