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Cardiac Arrest: Difference between revisions
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===Tachycardia=== | ===Tachycardia=== | ||
==Special circumstances== | ==Special circumstances== | ||
In all circumstances the normal protocol for BLS and ALS is the cornerstone in the treatment of cardiac arrest. However some conditions encountered during resuscitation or as a cause of cardiac arrest, can affect the procedure. | In all circumstances the normal protocol for BLS and ALS is the cornerstone in the treatment of cardiac arrest. However some conditions encountered during resuscitation or as a cause of cardiac arrest, can affect the procedure. | ||
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* <b>Cardiac arrest after cardiac surgery: </b>Cardiac arrest after cardiac surgery is usually caused by specific causes possibly related as a consequence of the cardiac surgery. Early resternotomy can be the key to survival, especially after repeated defibrillation has failed or of asystole is observed. | * <b>Cardiac arrest after cardiac surgery: </b>Cardiac arrest after cardiac surgery is usually caused by specific causes possibly related as a consequence of the cardiac surgery. Early resternotomy can be the key to survival, especially after repeated defibrillation has failed or of asystole is observed. | ||
* <b>Drowning: </b>Drowning is a common cause of accidental death. Correction of hypoxia is critical in the outcome of these victims. Care should be taken to start immediate resuscitation and restore oxygenation, ventilation and perfusion. | * <b>Drowning: </b>Drowning is a common cause of accidental death. Correction of hypoxia is critical in the outcome of these victims. Care should be taken to start immediate resuscitation and restore oxygenation, ventilation and perfusion. | ||
* <b>Electrocution:</b> Electrocution can result in | * <b>Electrocution:</b> Electrocution can result in multi-system injury and usually occur in the workspace in adult or at home in children. The direct effects of electric shock on tissue, for instance paralysis of respiratory system or muscles, VF in the myocardium, ischemia due to coronary artery spasm or asystole can result in a cardiac arrest setting. Electrical burns can complicate the resuscitation setting and care should be taken to avoid further complication resulting from these burns, adequate fluid therapy is required if there is significant tissue destruction. | ||
* <b>Electrolyte disorder:</b> Electrolyte abnormalities are common in potassium disorders. During cardiac arrest treatment of these abnormalities is no different than in the normal clinical setting. | * <b>Electrolyte disorder:</b> Electrolyte abnormalities are common in potassium disorders. During cardiac arrest treatment of these abnormalities is no different than in the normal clinical setting. | ||
* <b>Hyperthermia:</b> Exogenous or endogenous hyperthermia can result in heat stress, progressing to heat exhaustion and results in heat stroke. Heat stroke can lead to varying levels of organ dysfunction accompanied by mental changes. Rapid cooling of the victim should occur as soon as possible. | * <b>Hyperthermia:</b> Exogenous or endogenous hyperthermia can result in heat stress, progressing to heat exhaustion and results in heat stroke. Heat stroke can lead to varying levels of organ dysfunction accompanied by mental changes. Rapid cooling of the victim should occur as soon as possible. | ||
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* <b>Pregnancy:</b> If a cardiac arrest occurs during pregnancy the safety of the fetus should always be considered. Due to the growth of the uterus compression of the inferior vena cava and aorta can occur and as a result venous return and cardiac output is compromised. Furthermore the increased abdominal pressure can increase the risk of pulmonary aspiration and can hamper proper ventilation; therefore early intubation can lower risks and ease cardiopulmonary resuscitation. An emergency hysterotomy or caesarean section needs to be considered, if gestational age is after 20 weeks. After 20 weeks the size of the uterus is large enough to compromise cardiac output. | * <b>Pregnancy:</b> If a cardiac arrest occurs during pregnancy the safety of the fetus should always be considered. Due to the growth of the uterus compression of the inferior vena cava and aorta can occur and as a result venous return and cardiac output is compromised. Furthermore the increased abdominal pressure can increase the risk of pulmonary aspiration and can hamper proper ventilation; therefore early intubation can lower risks and ease cardiopulmonary resuscitation. An emergency hysterotomy or caesarean section needs to be considered, if gestational age is after 20 weeks. After 20 weeks the size of the uterus is large enough to compromise cardiac output. | ||
* <b>Traumatic Cardiorespiratory Arrest:</b> Blunt trauma can cause commotio cordis if there is an impact to the chest wall over the heart. This impact can cause arrhythmias and is sometimes seen in during sports. Penetrating trauma can be cause for and emergency thoracotomy. It is important to treat the resuscitation according to protocol and treat reversible causes. | * <b>Traumatic Cardiorespiratory Arrest:</b> Blunt trauma can cause commotio cordis if there is an impact to the chest wall over the heart. This impact can cause arrhythmias and is sometimes seen in during sports. Penetrating trauma can be cause for and emergency thoracotomy. It is important to treat the resuscitation according to protocol and treat reversible causes. | ||
=References= | =References= | ||
# ESC Textbook of Cardiovascular Medicine, 2nd Edition | # ESC Textbook of Cardiovascular Medicine, 2nd Edition | ||
# J.P. Nolan et al. / Resuscitation 81 (2010) 1219–1276 | # J.P. Nolan et al. / Resuscitation 81 (2010) 1219–1276 | ||