DEALING WITH CARDIAC ARREST

Cardiac arrest is an emergency which will often repond to appropriate treatment if this is given within approximately five minutes, after which irreversible cerebral damage occurs. The development of the technique of closed-chest cardiac massage (sometimes described as external cardiac massage) together with mouth to mouth artificial respiration has greatly improved the prognosis of cardiac arrest. Hence doctors, nurses, ambulance drivers and attendants should all receive instruction in this vitally important form of first aid.

The most frequent causes are anaesthesia, surgical operations, special diagnostic procedures, drug sensitivity or toxicity, myocardial infarction, heart block and electrocution.

Cardiac arrest may be due to ventricular asystole or ventricular fibrillation, but these two conditions can only be distinguished by electrocardiography or by direct inspection of heart.

The diagnosis is based on the absence of the pulse in the carotid or femoral artery, and of the heart sounds on auscultation.

The iimediate objective of the treatment is to restore an oxygenated blood supply to the brain and to the heart muscle, and for this purpose the following actions should be taken immediately.

Give a smart blow to the chest with fist and elevate both legs to 90^o for 15 seconds. If the heart does not start beating immediately, as indicated by the return of the carotid or femoral pulse, cardiopulmonary resuscitation must be started.

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