Adult Cardiac Arrest

• Guidelines based upon recommendations of
International Liaison Committee on Resuscitation (ILCOR) and American Heart Association (AHA)
• Life Support (LS) divided into 2 phases
Basic Life Support (BLS)
Advanced Life Support (ALS)

Basic Life Support (BLS)

• Consists of
1. Rescue Breathing Bag and mask, rate 10-12/min.
2. Chest Compression Depress lower half of sternum 5 cm, rate 80-100/min.
• 1 Person CPR Ventilation/Compression ratio 2:15
• 2 Person CPR Ventilation/Compression ratio 1:5
• Precordial Thump is recommended for a witnessed or monitored arrest

Unequivocal Advanced Life Support Interventions

• Scientific evidence supports only 3 interventions
Basic Cardiopulmonary Resuscitation (CPR)
Defibrillation (ASAP) if the rhythm is VF or Pulseless VT
Oxygenation and ventilation of the lungs through a patent secure airway, such as a ETT

Advanced Life Support - New Concepts

• Cardiac arrest rhythms can be divided into 2 subsets
1. VT / Pulseless VF
2. Non VF / VT [incorporates asystole & Pulseless electrical activity (PEA) & Electromechanical dissociation (EMD)]
• Amiodarone to replace Lignocaine as the antiarrhythmic of choice for VF/VT
• Vasopressin experimentally to be of greater benefit than Adrenaline and may eventually replace it

Potentially Reversible Causes

• The universal algorithm specially directs rescuers to seek and treat reversible causes of Cardiac Arrest, this applies to both subsets but especially the non VF / VT group
• Many of the causes of cardiac arrest can be reversed with specific interventions