CPR with Defibrillation – Life-Saving Intervention 🚑⚡

What CPR?
The 2025 American Heart Association (AHA) Guidelines define CPR (Cardiopulmonary Resuscitation) as a lifesaving technique that combines chest compressions and ventilations to maintain blood circulation and oxygenation during cardiac arrest. The updated guidelines emphasize high-quality compressions, early defibrillation, and system-wide readiness to improve survival outcomes

🔹 Why Use Defibrillation?
Defibrillation is essential in sudden cardiac arrest (SCA) due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). It delivers an electrical shock to reset the heart rhythm.

🔹 Which Concept?
AHA- CAB
Malaysia-DRABCD or DRSABCD
DR-CAB

How
CPR & Defibrillation Sequence (AHA 2020 Guidelines)

1️⃣ D-Danger: Check for Danger & Response (Ensure safety)
2️⃣ R-Respond: Check (-ve) response and Call for Help & Get an AED (Activate emergency response)
3️⃣ C-Compression: Check pulse (-ve) Start CPR (CAB Sequence)

Compressions (30) – Hard & fast at 100-120 bpm
4️⃣A-Airway – Open airway, clear airway- rescue breath interval (6 second)
5️⃣Breathing (2 breaths) – Use bag-valve mask if available

if any available
Apply Defibrillator (AED/Manual Defibrillator)
Attach pads to the patient’s chest
Analyse rhythm (Shockable = VF/VT)
Deliver shock if indicated
Immediately resume CPR for 2 minutes before rechecking rhythm
Continue CPR & Repeat Defibrillation if needed until ROSC.

ROSC (Return of Spontaneous Circulation) or emergency team takes over.
🔹 Key Points
✅ Shockable rhythms – VF/VT
✅ Non-shockable rhythms – Asystole/PEA (continue high-quality CPR)
✅ Minimise interruptions – Resume CPR immediately after shock (improve blood circulations)

💡 Early CPR + Early Defibrillation = Higher Survival Rates! Keep training, keep saving lives! 💙

INFO: In AHA 2020 guidelines, CPR is usually stopped when a pulse is detected. However, in clinical practice, if the no pulse and blood pressure is critically low (e.g., 19/5 mmHg), reason BP due to mechanical response not due to biological response

Continuing CPR may be considered if no pharmacological support is in place to improve circulation. The goal is to ensure adequate perfusion until cardiac output stabilizes.

MADAM YY
Cardiac Nursing
MALAYSIA