RCP(RESSUCITAÇÃO)

4. Parada Cardíaca

Quando o coração pára de bombear sangue para o organismo, as células deixam de receber oxigênio. Existem órgãos que resistem vivos, até algumas horas, porém, os neurônios do sistema nervoso central (SNC) não suportam mais do que seis minutos sem serem oxigenados e entram em processo de necrose. Desta forma, a identificação e a recuperação cardíaca devem ser feitas de imediato. Caso haja demora na recuperação cardíaca, o SNC pode sofrer lesões graves e irreversíveis, e a vítima pode, até mesmo, morrer.

4.1. Identificação

4.2. Tratamento

O socorrista deverá iniciar a massagem cardíaca externa o mais cedo possível.rcp1.jpg Para realizá-la deve:

rcp2.jpg

 

Somente a região hipotenar da palma da mão toca o esterno da vítima, evitando-se, dessa forma, pressionar as costelas.

Em consequência da massagem,o esterno, em vítima adultas, deverá ser deslocado para baixo entre 4 e 5 cm.rcp4.jpg

 

Em crianças, com idade entre 1 a 8 anos, a pressão deve ser exercida com apenas uma das mãos, e o esterno deve ser deslocado entre 2,5 a 4 cm.

Em bebês, com idade variando de 0 a 1 ano, a pressão é realizada com dois dedos, posicionando-os na intersecção do osso esterno com uma linha imaginária ligando os mamilos, fazendo o esterno ser deslocado de 1 a 2,5 cm. rcpbb.jpg

Nos casos de parada respiratória e cardíaca simultâneas, deve-se intercalar a respiração artificial com a massagem cardíaca, método conhecido como Reanimação Cardio-Pulmonar ou RCP, do seguinte modo:

CONFORME A GUIDELINES2005 DA ASSOCIAÇÃO AMERICANA DO CORAÇÃO

4.3.Não Ocorre RCP em Casos de sinais evidentes:

  • decapitação

  • calcinação

  • putrefação

  • rigidez cadavérica

  • manchas hipostáticas

TEXTO ORIGINAL

http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-12?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=infants+newborn+CPR&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

Sequence
If more than one person is present at the scene of a cardiac arrest, several actions can occur simultaneously. One or more trained rescuers should remain with the victim to begin the steps of CPR while another bystander phones the emergency response system and retrieves an AED (if available). If a lone rescuer is present, then the sequences of actions described below are recommended. These sequences are described in more detail in Part 4: "Adult Basic Life Support," Part 5: "Electrical Therapies," and Part 11: "Pediatric Basic Life Support."

For the unresponsive adult, the lay rescuer sequence of action is as follows:

  • The lone rescuer should telephone the emergency response system and retrieve an AED (if available). The rescuer should then return to the victim to begin CPR and use the AED when appropriate.
  • The lay rescuer should open the airway and check for normal breathing. If no normal breathing is detected, the rescuer should give 2 rescue breaths.
  • Immediately after delivery of the rescue breaths, the rescuer should begin cycles of 30 chest compressions and 2 ventilations and use an AED as soon as it is available.

For the unresponsive infant or child, the lay rescuer sequence for action is as follows:

  • The rescuer will open the airway and check for breathing; if no breathing is detected, the rescuer should give 2 breaths that make the chest rise.
  • The rescuer should provide 5 cycles (a cycle is 30 compressions and 2 breaths) of CPR (about 2 minutes) before leaving the pediatric victim to phone 911 and get an AED for the child if available. The reasons for immediate provision of CPR are that asphyxial arrest (including primary respiratory arrest) is more common than sudden cardiac arrest in children, and the child is more likely to respond to, or benefit from, the initial CPR.

In general, the rescue sequence performed by the healthcare provider is similar to that recommended for the lay rescuer, with the following differences:

  • If the lone healthcare provider witnesses the sudden collapse of a victim of any age, after verifying that the victim is unresponsive the provider should first phone 911 and get an AED if available, then begin CPR and use the AED as appropriate. Sudden collapse is more likely to be caused by an arrhythmia that may require shock delivery.
  • If the lone healthcare provider is rescuing an unresponsive victim with a likely asphyxial cause of arrest (eg, drowning), the rescuer should provide 5 cycles (about 2 minutes) of CPR (30 compressions and 2 ventilations) before leaving the victim to phone the emergency response number.
  • As noted above, the healthcare provider will perform some skills and steps that are not taught to the lay rescuer.