CARDIAC ARREST

CARDIAC ARREST: Etiology. Cardiac arrest implies sudden and. unexpected stop¬page of heart beat either because of cardiac asystole or ventricular fibrillation. It may occur in a variety c clinical settings, both medical & surgical, such as during the course of acute myocardial infarction, heart blocks, drug toxicity, anaesthesia, surgical operations, special diagnostic procedures (e.g., catheterization and angiography), endoscopic examinations, pleural and pericardial paracentesis, electrocution, drowning etc.
Diagnosis. What matters in the diagnosis of cardiac arrest is how quickly it is recognized after its onset because after approximately 3 minutes of cardiac arrest, irreversible brain damage
occurs as indicated by fixed dilated pupils*. The three most impor¬tant signs of cardiac arrest are:
(i) Sudden unexplained loss of consciousness
(ii) Absence of pulsation in big vessels such as carotid and femoral arteries
(iii) Gasping or absent respiration
Once cardiac arrest is suspected treatment should be started immediately and no time need be wasted on auscultation of the heart etc.
MANAGEMENT
Previously confined to the precincts of operation theatres and recovery rooms, resuscitation of a patient with cardiac arrest has now become a widely practised procedure, and not infrequently, highly rewarding. The results depend entirely upon the awareness of the medical and para-medical personnel immediately near the patient and their training in such a resuscitative procedure.
Since cardiac arrest and failure of respiration usually develop together, the condition is better described as cardiopulmonary arrest (CPA). Obviously, resuscitative efforts have to be directed to restore both the circulation and the respiration and therefore, the term cardiopulmonary resuscitation (CPR) is preferable to cardiac resuscitation.
The approach to a patient of CPA should cover the following three vital areas:
A) Airways—Patency of
B) Breathing—Restoration of
C) Circulation—Restoration of
These three principles constitute the ABC of cardiopulmonary resuscitation and should be implemented with the utmost speed, and in that order.

Related Resources

• ACUTE MYOCARDIAL INFARCTION
• General measures on Acute Myocardial Infarction