Cardiac arrest care is protocolized in ACLS for universal access, simplified for those who rarely run codes. As consultants specializing in Emergency Medicine, we should be on the forefront of resuscitation management, using cutting edge technologies and research to advance the field and save lives - Lauren Lacroix & Richard Hoang
image by: Knut Petter Dimmen
Over the past few years, there has been a significant paradigm shift in management from A-B-C to C-A-B, placing increasing importance on minimizing interruptions during chest compressions and decreasing the time to defibrillation...
STICK TO THE BASICS: Intubation should have a lower priority compared to high-quality chest compressions and early defibrillation when needed. Remember to consider your reversible causes and treat appropriately.
For cardiac arrests both inside and outside the hospital, there is moderate-quality evidence that supports basic airway interventions (BVM, maneuvers to minimize gastric insufflation, jaw thrust, low-pressure squeezes, OPA/NPA, and avoidance…
There is a lack of high-quality evidence and significant difficulty in conducting a randomized controlled trial to determine the best strategy for airway management in cardiac arrest. STICK TO THE BASICS: Intubation should have a lower priority compared to high-quality chest compressions and early defibrillation when needed. Remember to consider your reversible causes and treat appropriately.
One of the unique aspects of hypothermia is how differently cardiac arrest should be treated from normal ACLS protocol. Patients can have good neurologic outcomes despite prolonged resuscitative times, as demonstrated by several case reports and reviews.
Younger cardiac arrest patients often have different causes than older patients. Pay strong consideration to congenital abnormalities, conduction disorders, or other cardiac causes outside of coronary artery disease.
Introduction of ultrasound into the trauma evaluation has advanced management considerably. In the setting of TCA, bedside use of the focused assessment with sonography for trauma (FAST) exam allows for rapid determination of the presence of two potentially reversible causes of PEA arrest: pericardial effusion with cardiac tamponade and hypovolemia due to massive hemoperitoneum.
The pulseless cardiac arrest is caused by 4 different types of primary arrhythmias that consist of 2 shockable rhythms (ventricular tachycardia and ventricular fibrillation), and 2 non-shockable rhythms (pulseless electrical activity and asystole).
Managing a cardiac arrest can be mentally and emotionally taxing. Being methodical with each resuscitation will help mitigate the nuances of each individual patient.
A better understanding of this variability is fundamental to better prevention and resuscitation strategies. In this event, experts from around the world will focus on OHCA in their region, highlighting what can be learned, and the challenges yet to be addressed, to improve outcomes for individuals and communities locally and improve survival worldwide.
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