Cardiac standstill

Description:

It is a sudden stop of effective blood circulation which combines such concepts as an asystolia, fibrillation of ventricles and electromechanical dissociation.

Cardiac standstill reasons:

Origins of a cardiac standstill are divided into 2 groups: the cardial and extra cardial, i.e. not tied with problems hearts.
Cardial reasons:
1. Various nature of injury of a myocardium
2. Cardiac tamponade
3. All forms of coronary heart disease
4. Spasm of coronary vessels
5. Arrhythmias
6. Disturbances of electrolytic balance
7. Damage of the valve device of heart
8. Endocarditises and myocardites of infectious genesis
9. Thromboembolism of a pulmonary artery
10. Injuries of an aorta in the form of aneurism

Carry to the cardiac standstill reasons which are not connected with cardiac pathology:
1. Hypoxemic damages
2. Depressed cases
3. Cardiac standstill of reflex character
4. Heart injuries
5. Poisonings
6. Embolisms of an extracardiac origin

Cardiac standstill symptoms:

Such symptoms as are characteristic of a cardiac standstill:
- lack of pulse on carotid arteries. The carotid artery is palpated by an index and long finger on the side surface of a neck between a throat and muscles.
- an apnoea which is observed already several seconds later after a cardiac standstill
- expansion of pupils is observed 1,5 minutes later after a cardiac standstill.

Treatment of the Cardiac standstill:

First aid includes an outside cardiac massage and an artificial respiration which is carried out on methods 2:30, i.e. on each 2 artificial breaths carry out 30 rhythmical deep pressing a thorax. If the cardiac standstill is caused by fibrillation of a ventricle, carrying out a defibrillation is shown. The probability of a successful defibrillation decreases over time, approximately by 2 — 7% every minute, but first aid slows down this process, removing development of an asystolia.

Indirect cardiac massage and emergency defibrillation. Its use without preliminary ECG control is justified by the fact that more than in 90% of cases the cardiac standstill reason — fibrillation of ventricles:
• the adult it is consecutive: 4,5–5,5–7,5 kV (200, 300 or 360 J);
• to children: on condition of good contact with the surface of a thorax apply electrodes of the largest sizes (not only nurseries). At first the defibrillation is carried out by the category of 2 J/kg, then it is increased to 4 J/kg.
• artificial ventilation of the lungs (Ambu's bag, hardware breath);
• 100% oxygen by means of a mask or through an endotracheal tube;
• Catheterization of the central veins;
• Emergency medicinal treatment which is carried out путес administrations  of lidocaine atropine and Epinephrinum — it is possible to enter through an endotracheal tube from 10 ml 0,9% of solution of sodium of chloride or sterile water, or in/in, it is better to enter into the central venous catheter, Epinephrinum of 1 ml = 1 mg (at cultivation 1:1000) 0,1 ml = 0,1 mg (at cultivation 1:10 000).