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2 CPR qualityĭuring CPR, continuous quantitative waveform capnography can provide an indirect assessment of the patient's cardiac output during chest compressions, measured as end-tidal carbon dioxide (EtCO 2). To avoid delaying the initiation of CPR, lay rescuers do not perform pulse checks and may provide compression-only CPR. 3 Lay rescuers should confirm cardiac arrest based on patient unresponsiveness and breathing patterns, such as the absence of breathing and irregular or gasping respirations. Outside of the healthcare setting, lay rescuers are individuals who have not received formal emergency care training. Remember that gasping and/or irregular or agonal respirations are not considered breathing. 1 If the patient is not breathing but has a pulse, initiate rescue breathing at a rate of 1 breath every 6 seconds or 10 breaths/min. For adult patients, compressions should be hard (at least 2 in in depth, not to exceed 2.4 in) and fast (maintaining a rate of 100/min to 120/min). Start by providing chest compressions and ventilation in cycles with a ratio of 30 compressions to 2 ventilations.
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Once cardiac arrest has been identified, the emergency response system should be activated, the code team alerted, and CPR initiated promptly. If a pulse is not detected, assume the patient is experiencing a cardiac arrest. To minimize delay in initiation of CPR, assess the patient's breathing and perform a carotid pulse check simultaneously, taking at least 5 seconds but no longer than 10. This article discusses these changes, as well as the latest AHA recommendations for CPR and emergency cardiovascular care (ECC).Īfter verifying that the scene is safe, call for help and determine whether the patient is unresponsive, check his or her pulse, and confirm absent or abnormal breathing patterns such as agonal or gasping respirations.
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These were derived from a continuous review of the current research guidelines, including changes in the sequence of care, medication administration, and methods of education. THE AMERICAN Heart Association (AHA) recently released updated guidelines for advanced cardiovascular life support (ACLS), basic life support (BLS), and pediatric advanced life support (PALS) for in- and out-of-hospital responses from both healthcare professionals and nonprofessionals.