585
edits
Cardiac Arrest: Difference between revisions
Jump to navigation
Jump to search
no edit summary
No edit summary |
|||
| Line 26: | Line 26: | ||
==Preventing in Hosptial Cardiac Arrest== | ==Preventing in Hosptial Cardiac Arrest== | ||
The best way to prevent sudden death is to early detect deterioration of a patient and to act on early warning signs. An early warning score helps to create consensus among care providers about the sickness of a patient. If the summed score is ≥ 3 a doctor should be notified. The notified doctor should assess the patient within 30 minutes and discuss a treatment plan. If the patient does not improve within 60 minutes a reassessment should follow with possible inclusion of an urgent care team or intensive care specialist. | [[File:MEWS.svg|thumb|250px|right|'''Figure 2.''' An example of a MEWS<cite>IHI</cite>.]] | ||
The best way to prevent sudden death is to early detect deterioration of a patient and to act on early warning signs. An early warning score (Figure 2) helps to create consensus among care providers about the sickness of a patient. If the summed score is ≥ 3 a doctor should be notified. The notified doctor should assess the patient within 30 minutes and discuss a treatment plan. If the patient does not improve within 60 minutes a reassessment should follow with possible inclusion of an urgent care team or intensive care specialist. | |||
==Advanced Life Support (ALS)== | ==Advanced Life Support (ALS)== | ||
[[File:ALS.svg|thumb|750px|right|'''Figure | [[File:ALS.svg|thumb|750px|right|'''Figure 3.''' The advanced life support algorithm.]] | ||
BLS the cornerstone to the treatment of cardiac arrest. Early and high quality CPR is critical to survival. In the hospital setting trained experts and technical equipment can facilitate cardiac arrest management. In case of a witnessed cardiac arrest caused by VT/VF in a monitored setting, three successive shocks followed by immediate CPR may be considered. If no defibrillation options are available and a precordial thump can be given in the first few seconds after the cardiac arrest. It can not cause delay of the resuscitation attempt. The only intervention besides proper BLS and early defibrillation to increase survival is the administration of adrenaline. The ALS protocol deviates into two strategies encountered in the setting of cardiac arrest; a shock protocol and no-shock protocol. During both protocols it is important to establish intravascular access as soon as possible, as an alternative intraosseous injection of drugs can be performed. Furthermore assessment of airway management and ventilation is essential. Oxygen should be administered as soon as possible and be titrated to the arterial blood oxygen saturation. Tracheal intubation is the optimal method of providing and maintaining a clear and secure airway. Intubation should be performed by experienced personnel to reduce complications and delay between intubation and chest compressions. When there is return of spontaneous circulation the resuscitation team should stabilize the patient to prevent recurrence of cardiac arrest.<cite>Deakin4</Cite> | BLS the cornerstone to the treatment of cardiac arrest. Early and high quality CPR is critical to survival. In the hospital setting trained experts and technical equipment can facilitate cardiac arrest management. In case of a witnessed cardiac arrest caused by VT/VF in a monitored setting, three successive shocks followed by immediate CPR may be considered. If no defibrillation options are available and a precordial thump can be given in the first few seconds after the cardiac arrest. It can not cause delay of the resuscitation attempt. The only intervention besides proper BLS and early defibrillation to increase survival is the administration of adrenaline. The ALS protocol deviates into two strategies encountered in the setting of cardiac arrest; a shock protocol and no-shock protocol. During both protocols it is important to establish intravascular access as soon as possible, as an alternative intraosseous injection of drugs can be performed. Furthermore assessment of airway management and ventilation is essential. Oxygen should be administered as soon as possible and be titrated to the arterial blood oxygen saturation. Tracheal intubation is the optimal method of providing and maintaining a clear and secure airway. Intubation should be performed by experienced personnel to reduce complications and delay between intubation and chest compressions. When there is return of spontaneous circulation the resuscitation team should stabilize the patient to prevent recurrence of cardiac arrest.<cite>Deakin4</Cite> | ||