What Causes The Stomach To Inflate In CPR?
Gastric Distention. During rescue breathing or CPR, air may enter the casualty's esophagus (the tube leading from the throat to the stomach) and cause the stomach to inflate. This condition is called gastric distention. Oct 30, · case report describing gastric rupture after use of the laryngeal mask airway (LMA) during cardiopulmonary resuscitation (CPR). There is a potential risk of gastric inflation with all recommended airway and ventilation techniques during CPR. Positive pressure ventilation via a LMA can cause gastric inflation, particularly if the LMA is not positioned.
Cardiopulmonary resuscitation, or CPR, is a technique used to support the circulation of blood and oxygen in the body of a victim who is not breathing and does not have a pulse. CPR is physically invasive for the victim and techniques used during CPR carry risks and the chance of complications 2. Ultimately, the risk of complications is small and should not deter the use of CPR for a victim in cpg. Rib fractures are wat most common complication of CPR.
Chest compressions administered during CPR are given quickly and with enough force to compress the chest about 1 inch in depth. This provides pressure to the ribs, which can be strong enough to cause ribs to fracture. Victims who are elderly, small in stature or caues have the highest risk of developing rib fracture during chest compressions. Additionally, the chest bone, or sternum, also endures pressure and stress during chest compressions and can fracture as well.
Internal organs lie within the area pressured by chest compressions. As the chest is compressed during CPR, ribs and chest bones can break, puncturing the lungs and liver 2. Additionally, internal bruising of the heart and liver can occur. As chest compressions are administered, pressure builds inside the body, which can force stomach contents up the esophagus and result in vomiting. This causes the risk of aspiration, or absorbing the vomit into the respiratory system.
Aspiration is a serious complication which makes it difficult to provide the victim with adequate air and can ultimately damage what can cause gastric inflation when giving cpr tissue or result in infection, like pneumonia. CPR presents the risk of exposure to body fluids. Providing mouth-to-mouth rescue breathing to a victim without use of a mask results in saliva exposure between victim and rescuer.
The American Heart Association encourages the use of a barrier mask when administering rescue breathing during CPR for protection against contamination. Rescue breathing during CPR what is the role of education air directly into the lungs of the victim. If gastrix is delivered too forcefully or for too long a time, the victim can accumulate air build-up in the stomach, called gastric distention.
Gastric distention causes the stomach to swell and places pressure on the lungs. CPR efforts can become complicated if gastric distention occurs due to reduced ability to deliver adequate oxygen to the lungs, fastric can also result in vomiting and aspiration.
Gastric distention can often be avoided by proper, careful administration of rescue breathing during CPR. Elizabeth Otto has been writing professionally since She is a licensed emergency medical technician-intermediate with over 10 years of experience in the field. She has worked as a what can cause gastric inflation when giving cpr assistant in family health and emergency medicine since Otto is a freelance writer for various websites and holds an How to pass level 165 on candy crush saga of Science in medical assisting from Commonwealth College.
Monitor the health of what is a synonym for emerged community here. More Articles. Written by Elizabeth Otto. Hands-only CPR.
1. Gastric Inflation
Positive pressure ventilation via a laryngeal mask airway can cause gastric inflation, particularly if the airway is not positioned correctly and if the inspiratory pressure exceeds 20 cm H2O. Most gas leaking from the airway escapes into the pharynx to exit through the mouth. If the stomach inflates during a CPR, it could mean that the air has entered the stomach. This is not a good sign, call for professional medical help or an ambulance immediately. The person performing the CPR should always blow into the mouth slowly and gently. May 01, · Gastric inflation may contribute to gastric regurgitation with resultant aspiration, which was observed in 12% of subjects resuscitated for cardiac arrest where a bag-valve-mask was used to provide ventilatory support. 5 The objective of the predictive model presented by Dr Fitz-Clarke aimed to improve the understanding of the optimal bag-valve-mask and mouth-to-mouth ventilation technique to provide a mouth pressure and breath duration that will limit gastric inflation .
At some point in your career, you have probably dealt with a patient who was hyperventilating. This is generally referred to as respirations greater than 20 per minute.
When respirations become much faster than that, oxygen levels drop and your patient begins to feel lightheaded or dizzy. However, even when your patient cannot control his own respirations, such as during or after a code, he may still be hyperventilating due to rescuer attempts.
There are three main reasons why you should guard against excessive ventilation during ACLS, and one key thing that you should do instead. While gastric inflation is probably not your biggest concern during a patient code, it is one that can have eventual consequences.
Too much air in the stomach can lead to the expulsion of gastric contents, some of which could get into the lungs and lead to severe infection. In fact, some studies have looked at how this may even affect hemodynamic and pulmonary function over time. While additional studies could still be done to look at larger sectors of the population, initial findings show that there is definitely a negative effect from this.
While some of the air from excessive ventilation makes its way into the gastric organs, some of it can also cause significant problems in the thoracic cavity. When there is increased pressure in the lungs from too much air, the patient can suffer from decreased coronary perfusion. Obviously, if the heart muscle is unable to get enough oxygen, it will no longer be able to function well.
In fact, studies have shown that decreased survival rates are a direct result of this issue. If you have ever had a patient on a mechanical ventilator, you are probably familiar with the process of drawing blood gases regularly so that you can determine whether the patient is well oxygenated or whether his blood is becoming acidic from too much carbon dioxide.
Much as you or the respiratory therapist would adjust ventilator settings to deal with any problems seen on these blood gases, you must consider the same options when your patient is coding. A patient whose blood gases are too acidic can have significant issues with brain function.
Because of these concerns with excessive ventilation during CPR, the American Heart Association has modified its recommendations to state that respirations for a patient who is coding should be limited to only 12 to 16 per minute rather than the higher amount that was previously recommended.
In addition, they have prioritized cardiac support measures over ventilation, knowing that not only are these recommendations far easier to carry out for most individuals, but also they will lead to the best possible results.
Of course, in the hospital setting when you have plenty of first responders, you will be able to focus on both chest compressions as well as ventilation.
If you are responsible for giving rescue breaths with a bag-valve mask, be sure to count carefully so that you can rest assured that you are giving the correct number of respirations per minute.
Make sure your ACLS certification is up-to-date, reducing the chances over over-ventilation. The health and safety of our employees, instructors, students, and communities are our top priority. Project Heartbeat will remain open and continue to serve you during this challenging time. Due to the COVID 19 global pandemic, We have implemented CDC requirements for social distancing, additional disinfecting, and have modified the structure of our courses for the safety of our students and staff.
If you are sick or cannot attend your class for any reason please do not hesitate to contact us at —, ext 0 and we will be happy to accommodate you in a future class at no additional cost. Previous Next. Gastric Inflation While gastric inflation is probably not your biggest concern during a patient code, it is one that can have eventual consequences.
Decreased Cardiac Output While some of the air from excessive ventilation makes its way into the gastric organs, some of it can also cause significant problems in the thoracic cavity. Altered Blood Gases If you have ever had a patient on a mechanical ventilator, you are probably familiar with the process of drawing blood gases regularly so that you can determine whether the patient is well oxygenated or whether his blood is becoming acidic from too much carbon dioxide.
Focus on Cardiac Support Measures Because of these concerns with excessive ventilation during CPR, the American Heart Association has modified its recommendations to state that respirations for a patient who is coding should be limited to only 12 to 16 per minute rather than the higher amount that was previously recommended. Facebook Twitter LinkedIn Email. About the Author: Project Heartbeat. Go to Top.