1. 1. It is feasible only at the onset of a hemodynamically significant arrhythmia in a cooperative, conscious patient who has ideally been previously instructed on its performance, and as a bridge to definitive care. The literature supports prioritizing defibrillation and CPR initially and giving epinephrine if initial attempts with CPR and defibrillation are not successful. A case series suggests that mouth-to-nose ventilation in adults is feasible, safe, and effective. A more detailed approach to rhythm management is found elsewhere.1–3, This topic last received formal evidence review in 2010.17, Polymorphic VT refers to a wide-complex tachycardia of ventricular origin with differing configurations of the QRS complex from beat to beat. and 4. The precordial thump may be considered at the onset of a rescuer-witnessed, monitored, unstable ventricular tachyarrhythmia when a defibrillator is not immediately ready for use and is performed without delaying CPR or shock delivery. The next steps in care, including the performance of CPR and the administration of naloxone, are discussed in detail below. Discharges on EEG were divided into 2 types: rhythmic/periodic and nonrhythmic/periodic. The paucity of information on the efficacy of IO drug administration during CPR was acknowledged in 2010, but since then the IO route has grown in popularity. Check for no breathing or only gasping and check pulse (ideally simultaneously). The writing group acknowledged that there is no direct evidence that EEG to detect nonconvulsive seizures improves outcomes. Immediate defibrillation is reasonable for provider-witnessed or monitored VF/pVT of short duration when a defibrillator is already applied or immediately available. 2. of Care Writing Groups. Does hospital-based protocolized discharge planning for cardiac arrest survivors improve access to/ Enhancing survivorship and recovery after cardiac arrest needs to be a systematic priority, aligned with treatment recommendations for patients surviving stroke, cancer, and other critical illnesses.3–5, These recommendations are supported by “Sudden Cardiac Arrest Survivorship: a Scientific Statement From the AHA.”3. An IV dose of 0.05 to 0.1 mg (5% to 10% of the epinephrine dose used routinely in cardiac arrest) has been used successfully for anaphylactic shock. 2. The goal of ECPR is to support end organ perfusion while potentially reversible conditions are addressed. 16_suppl_2: S551–S579, and On behalf of the Adult Basic and Advanced Life Support, Pediatric Basic and Advanced response. The American Heart Association is qualified 501(c)(3) tax-exempt In intubated patients, failure to achieve an end-tidal CO. 5. Rescuers should recognize that multiple approaches may be required to establish an adequate airway. The theory is that the heart will respond to electric stimuli by producing myocardial contraction and generating forward movement of blood, but clinical trials have not shown pacing to improve patient outcomes. 2. ECPR indicates extracorporeal cardiopulmonary resuscitation. The 2020 Guidelines are a comprehensive revision of the AHA’s guidelines for adult, pediatric, neonatal, resuscitation education science, and systems of care topics. 1. Maintaining the arterial partial pressure of carbon dioxide (Paco2) within a normal physiological range (generally 35–45 mm Hg) may be reasonable in patients who remain comatose after ROSC. and 2. What are the optimal pharmacological treatment regimens for the management of postarrest seizures? Torsades de pointes typically presents in a recurring pattern of self-terminating, hemodynamically unstable polymorphic VT in context of a known or suspected long QT abnormality, often with an associated bradycardia.


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