Jump to content

How advance is modern medicine when person goes into cardiac arrest?


nec209

Recommended Posts

How much have changed or advance over the years when it comes to cardiac arrest the person heart stop beating.

 

How long can person be in cardiac arrest before the paramedics or doctors say person is gone at this point.

 

With out the defibrillator how else could they start the person heart again and get the heart beating again?

 

With out the defibrillator people in cardiac arrest would be dying lot more.

 

Are some of the new defibrillator better now at starting the person heart again than the old defibrillators?

Link to comment
Share on other sites

How long can person be in cardiac arrest before the paramedics or doctors say person is gone at this point.

 

Depends on the general health of the person, how soon and how well CPR was administered after the event and whether you mind being a vegetable upon resuscitation. Longest i've seen is about 2 hours, but then he died so not sure that counts.

 

Interestingly doctors are more likely to not want to receive CPR.

 

 

With out the defibrillator how else could they start the person heart again and get the heart beating again?

 

A pre-cordial thump - basically a punch to the sternum - will occasionally work, depending on the underlying arrhythmia.

 

 

With out the defibrillator people in cardiac arrest would be dying lot more.

 

Yes. Just about everything else you do in an arrest is just to keep a person alive before a defib works.

 

 

Are some of the new defibrillator better now at starting the person heart again than the old defibrillators?

 

I forget the details but old defibs send unidirectional currents through the chest, while newer, better, ones send bidirectional.

 

However, Automated External Defibs are everywhere now. They are used by ambulances and in hospital in most arrests - manual defibs are only used in particular circumstances. I'd guess that the ease of use and ubiquity of these machines has saved more people than any recent technological improvements.

When there is no heart activity, you can usually forget it. A defibrillator can only assist in getting an erratically beating heart back on a normal pulse.

 

A shot of adrenaline (maybe other drugs) can sometimes jolt the heart into an arrhythmia that can be shocked. Good CPR is needed until then.

Link to comment
Share on other sites

Years ago we kept up CPR for over 60 minutes on a well known Medical Doctor. Had to call in fresh code teams from all over the hospital. He did not survive. At one point we were glancing at one another. We (staff, RNs, MDs) knew he was dead, but the code boss is the boss in these situations. She finally called it. She knew the patient.

 

The big question is how long has the patient been in full card arrest? Back in the day, difficult to determine. A dynamic situation. Sometimes a patient starts to look "sour" and you have a big hunch and call a "slow code". Then he arrests in front of everybody inside the hospital. Then you know to the second. Then he has about 5 minutes.

 

Self life in the medical field is short. I have been away from it too many years. We need a currently practicing health care pro to tell us.

Link to comment
Share on other sites

So you are saying if some one in cardiac arrest for that say hour or two hours than CPR can bring them back? But more than two hours it is highly unlikely?

 

So normally if person been like that for over two hours they will not try CPR?

Link to comment
Share on other sites

No, i'm saying it depends on the general health of the person, how soon and how well CPR is administered after the event and whether you mind being a vegetable upon resuscitation.

 

There isn't a definitive cut-off point: the resus team will decide how long to continue CPR case by case.

Link to comment
Share on other sites

  • 2 weeks later...

No, i'm saying it depends on the general health of the person, how soon and how well CPR is administered after the event and whether you mind being a vegetable upon resuscitation.

 

There isn't a definitive cut-off point: the resus team will decide how long to continue CPR case by case.

 

Okay but do they not say if you have no blood flow to the brain after 6 minutes your brain cells start to die? If so how long can it go on before too may brain cells die and you are a vegetable 30 minutes or hour?

Link to comment
Share on other sites

  • 3 weeks later...

I hear there are machines in the hospital so called artificial heart machines and artificial breathing machines to keep the person alive in the hospital!! But the person will be hooked up to the machine and laying in bed!! What a terrible life.

 

No portable machines and no emergency machines the EMT can use on you before taking you to the hospital. So the EMT must get your heart beating and lungs working before taking you to the hospital.

Edited by nec209
Link to comment
Share on other sites

On 7/6/2017 at 2:51 AM, nec209 said:

 

Okay but do they not say if you have no blood flow to the brain after 6 minutes your brain cells start to die? If so how long can it go on before too may brain cells die and you are a vegetable 30 minutes or hour?

The brain is the most sensitive organ to ischaemia, i think 3 minutes before irreversible damage. But that's the point of chest compressions in CPR - you are trying to force blood to the brain until the heart starts beating again. How long someone can be kept alive by doing this depends on many parameters.

 

On 7/21/2017 at 11:12 PM, nec209 said:

I hear there are machines in the hospital so called artificial heart machines and artificial breathing machines to keep the person alive in the hospital!! But the person will be hooked up to the machine and laying in bed!! What a terrible life.

 

No portable machines and no emergency machines the EMT can use on you before taking you to the hospital. So the EMT must get your heart beating and lungs working before taking you to the hospital.

By artificial heart machine do you mean a bypass machine? These are only used for relatively short periods during heart surgery, not in CPR. More common is to use inotropes and other drugs to support the heart post arrest (the heart needs to be beating).  Intensive care units are full of people on respirators though, and can be kept alive for ages. I agree it's grim, i'd rather be allowed to die if there is little prospect of a good recovery.

An EMT will try to get your heart beating if possible, but otherwise will try to keep your brain perfused by CPR until they can get you to more definitive treatment. Most EMTs in the UK are trained to intubate but there is debate in the profession whether it is better to attempt such things or just get a patient to hospital ASAP.

Link to comment
Share on other sites

12 minutes ago, Prometheus said:

The brain is the most sensitive organ to ischaemia,  i think 3 minutes before irreversible damage. But that's the point of chest compressions in CPR - you are trying to force blood to the brain until the heart starts beating again. How long someone can be kept alive by doing this depends on many parameters.

1

 Doesn't that depend on the temperature of the body?

Link to comment
Share on other sites

4 minutes ago, Prometheus said:

Yeah, that's one of the parameters. Approx. 3 mins at normal body temperature. Always hated putting ice packs on people - it just felt wrong.

But if they're essentially dead, why not try?

Link to comment
Share on other sites

Should clarify - induced hypothermia is not used during an arrest, it would interfere with the effectiveness of the drugs given and would be impractical to achieve anyway. It's only done after the heart starts beating again.

But yeah, why not try. I just found it slightly uncomfortable. Everyone has some things they don't like doing, this was one of mine.

Link to comment
Share on other sites

On 2017-07-25 at 0:27 PM, Prometheus said:

The brain is the most sensitive organ to ischaemia, i think 3 minutes before irreversible damage. But that's the point of chest compressions in CPR - you are trying to force blood to the brain until the heart starts beating again. How long someone can be kept alive by doing this depends on many parameters.

 

Sorry I should of clarified of saying not how long they will do CPR before calling it end and saying enough is enough that stop there is no point doing CPR any longer. But how long person can be in cardiac arrest or respiratory arrest before the EMT saying no there is no point doing CPR the person is gone?

If you been in cardiac arrest or respiratory arrest for over minutes than there is no chance bringing you back thus the EMT will not do CPR? But if you been in cardiac arrest or respiratory arrest for under 30 minutes they will?

Link to comment
Share on other sites

Everyone at my work is a First-Aid responder, and I've personally had training for over 25 yrs in both CPR and defibrillator use.
If a defibrillator is not available, good old fashioned CPR, consisting of chest compressions and assisted breathing is still effective until emergency medical assistance arrives. It needs to be started immediately as we are taught you have a 4 min window before irreparable brain damage. The compressions actually compress the heart and circulate some blood to the brain. Compressions are approx. 100-120 per minute ( to the tune of the BeeGee's 'Stayn' Alive ')

And you keep going until Emergency Medical assistance arrives, or someone else takes over.

Edited by MigL
Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.