ECC, also known as Emergency Cardiovascular Care covers the areas of Basic Life Support and Advanced Cardiac Life Support. Before, the sequence of ABC or Airway, Breathing and Circulation are followed. But with 2010 update from the American Heart Association, they revised it to CAB in which they emphasized the sequence of ventilation, oxygenation and defibrillation along with well performed chest compressions.
Basic Life Support
Bsic Life Support is the foundation of Advanced Cardiac Life Support. Therefore a well performed BLS results in good ACLS and PALS (pediatric advanced life support).
1. Assess the victim’s ability to respond by shaking the victim and shout to get his or her attention. If the victim is unresponsive, check if the victim is breathing. If not, determine what type of cardiac arrest as you expect. Call for professional emergency medical services through the local emergency hotline and obtain an automated external defibrillator also known as an AED.
2. After assessing and activating the EMS. Check for the carotid pulse for 5 to 10 seconds.
3. If there is pulse but no breathing, proceed to provide rescue breaths. The rescue breaths are delivered at a rate of one breath for every 5 to 6 seconds (10 to 12 breaths per minute). If pulse is absent, start doing chest compressions, and if there is a pulse but it is weak and thready, still provide chest compressions to maintain adequate perfusion. The compressions need to be hard, fast and deep with minimum interruptions. Position yourself directly over the victim’s chest while keeping your arms straight and elbows locked using the weight of your body for chest compression. The chest compressions are delivered at a rate of 100 per minute and interruptions are kept to a minimum to increase better chances for ROSC (return of spontaneous circulation).
Advanced Cardiac Life Support
1. The assessment of the patient is important. It should be organized since the information that is gathered during assessment is essential to making good treatment plans. Avoid placing the electrode pads on top of other devices to prevent alterations of data. Look for medication patches; these may cause burns while there are implanted defibrillators under the patient’s skin.
2. Use a bag- mask and use an advanced airway if rescue breathing is not enough. If endotracheal tube placement is decided, use waveform carnography to confirm and monitor the ET tube placement.
3. Support ventilation and provide adequate oxygen administration
4. Monitor cardiopulmonary quality
5. Attach and monitor a defibrillator
6. Provide cardioversion
7. Establish intravenous access
8. Give the appropriate pharmacologic medications
The american heart association emergency cardiovascular care emphasizes the performance of high quality chest compressions during emergency care. The first 6-10 minutes of providing CPR to the cardiac arrest victim are critical for the victim’s chances of survival. These guidelines guide every health care provider as well as those basic life support and advanced cardiac life support providers for them to provide quality and effective emergency cardiovascular care.