Cardiac arrest involves sudden stoppage of the heart with compromise to the circulation and normal breathing and may lead to sudden death if not managed meticulously. In the case of a cardiac arrest, cardiopulmonary resuscitation should be as fast as possible to save the vital areas. It is necessary for all rescuers to understand the anatomy and pathophysiology of cardiac arrest so as to be able to save lives. Chest compression refers to the technique of restoring the cardiac activity manually in case of heart attack or cardiac arrest. The purpose of this manoeuvre is to restore normal cardiac rhythm necessary for adequate perfusion of tissues. This essay will discuss the effect of chest compression in the management of patients or victims of cardiac arrest.

Anatomy involved

Chest compression involves multiple anatomical structures. Importantly, it involves all the systems significant in oxygenation of tissues. The three systems involved are the respiratory system, the cardiovascular system and the nervous system. The respiratory system involves the airways, the ribcage and the attached intercostal muscles. The cardiovascular system includes the heart and the blood vessels that supply the lungs while the nervous system involve the nervous system that supply the above structures that sense (Tortora & Derrickson, 2008).

Pathophysiology of Cardiac Arrest

Cardiac arrest involves sudden stoppage or cessation in cardiac activity resulting to hemodynamic collapse. Typically, this is due to sustained ventricular fibrillations or tachycardia. Other common conditions that lead to cardiac arrest include myocardial infarction, brain hemorrhage, severe multiple traumas or severe electrolyte imbalance in the body. Following arrest, the blood flow is altered with less than 30 % delivery to the lungs. Consequently, the amount of oxygenated blood circulating in the body system decrease leading to death of vital organs like brain, heart and kidneys. If not arrested early, the brain may die within six second due to hypoxia. Chest compression is, therefore, meant to increase oxygen delivery to the vital centers before the definitive treatment measure is put in place.

Risk factors

Sudden cardiac arrest is mostly associated with coronary heart disease. Therefore, any condition that predisposes one to coronary disease may be a risk factor to cardiac arrest. These factors include old age, diabetes, and obesity, high blood pressure, smoking sedentary lifestyle, high blood cholesterol and familiar history of coronary disease. Another factor that may predispose one to a heart attack is a previous history of cardiac arrest, hypokalemia, hypocalcaemia, drug abuse like cocaine and amphetamines, and genetic factors.

During chest compression, various risks may be associated with inadequate compression. The factors may be structural or physiological. Anatomical risk factors for inadequate chest compression include narrowing of the airways, rigid bones that may be associated with bone diseases or blockage of the airways with foreign bodies. Functional risk factors that would deter compression include poor position of the airway during CPR, or leaking mas. In addition, the extremes of age may complicate chest complications. Obesity also may compromise chest compression (Field, et al 2010; Nolan, et al 2010).

Signs and symptoms

Cardiac arrests often occur suddenly and immediately. Some of the symptoms of sudden cardiac arrest are unconsciousness, loss of pulse, loss of breath and sudden collapse. Other symptoms that precede a heart attack include a characteristic severe chest pain that may be misdiagnosed for angina and that may be radiating to the left arm and in some instances both arms, the jaws neck or abdomen anxiety characteristic of a panic attack (Field, et al 2010)

Treatment

The management of cardiac arrest can be classified into two: Pre-hospital and hospital management (Bohm, Rosenqvist, Herlitz, Hollenberg & Svensson, 2007). Pre hospital management is done to patients who collapse in the community where civilians are mostly the people offering the care. It is the first support the patient get before arriving at the hospital for definitive management. The first step during a cardiac arrest is to initiate breathing and restore normal heart activity (SOS-Kanto Study Group, 2007). This is usually done by performing a cardiopulmonary chest compression (CPR). CPR involves giving chest compression and breaths interchangeably until the victim can breathe spontaneously. The recommended ratio of breaths and compression for the adult is usually 30 breaths and 2 compressions in every 30 seconds for the first 2 minutes. In children chest compression to breaths is done at ratio of 15:2 or 20:2 depending with the age and response (Lloyd, et al., 2010).

In a hospital setting, defibrillators and drugs may be used to enhance resuscitation. Drugs are, however, of secondary necessity while defibrillation and resuscitation are primary. After starting CPR and defibrillation, the health care provider should establish an intravenous access for the patient through which the drugs are given. Among the common drugs used during resuscitation in the management of cardiac arrest includes atropine, epinephrine, lidocaine and vasopressin and naloxone (Field, et al 2010; Nolan, et al 2010).