Respiratory Therapy Services: Cardio Pulmonary Resuscitation
Cardio Pulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) is a procedure to support and maintain breathing and circulation for an infant, child, or adolescent who has stopped breathing (respiratory arrest) and/or whose heart has stopped (cardiac arrest).
CPR is performed to restore and maintain breathing and circulation and to provide oxygen and blood flow to the heart, brain, and other vital organs. CPR can be performed by trained laypeople or healthcare professionals on infants, children, adolescents, and adults. CPR should be performed if an infant, child, or adolescent is unconscious and not breathing. Respiratory and cardiac arrest can be caused by allergic reactions, an ineffective heartbeat, asphyxiation, breathing passages that are blocked, choking, drowning, drug reactions or overdoses, electric shock, exposure to cold, severe shock, or trauma. In newborns, the most common cause of cardiopulmonary arrest is respiratory failure caused by sudden infant death syndrome (SIDS), airway obstruction (usually from inhalation of a foreign body), sepsis, neurologic disease, or drowning. Cardiac arrest in children over one year of age is most commonly caused by shock and/or respiratory failure resulting from an accident or injury.
CPR is part of the emergency cardiac care system designed to save lives. Many deaths can be prevented by prompt recognition of cardiopulmonary arrest and notification of the emergency medical system (EMS), followed by early CPR, defibrillation (which delivers a brief electric shock to the heart in attempt to get the heart to beat normally), and advanced cardiac life support measures. When performed by a layperson, CPR is designed to support and maintain breathing and circulation until emergency medical personnel arrive and take over. When performed by healthcare personnel, it is used in conjunction with other basic and advanced life support measures.
Intubation, sometimes entubation is the insertion of a tube into an external or internal orifice of the body for the purpose of adding or removing fluids or air. It is sometimes considered synonymous with tracheal intubation, but it can also involve the gastrointestinal tract, as with balloon tamponade with a Sengstaken-Blakemore tube. Intubation into the trachea may be performed through the mouth (orotracheal intubation) or through the nose (nasotracheal intubation). Successful tracheal intubation depends on three requirements:
Correct patient positioning;
Depression of pharyngeal reflex;
Immobilization of the patient.
The highest priority in an emergency is to enable a patient to breathe by securing their airway (passage from the nose and mouth into the lungs). Endotracheal intubation is one of various ways to secure the airway. A Cochrane review, examines whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome and no difference was found between endotracheal intubation and other airway securing strategies for reducing deaths after acute illness or injury.