Excellent CPR is crucial. |
- Anything short of excellent CPR does not achieve adequate cerebral and coronary perfusion.
- Excellent chest compressions must be performed throughout the resuscitation without interruption, using proper timing (100 to 120 compressions per minute) and force (5 to 6 cm [2 to 2.5 inches] depth), and allowing for complete chest recoil.
- Excellent chest compressions take priority over ventilation.
- If a second rescuer is present, ventilations must be performed using proper timing (6 to 8 breaths per minute in the intubated patient; ratio of 30 compressions to 2 ventilations if not intubated) and force (deliver each breath over one second, and only until chest begins to rise). Avoid hyperventilation.
- Do not stop compressions until the defibrillator is fully charged.
|
Defibrillate VF and pulseless VT as rapidly as possible. |
Rapidly identify and treat causes of non-shockable arrest (PEA, asystole). |
- Important causes include the 5 H's and 5 T's: Hypoxia, Hypovolemia, Hydrogen ions (acidosis), Hyper/Hypo-kalemia, Hypothermia; Tension pneumothorax, Tamponade-cardiac, Toxins, Thrombosis-coronary (MI), Thrombosis-pulmonary (PE).
- If immediately reversible causes (eg, tension pneumothorax, cardiac tamponade) are not corrected rapidly, the patient has little chance of survival.
|