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Emergency Medicine Part 9: Cardiac Arrest
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Cardiac arrest occurs when the heart ceases to pump blood. The victim – unconscious, not breathing, and with no blood pressure – will die unless effective resuscitative efforts are commenced immediately. This program discusses the recognition and management of cardiac arrest emphasizing the importance of basic life support (CPR) and defibrillation (AED) in improving the chances for a successful outcome.


Learning Objective:

  1. Discuss survival rates for out-of-hospital sudden cardiac arrest in adults and in children
  2. List and describe the steps of the BLS-HCP algorithm (the ‘Chain of Survival’)
  3. Explain the rationale behind the change in technique of BLS from A-B-C to C-A-B
  4. Name the ‘shockable’ rhythms of cardiac arrest
  5. Name the 4 rhythms of cardiac arrest
  6. Discuss the automated external defibrillator (AED)


More than 360,000 deaths from sudden cardiac arrest occur in the United States annually – approximately 1,000 every day. The causes of cardiac arrest, in both adult and pediatric patients, are reviewed along with the presenting premonitory signs & symptoms that lead to sudden cardiac arrest.  Management of cardiac arrest – the successful resuscitation of the victim without brain damage – is predicated on circulating blood containing oxygen to the heart and brain and delivering an electric shock (defibrillation) as soon as possible after collapse. The use of an AED and its mechanism of action is discussed.


  1. Introduction
    1. The Heart
      1. Function of the heart is to pump
      2. Coronary arteries
        1. Coronary artery disease
    2. What is a ‘heart attack’?
      1. Myocardial infarction versus cardiac arrest
  2. Acute myocardial infarction
  3. Management
    1. Classical signs & symptoms
    2. Pre-hospital management
      1. PCAB
      2. MONA
    3. Acute MI dysrhythmias
      1. PVCs signs & symptoms
  4. Sudden cardiac arrest
    1. When does AMI degenerate into SCA?
    2. Definition of cardiac arrest
    3. Cardiac arrest rhythms
      1. Shockable rhythms
        1. Ventricular tachycardia
        2. Ventricular fibrillation
      2. Non-shockable rhythms
        1. Asystole
        2. Pulseless electrical activity (PEA)
    4. Signs & symptoms of cardiac arrest
      1. Clinical death
      2. Biological (cellular) death
    5. Management of cardiac arrest
      1. PCABD
      2. Survival from cardiac arrest
        1. The importance of time
        2. The importance of bystander initiated BLS
        3. The importance of defibrillation
      3. 2010 American Heart Association algorithms for BLS
        1. Lay-person CPR
        2. Heathcare Provider CPR
        3. Review of BLS for Healthcare provider guidelines and changes from previous guidelines
      4. Defibrillation
        1. The importance of time from collapse to defibrillation
        2. AEDs
          1. How to use an AED
          2. How an AED works
    6. Pediatric cardiac arrest
      1. Etiologies
        1. Airway obstruction most common cause in younger children
      2. Prevention of pediatric cardiac arrest


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