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Resuscitation

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The resuscitation department is part of the Cardiology Service and teaches health care professionals the most effective methods of resuscitation appropriate to their own needs.

The Resuscitation Department’s aims are to:

  • encourage research into methods of resuscitation
  • study resuscitation teaching techniques
  • establish appropriate guidelines for resuscitation procedures
  • promote the teaching of resuscitation as established by the New Zealand Resuscitation Council
  • establish and maintain standards for resuscitation
As a department, it also coordinates and provides the following educational opportunities and courses:

  • C.O.R.E (certificate of resuscitation and emergency care) - mandatory training for all clinical staff on the cardiac arrest team.
  • Paediatric Life Support – mandatory training for all clinical staff who care for/treat children
  • New born course
  • Trauma extension course
  • Core skills

 

Community Defibrillator Project


Why is MidCentral DHB putting defibrillators in the community?

A casualty’s survival from sudden cardiac arrest is directly related to the time from collapse to defibrillation. If a defibrillator can be used in the community while an ambulance is on its way, survival rates can be improved dramatically. There is a vast body of international evidence that supports early use of defibrillation, and public access defibrillators are common in both the US and Europe.


How were the locations selected?
The defibrillators need to be placed in a location that is both secure and accessible, and consideration was also given to the location of existing defibrillators within the region. Proximity to population centres and high foot-traffic areas was an important factor.
 
What is sudden cardiac arrest?
Sudden cardiac arrest simply means that the heart unexpectedly and abruptly stops beating. This is usually caused by an abnormal heart rhythm called ventricular fibrillation (VF).
 
Is sudden cardiac arrest the same as a heart attack?
No. A heart attack is a condition in which the blood supply to the heart muscle is suddenly blocked, resulting in the death of the heart muscle. Heart attack casualties usually (but not always) experience chest pain and usually remain conscious. Heart attacks are serious and sometimes can lead to sudden cardiac arrest. However, sudden cardiac arrest may occur independently from a heart attack and without warning signs. Sudden cardiac arrest results in death if not treated immediately.
 
Who is at risk for sudden cardiac arrest?
While the average age of sudden cardiac arrest casualties is about 65, sudden cardiac arrest is unpredictable and can strike anyone, anywhere, anytime.
 
What is ventricular fibrillation?
Ventricular fibrillation (VF) is an abnormal heart rhythm often seen in sudden cardiac arrest. This rhythm is caused by an abnormal and very fast electrical activity in the heart. VF is chaotic and unorganized; the heart just quivers and cannot effectively pump blood. VF will be short lived and deteriorate to asystole (a flat line) if not treated promptly.
 
How is ventricular fibrillation treated?
The only effective treatment for VF is an electrical shock called defibrillation. Defibrillation is an electrical current applied to the chest. The electrical current passes through the heart with the goal of stopping the VF and giving an opportunity for the heart's normal electrical system to take control. This current helps the heart reorganize the electrical activity so it can pump blood again. An automatic external defibrillator (AED) can defibrillate the heart.

What is a defibrillator?
A defibrillator is a device that analyzes and looks for shockable heart rhythms, advises the rescuer of the need for defibrillation, and delivers the defibrillation shock if needed.
 
What's the difference between the public access defibrillators and the defibrillators that are shown on TV?
The defibrillators often shown on TV are called "manual defibrillators." A manual defibrillator is not "automatic" the defibrillator does not interpret the need for defibrillation. Trained medical personnel interpret the heart's rhythm and make the decision whether to shock the casualty or not. The shock can be delivered by the use of paddles or defibrillation pads.
 
Can a collapsed casualty be hurt by use of the defibrillator?
When used on people who are unresponsive, not breathing, the defibrillator is extremely safe. The defibrillator makes shock-delivery decisions based upon the casualty's heart rhythm, and will not allow a shock to be delivered if not needed. The machine will not let you shock a non-shockable rhythm. If the casualty meets the criteria; unresponsive, not breathing, they are essentially "dead".  Since the casualty is already dead, anything a rescuer does (i.e., using a defibrillator, starting CPR) can only help the casualty.
 
Should a rescuer provide CPR first or apply the defibrillator?
Do CPR until the defibrillator arrives. The electrodes should be applied to the casualty's bare chest and the voice prompts and messages given by the defibrillator should be followed. It will advise when to resume CPR.

CPR is a holding action until the heart is defibrillated.
 
If defibrillation is so important, why do CPR?
CPR provides some circulation of oxygen rich blood to the casualty’s heart and brain. This circulation delays both brain death and the death of heart muscle. CPR buys some time until the defibrillator can arrive and also makes the heart more likely to respond to defibrillation.
 
Can another rescuer be shocked?
Automatic external defibrillators are extremely safe when used properly. The electric shock is programmed to go from one pad to another through the casualty’s chest. Basic precautions, such as verbally warning others to stand back and visually checking the area before and during the shock, will ensure the safety of rescuers.
 
Will early defibrillation always be effective?
Unfortunately, because of other underlying medical or heart problems, not all casualties of cardiac arrest who are in VF will survive even if defibrillation is done promptly and correctly.

What if all the steps of CPR and defibrillation aren’t performed perfectly?
A cardiac arrest is a high stress situation. Even experienced health care providers do not do everything perfectly. In a cardiac arrest, performing CPR, even imperfectly, and using a defibrillator can only help the casualty.
 

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