Cardiac Arrest: Difference between revisions

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''Sébastien Krul, MD, Jonas de Jong, MD''
''Sébastien Krul, MD, Jonas de Jong, MD''


{{DevelopmentPhase}}
=Introduction=  
=Introduction=  
Survival of cardiac arrest continues to be very poor. In-hospital cardiac arrest has a survival to hospital discharge of 17,6% all rhythms<cite>Meaney</cite>. Out-of-hospital cardiac arrest has a worse survival with 10,7% survival to hospital discharge for all rhythms.<cite>Atwood</cite> Survival is dependent on the characteristics of the cardiac arrest (rhythm), on the patient’s medical history, and the time between the cardiac arrest en start of resuscitation.<cite>Waalewijn, Holmberg1, Holmberg2</cite> The introduction of the automated external defibrillator (AED) has dramatically increased survival of out-of-hospital cardiac arrest victims.<cite>ESC, Nolan1</cite> In this chapter we give an overview of basic life support (BLS) and advanced life support (ALS) based on the recommendation of the European Resuscitation Council Guidelines for Resuscitation 2010.
Survival of cardiac arrest continues to be very poor. In-hospital cardiac arrest has a survival to hospital discharge of 17,6% all rhythms<cite>Meaney</cite>. Out-of-hospital cardiac arrest has a worse survival with 10,7% survival to hospital discharge for all rhythms.<cite>Atwood</cite> Survival is dependent on the characteristics of the cardiac arrest (rhythm), on the patient’s medical history, and the time between the cardiac arrest en start of resuscitation.<cite>Waalewijn, Holmberg1, Holmberg2</cite> The introduction of the automated external defibrillator (AED) has dramatically increased survival of out-of-hospital cardiac arrest victims.<cite>ESC, Nolan1</cite> In this chapter we give an overview of basic life support (BLS) and advanced life support (ALS) based on the recommendation of the European Resuscitation Council Guidelines for Resuscitation 2010.
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==Preventing in Hosptial Cardiac Arrest==
==Preventing in Hosptial Cardiac Arrest==
[[File:MEWS.svg|thumb|500px|right|'''Figure 2.''' An example of a MEWS<cite>IHI</cite>.]]
[[File:MEWS.svg|thumb|500px|right|'''Figure 2.''' An example of a MEWS. Adapted from: <cite>IHI</cite>.]]
The best way to prevent sudden death is to early detect deterioration of a patient and to act on early warning signs.<cite>Smith</cite> Cardiac arrest is rarely unpredictable and is precipitated by a slow deterioration.  An early warning score (Figure 2) helps to create consensus among care providers about the sickness of a patient.<cite>Hodgetts, Hillman</cite> If the summed score reached a certain threshold, a doctor should be notified. The notified doctor should assess the patient within 30 minutes and discuss a treatment plan. If the patient does not improve within 60 minutes a reassessment should follow with possible inclusion of a medical emergency team (MET) or intensive care specialist.<cite>Bellomo</cite>
The best way to prevent sudden death is to early detect deterioration of a patient and to act on early warning signs.<cite>Smith</cite> Cardiac arrest is rarely unpredictable and is precipitated by a slow deterioration.  An early warning score (Figure 2) helps to create consensus among care providers about the sickness of a patient.<cite>Hodgetts, Hillman</cite> If the summed score reached a certain threshold, a doctor should be notified. The notified doctor should assess the patient within 30 minutes and discuss a treatment plan. If the patient does not improve within 60 minutes a reassessment should follow with possible inclusion of a medical emergency team (MET) or intensive care specialist.<cite>Bellomo</cite>


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