Emergency medicine clinics of North America
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Every pediatric patient should be resuscitated unless there is rigidity, body decay, known terminal illness, or irreparable damage. The techniques for pediatric CPR are described in detail.
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Emerg. Med. Clin. North Am. · Dec 1983
ReviewAcute resuscitation of the patient with head and spinal cord injuries.
The major immediate goal in the treatment of a patient with central nervous system injuries is to prevent secondary injuries resulting from hypotension, hypoxemia, hypercapnia, intracranial hypertension, infection, and unnecessary motion of an unstable spinal column. This combined with application of the fundamentals of trauma resuscitation should achieve optimal results.
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The introduction of closed chest massage in 1960 initiated a widespread interest in cardiopulmonary resuscitation. Until that time, open chest cardiac massage was the standard for CPR. Initial explanations for blood flow during closed chest CPR were based upon direct compression of the heart. ⋯ Cardiac output with open chest massage is approximately double that obtained by closed chest massage. Cerebral blood flow during open chest massage approaches physiologic values. The use of drugs possessing alpha adrenergic activity and maneuvers that augment intrathoracic pressure improve vital organ perfusion.
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Evaluation of the burned patient in the emergency department and fluid resuscitation of burned patients are discussed in detail.
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Pharmacologic agents are used to improve conditions that may contribute to the development of cardiac arrest such as dysrhythmias, hypotension, shock, or anoxia. The authors review the clinical application of several specific agents in resuscitation.