Sudden Cardiac Death (SCD) - Management

Dateline: 11/08/98

Have you read my previous article on SCD syndrome - Sudden Cardiac Death - Detection ?

How to manage a cardiac arrest victim ?

Management of the cardiac arrest victim is divided into five elements:

1. the initial response
2. basic life support
3. advanced life support and definitive resuscitative efforts
4. post-cardiac arrest care
5. long-term management

Of these, the first (initial response) can be applied by a broad population base including physicians, nurses, paramedics, emergency rescue technicians and LAY-PEOPLE (that means YOU, my friend) educated in bystander intervention.

What to do when you see a person having a cardiac arrest ?

First of all, confirm that collapse is indeed due to cardiac arrest. Here's what to do

1. Observe for respiratory movements and skin color
2. Feel for pulsations over major arteries (carotid in the neck, femoral in the groin)

A few seconds' observation will let you form an impression. The absence of pulses, no respirations and a pale or intensely cyanotic (blue) skin color are suggestive of cardiac arrest.

The next step involves taking immediate initial efforts. Here's what to do next

• Thumpversion - deliver one or two firm blows to the chest. The blows should be to the mid and lower parts of the breastbone, from a height of 8 to 10 inches. If a spontaneous pulse and breathing are not resumed immediately, stop.
• Clearing the airway - tilt the head backwards, lift up the chin, look for dentures or other foreign bodies that could block the airways and remove them. If a foreign body blocking the airway is suspected, the Heimlich maneuver is performed.

Basic Life Support

The goals here are to maintain function of the heart, brain and other vital organs until definitive intervention can be achieved. These procedures too can be carried out by emergency technicians and educated laypeople.

• Mouth to mouth respiration to maintain oxygenation
• Chest compression to mimic heart action of blood circulation

Recommended Reading :

Sudden Cardiac Death in the Community
Mickey S. Eisenberg / Hardcover / Published 1984
Buy it from Amazon.com. Visit the Heart Bookstore for more titles on SCD.

You can read more about basic life support systems from other sections of this site.

To learn more about Sudden Cardiac Death syndrome, read the next article in this series.