Emergency medicine clinics of North America
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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.
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Myocardial disease and death from cardiac arrest remain significant public health problems. Sudden death events and out-of-hospital cardiac arrests (OHCA) are encountered frequently by emergency medical services. Despite more than 30 years of research, survival rates remain extremely low. This article reviews access and presentations, demographics, OHCA outcomes, and response systems and processes in treatment of patients with arrest in this setting.
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Cardiac arrest remains a common problem throughout the world. This article explores several factors that aid in determining prognosis after cardiac arrest. ⋯ Intra-arrest factors look at the partial pressure of end-tidal CO2 and the presence of cardiac standstill on ultrasound. Postarrest factors include early outcome measures as well as a more comprehensive algorithmic approach to predicting neurologic outcome.