What Is Resuscitation?
Resuscitation is the revival of a patient from unconsciousness or apparent death. It corrects physiologic disorders such as lack of breath and heartbeat in critically ill patients. Resuscitation is considered a very important part of emergency medicine. The two most important types of resuscitation are CPR (cardiopulmonary resuscitation) and mouth-to-mouth resuscitation.
CPR is the emergency procedure performed when the heart starts breathing abnormally or stops breathing. Immediate CPR can bring back the normal heartbeat and can increase the chances of survival even after cardiac arrest to a large extent. When the resuscitation procedure is performed in adults, it is known as adult resuscitation, while for children, it is known as pediatric resuscitation.
What Is Adult Resuscitation?
When performed in adult patients, resuscitation is said to be an adult resuscitation. The resuscitation usually involves two steps:
1. CPR (cardiopulmonary resuscitation): CPR is an emergency life-saving procedure performed when a person’s heart stops breathing. Immediate CPR can increase the chances of survival to a great extent. Chest compressions are given in CPR, followed by rescue breaths.
2. Breath rescue (mouth-to-mouth breaths): This is done to restore the person's regular breathing. It is a type of artificial ventilation.
What Are the Indications of Resuscitation?
Resuscitation can be done on a patient:
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Who becomes cyanotic/asystolic (a clinical condition in which the heart stops breathing).
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In cardiac arrest patients.
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In patients who experience respiratory issues.
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It can also be performed in any ill-appearing patient whose respiratory rate is less than 60 bpm (beats per minute).
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It is also recommended for neonates. Approximately 10 % of neonates require medical assistance to begin breathing when they are born.
How Is Adult Resuscitation Followed by Cardiac Arrest Done?
Cardiac arrest is the sudden cessation of ventilation and circulation in which a person becomes unconscious within seconds. To recover from this condition, resuscitation is the first aid given.
Resuscitation is the sequential response to cardiac arrest; in addition to that, it includes:
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Proper check-up for the absence of breathing and circulation.
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Basic life support (BLS) with chest compressions and rescue breathing.
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Advanced cardiac life support (ACLS) with proper airway and rhythm control.
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Post resuscitative care.
The steps that are followed during resuscitation are:
1.Checking of Consciousness: Check whether the person is conscious, simply by asking. If they respond, they are said to be conscious. If not, the rescuer confirms that a person would have collapsed with a possible cardiac arrest in case of absence of consciousness and breathing. The rescuer should immediately call either an ambulance or for help to activate the emergency response system and, if possible, obtain a defibrillator.
2. Chest Compressions: Make sure the person is lying on their back or in a flat position. In case of recognition of cardiac arrest, chest compressions should be immediately started and done with no interruption until defibrillator access is received. The rescuer starts essential life support by giving 30 chest compressions at a rate of 100/120 compressions per minute, and in adults, it can be given up to a depth of 5 to 6 cm, allowing the chest wall to return to its full height between compressions. It is a cycle of 50 % compression and 50 % release, allowing the chest to recoil fully. The procedure for chest compression involves:
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Allow a person to be on their back. Place the heel of one hand on the lower half of a person’s breastbone (in the middle of the chest).
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Place one hand over the chest or grasp the wrist. One can also interlock the fingers in whichever way they are comfortable.
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Place the arms straight and press down on the chest to one-third of the chest’s depth.
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Release the pressure. This counts as one compression.
3. Clearing the airway by giving two rescue breaths or mouth-to-mouth breathing immediately after chest compressions. It is a cycle of 30 chest compressions and two rescue breaths in two minutes. The steps in giving mouth-to-mouth breathing are:
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Make sure a person is lying on their back with a firm surface.
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Open the airway by tilting their head back and lifting the chin.
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Place the fingers and thumb on both nostrils and close them.
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Gently mouth should be placed on the patient's mouth, fully covering it, and no air should leak out.
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Give two full breaths to the person (this is called rescue breathing).
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Check whether the person’s chest is raised or not.
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If the chest does not rise and fall, tilt the head back, pinch the nostrils, and seal the patient’s mouth to the rescuer’s mouth.
Follow a ratio of 30:2, that is, 30 chest compressions and two rescue breaths in two minutes.
What Are the Drugs Given After Resuscitation?
The choice of drugs that are recommended after resuscitation are:
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Epinephrine is the first choice of drug given after resuscitation. This helps reverse cardiac arrest by increasing the arterial pressure and coronary perfusion during CPR through the alpha-1 adrenoreceptor effect. The first dose of epinephrine decides the rate of restoration of spontaneous circulation (ROSC).
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Other drugs can also be given, such as Atropine sulfate, calcium chloride, Lidocaine, Phenytoin, sodium chloride, etc.
Conclusion:
The above-given details of resuscitation, CPR, mouth-to-mouth breathing, and the need for resuscitation immediately after a cardiac arrest are essential to know in case of emergencies. Cardiac arrest is when the heart stops breathing, the person becomes unconscious, and sometimes even leads to death. Instant resuscitation can reverse the effects of cardiac arrest. This is started by checking whether a person is conscious. The rescuer should give chest compression in the ratio of 30:2, 30 chest compressions followed by two rescue breaths in two minutes. This should be done until the defibrillator is obtained. A defibrillator is a device that sends electric signals or shocks to the heart to regain a normal heartbeat.
Various devices are also used in resuscitation, like valves, masks, defibrillator paddles, ventilation bags, endotracheal tubes, etc.
CPR can also be dangerous sometimes, so it should be done with care, as it can result in the breaking of the ribs of the patient. Although this can still be better than not receiving CPR.
