CPR

Thank you for your time & attention!

Deborah L. Nemetz, MSN, ACNP-BC, WFR

The "Interesting" Stuff...

Terms/ Formulas/ Values

Images Courtesies of:

University of Michigan Plastication Dept

Mayfield Clinic, Cincinnati, OH

American Heart Association

References

A.D.A.M Medical Images

American Heart Association

Samsung Medical Center

American Heart Association

Conclusion

• Carotid Blood flow is indicative of coronary perfusion. This perfusion is necessary for circulation following defibrillation and for adequate cerebral perfusion. Takes 1 minute to recover to plateau levels after compressions are reinstituted.

• Increased intrathoracic pressures r/t positive pressure breaths decrease venous return and subsequently increase in ICP

• Decreased morbidity is dependent on maintaining CbPP of =>70 mmHg. Takes 2 minutes to recover after compressions are reinstituted

Compression Only CPR...

Forget your ABC's and get a CAB

Cerebral Perfusion

• Approximately 2 minutes to achieve CbPP of 70 mmHg

• Mortality increases approximately 20% for each 10 mmHg loss of CbPP

Carotid Artery Blood Flow

Carotid Blood Pressure (CBP)

• CBP Necessary for effective circulation and defibrillation

• Interruptions of compressions = dramatic reduction in carotid blood flow

• 1 minute to recover to plateau levels when compressions are reinstituted.

Intrathoracic Pressure & ICP

• Rescue Breaths actually cause positive pressure within the pleural space leading to increased intrathoracic/pleural pressure (PP).

• Increased PP "H" decreases jugular venous drainage "CVP" leading to increased ICP "B"