BASIC KNOWLEDGE ABOUT CPR

Defib:

The procedure of the first defibrillation:

Switch on defibrillator

Set energy 200 Joule

If not done automatically, set ECG derivation via Defi paddles

Apply gel or...

Place paddles: right parasternal below the clavicle, left in the apex area

Controlling the rhythm on the monitor

Press the "Start" button on the paddle to load, warn those present.

When the set energy is charged, inform all participants that sufficient distance is being maintained from the patient.

Even make sure that there is no patient contact.

Pressure on each paddle approx. 10 kg

Simultaneously press both "shock" buttons (one on each paddle).

Leave the paddles on the patient

Control the rhythm. Feel pulse when rhythm is unclear

If ventricular fibrillation persists, press the "Start" button again.

The shocks are performed with 200, 200 and 360 joules (if further defibrillations are necessary, only 3x360 joules are defibrillated).

In total, the defibrillator defibrillates 3 times in a row if there is no ordered heart rhythm. The process should take a maximum of 45 seconds. Then CPR (cardiac massage and ventilation) is continued immediately.

Heart pressure massage:

The aim of external cardiac massage is to maintain minimal blood circulation and thus perfusion of the organs with blood and oxygen.

The mechanisms are the direct compression of the heart between sternum and spine and on the other hand a pumping and suction effect on the large vessels in the thorax.

The external heart pressure massage is performed with a frequency of 100-120/min. This corresponds to the rhythm of the song "Staying alive". The pressure depth of the adult is at least 5 cm, the duration of pressure phase and relief phase should be the same. The pressure point is found as follows: Halve the sternum, place the ball of the thumb on the beginning of the lower half of the sternum. VIDEO (Doll!!)

BTW: The discosong of the Bee Gees "Stayin' Alive" corresponds with 103 BPM to the recommended frequency for the Heart Pressure Massage and is due to its popularity and the suitable title well suited as a memory aid. In 2011 an action video of the American Heart Association was published, in which the doctor Ken Jeong appears in the costume of John Travolta.

See Wikipedia _{(Wikipedia CC-by-sa-3.0)}

Intubation:

Endotracheal intubation is the preferred technique for securing ventilation in cardiopulmonary resuscitation. The advantages lie in keeping the airways clear, protection against aspiration and over-inflation of the stomach, facilitation of mechanical ventilation and the provision of a high oxygen concentration. The endotracheal administration of drugs (suprarenin, atropine, lidocaine) is no longer recommended and has been replaced by the possibility of a rapidly applied intrabony access.

VIDEO (Doll!!)

EMD (Electromechanical Dissociation):

EMD (electromechanical dissociation) or PEA (pulse-free electrical activity) means the presence of an electrical activity of the heart (broad, deformed ventricular complexes) without mechanical heart activity, i.e. no pulse can be felt.

There are a number of remedyable causes of EMD: hypovolemia, tension pneumothorax, pericardial tamponade, pulmonary embolism, drug intoxication, hypothermia, electrolyte shifts,...

The identification of such causes is important, otherwise the prognosis for EMD is very poor.