Emergency cardiovascular care
ECC, also known as Emergency Cardiovascular Care, covers the areas of Basic Life Support and Advanced Cardiac Life Support. Before the sequence of ABC or Airway, Breathing and Circulation is followed. But with the 2010 update from the American Heart Association, they revised it to CAB in which they emphasized the sequence of ventilation, oxygenation, and defibrillation along with well-performed chest compressions.
Basic vital support
Basic Life Support is the basis of Advanced Cardiac Life Support. Therefore, a well-performed BLS results in a good ACLS and PALS (Pediatric Advanced Life Support).
1. Assess the victim’s responsiveness by shaking and yelling to get your attention. If the victim is unresponsive, check to see if she is breathing. If not, determine what type of cardiac arrest you expect. Call professional emergency medical services through your local emergency hotline and obtain an automated external defibrillator, also known as an AED.
2. After evaluating and activating EMS. Check the carotid pulse for 5 to 10 seconds.
3. If there is a pulse but no breathing, proceed to rescue breaths. Rescue breaths are delivered at a rate of one breath every 5 to 6 seconds (10 to 12 breaths per minute). If there is no pulse, begin chest compressions, and if a pulse is present but weak and thready, still give chest compressions to maintain adequate perfusion. Compressions should be strong, fast, and deep with minimal interruptions. Position yourself directly over the victim’s chest while keeping your arms straight and elbows locked using your body weight for chest compression. Chest compressions are delivered at a rate of 100 per minute and interruptions are kept to a minimum to increase the chance of ROSC (Return Of Spontaneous Circulation).
Advanced cardiac life support
1. Patient assessment is important. You need to be organized as the information gathered during the evaluation is essential to making good treatment plans. Avoid placing electrode pads on top of other devices to avoid data corruption. Look for medication patches; these can cause burns while defibrillators are implanted under the patient’s skin.
2. Use a bag-mask and use an advanced airway if mouth-to-mouth resuscitation is not sufficient. If endotracheal tube placement is decided, use waveform cartography to confirm and monitor ET tube placement.
3. Support ventilation and provide adequate oxygen administration
4. Monitor cardiopulmonary quality
5. Connect and monitor a defibrillator
6. Provide cardioversion
7. Establish intravenous access
8. Administer appropriate pharmacological medications
The American Heart Association Emergency Cardiovascular Care emphasizes high-quality chest compressions during emergency care. The first 6 to 10 minutes of providing CPR to a cardiac arrest victim are critical to the victim’s chances of survival. These guidelines guide all health care providers, as well as providers of basic life support and advanced cardiac life support, in delivering quality and effective emergency cardiovascular care.