OBJECTIVES:-

To provide basic life support level of care for patients in cardiopulmonary arrest.

INDICATION OF PROCEDURE:-

• Patient in cardiac arrest (breathless and pulseless).
• Patient must be 8 years of age and older.
• Patient must weight 40 kg or more.

PROCEDURE

• Undertake universal precautions (BSI).
• Maintain ABC
• Attach Monitor to analyze rhythm obtain BP and Pulse Oxymetre.
• Establish IV/IO access
• Verify the absence of pulse and respiration.
• Initiate CPR with C-A-B sequence 5 cycles or 2 minutes (30compressions: 2 breaths)
• Switch the AED ON.
• Place electrodes on the patient chest.
• Connect electrodes to the AED cable.
• Clear the patient to analyze the rhythm.
• If shock is advised.
  • Insure all individuals are clear of the patient.
  • Deliver shock.
  • Immediate resume CPR for 5 cycle 2 minutes without checking for pulse, BVM ventilation and insert oropharyngeal airway.
  • After 2 minutes AED will prompt to repeat step G and H by initiate rhythm analysis and deliver additional shocks if advised by the AED.
  • If "No shock advised" indicated and the patient remains in cardiac arrest immediately restart CPR beginning with Chest compression.
  • Attach patient to manual defibrillator, analyse rhythm and treat according to protocol.
    • Transport immediately to hospital while continuing CPR.

MEDICAL DIRECTOR:-

Contact medical director as soon as possible.

POST-SHOCK CARE.

• If pulse is regained after defibrillation ROSC. Post Cardiac Arrest management. Continue ROSC care and ventilatory support and transport to the hospital.
• If pulse is lost after successful defibrillation
  • Restart CPR.
  • Stop CPR and push analysis, then check if shock is indicated (repeat the above protocol).

PRECAUTIONS

• Make sure the patient and the environment are dry.
• Avoid placing pads over cardiac pacemakers/defibrillators or nitroglycerin patches.
• Do not touch the patient while the AED is assessing the patient or charging.
• Ensure that no one is touching the patient when the shock button is pushed.
• Never defibrillate while moving the patient or when in a moving ambulance.

COMPLICATIONS.

• Burn to skin.
• Deactivation of patients implanted pacemaker.
• Injury to patient, self and or bystanders.