Emergency medicine clinics of North America
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Airway management has been emphasized as crucial to effective resuscitation of patients in cardiac arrest. However, recent research has shown that coronary and cerebral perfusion should be prioritized rather than airway management. ⋯ This article reviews the current state of the literature regarding airway management of the patient in cardiac arrest. Ventilatory management strategies are also discussed.
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Emerg. Med. Clin. North Am. · Feb 2012
ReviewRapid response systems: identification and management of the "prearrest state".
Rapid response systems (RRS) are both intuitive and supported by data, but the institution of an RRS is not a panacea for in-hospital cardiac arrest or unexpected deaths. RRS implementation should be one component of an institution-wide effort to improve patient safety that includes adequate nursing education and staffing, availability and involvement of a patient's primary caregivers, and hospital provision of sufficient resources and efficiency.
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Even the best conventional manual cardiopulmonary resuscitation (CPR) is highly inefficient, producing only a fraction of normal cardiac output. Over the past several decades, many therapeutic devices have been designed to improve on conventional CPR during cardiac arrest and increase the probability of survival. This article reviews several adjuncts and mechanical alternatives to conventional CPR for use during cardiac arrest. Recent clinical studies comparing conventional resuscitation techniques with the use of devices during cardiac arrest are reviewed, with a focus on clinical implications and directions for future research.
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Emerg. Med. Clin. North Am. · Feb 2012
ReviewThe impact of the code drugs: cardioactive medications in cardiac arrest resuscitation.
The goal of treating patients who present with cardiac arrest is to intervene as quickly as possible to affect the best possible outcome. The mainstays of these interventions, including early activation of the emergency response team, early initiation of cardiopulmonary resuscitation, and early defibrillation, are essential components with demonstrated positive impact on resuscitation outcomes. Conversely, the use of the code drugs as a component of advanced life support has not benefited these patients to the same extent as the basic interventions in a general. Although short-term outcomes are improved as a function of these medications, the final outcome has not been altered significantly in most instances.
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Cardiopulmonary resuscitation (CPR) is vital therapy in cardiac arrest care by lay and trained rescuers. Chest compressions are the key component of CPR. ⋯ Even then, interruptions of chest compressions should be minimized to maintain cardiocerebral perfusion and increase survival. Finally, the ventilation rate should be no more than 8 to 10 breaths per minute.