scholarly journals Hyperkalemic circulatory shock and cardiac arrest altered by therapeutic management: A case report

2021 ◽  
Vol 9 (3) ◽  
pp. 94-102
Author(s):  
Rohit Mody ◽  
◽  
Debabrata Dash ◽  
Bhavya Mody ◽  
◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Potassium Concentration ◽  
Circulatory Shock ◽  
Therapeutic Management ◽  
Selective Method ◽  
Serum Potassium Concentration ◽  
Electrolyte Disturbances ◽  
Severe Hyperkalemia

Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Severe hyperkalemia (Serum potassium concentration > 6.5 mmol/L) occurs most commonly from renal failure or the release of potassium from cells and can cause circulatory shock, cardiac arrhythmias or cardiac arrest. Current BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) protocol should be used to manage cardiac arrest associated with hyperkalemia. But early consideration should be given to using the selective method of therapeutic management in addition to standard ACLS protocols that can be provided rapidly, effectively in patients with cardiovascular instability. We describe here a case of chronic kidney disease and congestive heart failure who developed circulatory shock and eventually cardiac arrest due to hyperkalemia managed with Calcium Gluconate, Sodium Bicarbonate and Insulin along with standard advanced cardiovascular life support protocol. Keywords: Potassium, hyperkalemia, acidosis, calcium, insulin, cardiac arrest.

scholarly journals Effects of a Clinical Simulation Course about Basic Life Support on Undergraduate Nursing Students’ Learning

2021 ◽  
Vol 18 (4) ◽  
pp. 1409
Author(s):  
María del Mar Requena-Mullor ◽  
Raquel Alarcón-Rodríguez ◽  
María Isabel Ventura-Miranda ◽  
Jessica García-González
Keyword(s):  
Cardiac Arrest ◽  
Nursing Students ◽  
Learning Outcomes ◽  
Basic Life Support ◽  
Life Support ◽  
Undergraduate Nursing Students ◽  
Assessment Protocol ◽  
Clinical Simulation ◽  
Undergraduate Nursing ◽  
Post Test

Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. A pre-test and post-test were carried out to evaluate theoretical knowledge of BLS through questions about anatomical physiology, cardiac arrest, the chain of survival, and CPR. A checklist was used in the simulation to evaluate practical skills of basic CPR. The learning outcomes showed statistically significant differences in the total score of the pre-test and after completing the BLS clinical simulation course (pre-test: 12.61 (2.30), post-test: 15.60 (2.06), p < 0.001). A significant increase in the mean scores was observed after completing the course in each of the four parts of the assessment protocol (p < 0.001). The increase in scores in the cardiac arrest and CPR sections were relevant (Rosenthal’s r: −0.72). The students who had prior knowledge of BLS scored higher on both the pre-test and the post-test. The BLS simulation course was an effective method of teaching and learning BLS skills.

Knowledge and Skills of Lay Participants Training with Basic Life Support Program in Case of Cardiac Arrest

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S44-S48
Keyword(s):  
Cardiac Arrest ◽  
Training Program ◽  
Basic Life Support ◽  
Life Support ◽  
Training Session ◽  
Smartphone Application ◽  
Knowledge And Skills ◽  
Lay People ◽  
Before And After ◽  
Hospital Cardiac Arrest

Background: Out-of-hospital cardiac arrest is an important cause that leads to hospital admission and death. Improving lay people’s knowledge and skills in basic life support (BLS) may lead to reduced death associated with out-of-hospital cardiac arrest. “BLS NU KKU” is a BLS training program developed from up-to-date literature as a smartphone application used to train lay people in the community. Objective: To evaluate BLS-related knowledge and skills of participants before and after BLS training. Materials and Methods: A one group pretest-posttest design was used to implement the present study in Khon Kaen, Thailand. Participants were 350 individuals age 18 and older. An 8-hour BLS training session was offered to 10 groups of 35 participants over the period of 10 months between November 2018 and August 2019. Self-administered questionnaires were used to assess BLS knowledge and Cardiopulmonary resuscitation (CPR) skills. Results: The mean score for BLS-related knowledge significantly increased after the BLS training (mean = 15.05, SD = 2.51) compared to the scores before the training (mean = 10.47, SD = 3.43) (p<0.05). BLS skills improved from 0% to 100% (p<0.001) will all skills rated with mostly “excellent” and “good”. Satisfaction with the training program was also rated mostly with “excellent” and “good”. Conclusion: The BLS training program effectively improved participants’ knowledge and skills for basic life support. This program should be disseminated to train lay people in other settings. Keywords: Basic life support, Cardiac arrest, Mobile application

scholarly journals THE EFFECT OF SIMULATION OF THE BASIC LIFE SUPPORT TRAINING ON NURSING STUDENTS' KNOWLEDGE

2020 ◽  
Vol 9 (2) ◽  
pp. 177-183
Author(s):  
Ida Rahmawati ◽  
Dwi Putri Sulistiya Ningsih
Keyword(s):  
Cardiac Arrest ◽  
Nursing Students ◽  
Nursing Student ◽  
Basic Life Support ◽  
Life Support ◽  
Cerebral Oxygenation ◽  
Sampling Technique ◽  
P Value ◽  
Knowledge Questionnaire ◽  
Post Test

ABSTRACTBackground: Cardiac arrest is a health problem that is increasing to be the leading cause of death in the world. The main action to save cardiac arrest aims to maintain optimal myocardial and cerebral oxygenation so that death does not occur. Providing Basic Life Support (BLS) is an effort to save and restore this function. Knowledge about cardiac arrest among health students is still a neglected problem due to a lack of awareness in seeking basic knowledge.Objective: This study aimed to determine the effect of basic life support-based simulation training on knowledge of nursing students in the city of Bengkulu.Methods: This study used a pre-experimental design with a pre-test post-test approach. The population in this study were all 61 students of the fourth semester of STIKES Tri Mandiri Sakti Bengkulu nursing students. Samples were taken using total sampling technique. Data were collected using a knowledge questionnaire containing 10 question items which were adopted from the questionnaire Yunanto et al., (2017). Data were analyzed using paired sample t-test.Result: Based on the results of the study, it was found that there was a significant effect of BLS training based on manikin simulation on nursing student knowledge with a value of t test = -15.169, p = value = 0.000 <α = 0.05.Conclusion: Nursing students need to provide knowledge about BLS from the start so that they are more confident and able to apply it in case of cardiac arrest outside the hospital. Higher education institutions should provide health education about BLS from the beginning of the academic year, so that in the following semester students are better able to improve the quality of the skills they have formed.Keywords: Basic Life Support, Knowledge, Simulation.  

Abstract 14109: Basic Life Support With Reperfusion Injury Protection Improves 24 Hour Survival Outcomes in a Porcine Model of Prolonged Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Guillaume Debaty ◽  
Keith G Lurie ◽  
Anja Metzger ◽  
Michael Lick ◽  
Jason Bartos ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Reperfusion Injury ◽  
Basic Life Support ◽  
Life Support ◽  
Coronary Perfusion Pressure ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Left Ventricular Ejection ◽  
Coronary Perfusion ◽  
Ventricular Ejection Fraction

Introduction: Ischemic postconditioning (PC) using 3 intentional short pauses at the start of cardiopulmonary resuscitation (CPR) improves outcomes after cardiac arrest in pigs when epinephrine (epi) is used before defibrillation. Hypothesis: Basic life support (BLS) with PC will protect against reperfusion injury and enhance 24 hour functional recovery in the absence of epi. Methods: Female pigs (n=46; wt ~ 40 kg) were anesthetized (isoflurane). PC was delivered using 3 cycles alternating between automated CPR for 20 sec and no CPR for 20 sec at the start of each protocol. Protocol A: After 12 minutes of ventricular fibrillation (VF), 28 pigs were randomized in 4 groups: A/ Standard CPR (SCPR), B/ active compression-decompression with an impedance threshold device (ACD-ITD), C/ SCPR+PC (SCPR+PC) and D/ ACD-ITD+PC. Protocol B: After 15 min of VF, 18 pigs were randomized to ACD-ITD CPR or ACD-ITD + PC. The BLS duration was 2.75 min in Protocol A and 5 min in Protocol B. Following BLS up to 3 shocks were delivered. Without return of spontaneous circulation (ROSC) CPR was resumed and epi (0.5 mg) and defibrillation delivered. The primary end point was the incidence of major adverse outcomes at 24 h (defined as death or coma, refractory seizures and cardio-respiratory distress leading to euthanasia). Hemodynamic parameters and left ventricular ejection fraction (LVEF) were also measured. Data are presented as mean ± standard error of mean. Results: Protocol A: ACD-ITD CPR + PC (group D) provided the highest coronary perfusion pressure after 3 min of BLS compared with the 3 other groups (28 ± 6, 35 ± 7, 23 ± 5 and 47 ± 7 for groups A, B, C, D respectively, p= 0.05 by ANOVA). ROSC with BLS was achieved in 0, 3, 0, and 3 pigs in groups A, B, C and D, respectively (p=0.22) with no significant differences in 24-hour survival between groups. Protocol B: Four hours post ROSC, LVEF was significantly higher with ACD-ITD+IPC vs ACD-ITD alone (52.5 ± 3% vs. 37.5 ± 6.6%, p = 0.045). There was a significantly lower incidence of major adverse outcomes 24 hr after ROSC with ACD-ITD+PC compared with ACD-ITD alone (Log-rank comparison, p=0.027). Conclusion: BLS using ACD-ITD + PC mitigates post resuscitation cardiac dysfunction and facilitates neurological recovery after prolonged untreated VF in pigs.

Resuscitation on the field: basic and advanced life support and automatic external defibrillators

2019 ◽  
pp. 403-410
Author(s):  
Mark S. Link ◽  
Mark Estes III
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Basic Life Support ◽  
Life Support ◽  
Action Plan ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Screening Strategy ◽  
Automated External Defibrillators ◽  
Playing Field

Resuscitation on the playing field is at least as important as screening in the prevention of death. Even if a screening strategy is largely effective, individuals will suffer sudden cardiac arrests. Timely recognition of a cardiac arrest with rapid implementation of cardiopulmonary resuscitation (CPR) and deployment and use of automated external defibrillators (AEDs) will save lives. Basic life support, including CPR and AED use, should be a requirement for all those involved in sports, including athletes. An emergency action plan is important in order to render advanced cardiac life support and arrange for transport to medical centres.

Life-threatening emergencies

2012 ◽  
pp. 40-61
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Central Venous Access ◽  
Treatment Algorithm ◽  
Advanced Life Support ◽  
Venous Access ◽  
Central Venous ◽  
Life Threatening

Anaphylaxis 42 Treatment algorithm for adults with anaphylaxis 44 Choking 45 Cardiac arrest 46 In-hospital resuscitation algorithm 47 Adult basic life support 48 Cardiac arrest management 50 Advanced life support algorithm 52 Notes on using the advanced life support algorithm 53 Post-resuscitation care 54 Central venous access ...

A Cross-Over Trial Comparing Conventional to Compression-Adjusted Ventilations with Metronome-Guided Compressions

2019 ◽  
Vol 34 (02) ◽  
pp. 220-223 ◽  
Author(s):  
Dhimitri A. Nikolla ◽  
Brandon J. Kramer ◽  
Jestin N. Carlson
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Null Hypothesis ◽  
Basic Life Support ◽  
Life Support ◽  
Minute Ventilation ◽  
Group Versus ◽  
Time Intervals ◽  
Minute Interval ◽  
Ventilation Rates

Introduction:Hyperventilation during cardiopulmonary resuscitation (CPR) negatively affects cardiopulmonary physiology. Compression-adjusted ventilations (CAVs) may allow providers to deliver ventilation rates more consistently than conventional ventilations (CVs). This study sought to compare ventilation rates between these two methods during simulated cardiac arrest.Null Hypothesis:That CAV will not result in different rates than CV in simulated CPR with metronome-guided compressions.Methods:Volunteer Basic Life Support (BLS)-trained providers delivered bag-valve-mask (BVM) ventilations during simulated CPR with metronome-guided compressions at 100 beats/minute. For the first 4-minute interval, volunteers delivered CV. Volunteers were then instructed on how to perform CAV by delivering one breath, counting 12 compressions, and then delivering a subsequent breath. They then performed CAV for the second 4-minute interval. Ventilation rates were manually recorded. Minute-by-minute ventilation rates were compared between the techniques.Results:A total of 23 volunteers were enrolled with a median age of 36 years old and with a median of 14 years of experience. Median ventilation rates were consistently higher in the CV group versus the CAV group across all 1-minute segments: 13 vs 9, 12 vs 8, 12 vs 8, and 12 vs 8 for minutes one through four, respectively (P &lt;.01, all). Hyperventilation (&gt;10 breaths per minute) occurred 64% of the time intervals with CV versus one percent with CAV (P &lt;.01). The proportion of time which hyperventilation occurred was also consistently higher in the CV group versus the CAV group across all 1-minute segments: 78% vs 4%, 61% vs 0%, 57% vs 0%, and 61% vs 0% for minutes one through four, respectively (P &lt;.01, all).Conclusions:In this simulated model of cardiac arrest, CAV had more accurate ventilation rates and fewer episodes of hyperventilation compared with CV.Nikolla DA, Kramer BJ, Carlson JN. A cross-over trial comparing conventional to compression-adjusted ventilations with metronome-guided compressions. Prehosp Disaster Med. 2019;34(2):220–223

scholarly journals 2019 American Heart Association Focused Update on Pediatric Basic Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽  
2019 ◽  
Vol 140 (24) ◽  
Author(s):  
Jonathan P. Duff ◽  
Alexis A. Topjian ◽  
Marc D. Berg ◽  
Melissa Chan ◽  
Sarah E. Haskell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
American Heart Association ◽  
Basic Life Support ◽  
Life Support ◽  
American Heart ◽  
Heart Association ◽  
Liaison Committee ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

This 2019 focused update to the American Heart Association pediatric basic life support guidelines follows the 2019 systematic review of the effects of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) on survival of infants and children with out-of-hospital cardiac arrest. This systematic review and the primary studies identified were analyzed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation’s continuous evidence review process, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update summarizes the available pediatric evidence supporting DA-CPR and provides treatment recommendations for DA-CPR for pediatric out-of-hospital cardiac arrest. Four new pediatric studies were reviewed. A systematic review of this data identified the association of a significant improvement in the rates of bystander CPR and in survival 1 month after cardiac arrest with DA-CPR. The writing group recommends that emergency medical dispatch centers offer DA-CPR for presumed pediatric cardiac arrest, especially when no bystander CPR is in progress. No recommendation could be made for or against DA-CPR instructions when bystander CPR is already in progress.

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