Decreasing the Stress of Medication Management During Cardiac Arrest

2020 ◽  
Vol 31 (4) ◽  
pp. 394-400
Author(s):  
Colleen Teevan ◽  
Emily Perriello

Cardiac arrest affects more than 500 000 people every year, with significant associated morbidity and mortality. In addition to high-quality cardiopulmonary resuscitation and early defibrillation, medications are included in treatment algorithms. Epinephrine and amiodarone are commonly used, with other medications being used in specific situations of cardiac arrest. Although participating in the care of a patient in cardiac arrest is complex and stressful, having a baseline understanding of the medications being used, routes of administration, and special considerations can be helpful in mitigating some of the stress in these situations.

2018 ◽  
pp. 89-93
Author(s):  
Erik Rueckmann

The management of out-of-hospital, atraumatic cardiac arrest has changed over the past decade. This case details the evidence-based changes in care that optimize the chance of neurologically intact survival. The key factors include immediate, continuous, high-quality cardiopulmonary resuscitation with minimal interruptions, early defibrillation, and the use of capnography to assess resuscitative efforts. The orchestration of resuscitative efforts is a bundle of care that must all be met to provide the patient the best chance of survival. Furthermore, this case illustrates the key points of postarrest care and touches on termination of resuscitation. This chapter examines the case of emergency medical services call for an unresponsive patient in cardiac arrest on arrival.


2020 ◽  
pp. 3839-3848
Author(s):  
Gavin D. Perkins ◽  
Jasmeet Soar ◽  
Jerry P. Nolan ◽  
David A. Gabbott

Cardiovascular disease is the most common cause of sudden cardiac arrest, which causes over 60% of adult coronary heart disease deaths. Most cardiac arrests are preventable. Survival depends on early recognition and prompt initiation of chest compressions and ventilations (cardiopulmonary resuscitation), and early defibrillation if appropriate. High-quality cardiopulmonary resuscitation is defined by compressions to a depth of 5–6 cm, at a rate of 100–120 per minute, full release of pressure between compressions and minimal interruptions to chest compression. Drugs have a limited role in treating cardiac arrest. If initial resuscitation is successful the quality of post-resuscitation care determines the patient’s final outcome. Use emergency care treatment plans to record in advance, recommendations for emergency treatments, including CPR.


Author(s):  
Yi-Rong Chen ◽  
Chi-Jiang Liao ◽  
Han-Chun Huang ◽  
Cheng-Han Tsai ◽  
Yao-Sing Su ◽  
...  

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.


2021 ◽  
Vol 9 (2) ◽  
pp. 149
Author(s):  
Anugerah Ruben Ananda ◽  
Desi Friska Dela Zalukhu ◽  
Firdaus G Junior ◽  
Marisa Junianti Manik ◽  
Swingly Wikliv D

<p><em>Cardiac arrest is a significant cause of death worldwide, and an estimated 17.9 million people die from heart disease. In 2016, cardiac arrest represented 31% of all global deaths, and heart attacks and strokes caused 85%. In the treatment of cardiac arrest, health providers must perform cardiac and pulmonary resuscitation, a combination of chest compressions, and assistance for the victim's breathing. Nurses must be able to provide high-quality CPR to the patients for optimal outcomes. This study aimed to describe the knowledge of nurses in six private hospitals in Indonesia about high-quality CPR. This research was quantitative descriptive using a modified questionnaire regarding the theory of high-quality CPR. The population in this study were nurses from adult inpatient wards at six private hospitals in Indonesia with a total sample of 86 respondents through convenience sampling technique. The results showed that 79.1% inpatient nurses at six hospitals in Indonesia had good knowledge about high-quality CPR. Nurses are expected to maintain and improve their knowledge and ability to provide high-quality CPR so that the basic life support provided will be of high quality and provide optimal results for cardiac arrest patients in hospitals.</em><strong><br /><br />BAHASA INDONESIA ABSTRAK: </strong>Henti jantung merupakan penyebab kematian yang signifikan di dunia dan diperkirakan 17,9 juta orang meninggal karena penyakit jantung. Pada 2016, henti jantung mewakili 31% dari semua kematian global, dan 85% disebabkan oleh serangan jantung dan stroke. Dalam penanganan henti jantung, perawat harus melakukan resusitasi jantung dan paru yaitu kombinasi dari kompresi dada dan bantuan terhadap pernafasan korban. Tenaga kesehatan harus mampu memberikan<em> high-quality</em> CPR kepada korban untuk hasil yang optimal. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan perawat tentang high-quality CPR di enam rumah sakit swasta di Indonesia. Penelitian ini merupakan studi deskriptif kuantitatif dengan menggunakan kuesioner mengenai teori <em>high-quality</em> CPR yang telah dimodifikasi. Populasi dalam penelitian ini adalah perawat ruang rawat inap dewasa di enam rumah sakit swasta di Indonesia dengan jumlah sampel sebanyak 86 responden melalui teknik sampel konvenien. Hasil penelitian menunjukan 79.1% perawat rawat inap di enam rumah sakit di Indonesia memiliki pengetahuan tentang <em>high-quality</em> CPR pada tingkat yang baik. Perawat diharapkan untuk tetap mempertahankan dan meningkatkan pengetahuan dan kemampuan pemberian <em>high-quality CPR</em> sehingga bantuan hidup dasar yang diberikan akan berkualitas dan memberikan hasil optimal bagi pasien henti jantung dalam rumah sakit.</p>


2018 ◽  
Vol 10 (1) ◽  
pp. 168781401774874 ◽  
Author(s):  
Carlo Remino ◽  
Manuela Baronio ◽  
Nicola Pellegrini ◽  
Francesco Aggogeri ◽  
Riccardo Adamini

Rate of survival without any neurological consequence after cardiac arrest is driven not only by early recognition but also by high-quality cardiopulmonary resuscitation. Because the effectiveness of the manual cardiopulmonary resuscitation is usually impaired by rescuers’ fatigue, devices have been devised to improve it by appliances or ergonomic solutions. However, some devices are thought to replace the manual resuscitation altogether, either mimicking its action or generating hemodynamic effects with working principles which are entirely different. This article reviews such devices, both manual and automatic. They are mainly classified by actuation method, applied force, working space, and positioning time. Most of the trials and meta-analyses have not demonstrated that chest compressions given with automatic devices are more effective than those given manually. However, advances in clinical research and technology, with an improved understanding of the organizational implications of their use, are constantly improving the effectiveness of such devices.


Perfusion ◽  
2017 ◽  
Vol 33 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Yong Mei ◽  
Xufeng Chen ◽  
Kai Sun ◽  
Jinru Lv ◽  
Hao Sun ◽  
...  

In recent years, the development of extracorporeal membrane oxygenation (ECMO) technology has led to its extensive use in clinical practice. In particular, ECMO can play an important role in cardiopulmonary resuscitation (CPR). The American Heart Association CPR guidelines recommend its use in patients with cardiac arrest due to reversible disorders, along with high-quality CPR. This is called extracorporeal cardiopulmonary resuscitation (ECPR). However, it is important to be aware of the possibility of infection-related complications. Here, we report on a patient who suffered a cardiac arrest in hospital and was rescued with ECMO, but who subsequently developed an infection with Scedosporium apiospermum.


Heart ◽  
2018 ◽  
Vol 104 (13) ◽  
pp. 1056-1061 ◽  
Author(s):  
Andrew W Harris ◽  
Peter J Kudenchuk

Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.


Author(s):  
Joel Pinto ◽  
Paulo Almeida ◽  
Fani Ribeiro ◽  
Rita Simões

Cardiopulmonary resuscitation-induced consciousness is a rarely described and often misunderstood phenomenon, although it can be encountered. High quality cardiopulmonary resuscitation (CPR) may lead a patient to recover consciousness while in cardiac arrest. The authors present the case of an 89-year-old male patient who received CPR after a cardiac arrest. Spontaneous movements during CPR were noted and prompted several CPR interruptions. These movements immediately stopped during chest compression pauses. Physical restraint was used in order to be able to continue with the CPR algorithm, but sedation may be the best approach. Guidelines on how to identify and manage these cases need to be developed.


2018 ◽  
Vol 164 (6) ◽  
pp. 438-441
Author(s):  
Iain T Parsons ◽  
A T Cox ◽  
P S C Rees

Maintaining high-quality chest compressions during cardiopulmonary resuscitation following cardiac arrest presents a challenge. The currently available mechanical CPR (mCPR) devices are described in this review, coupled with an analysis of the evidence pertaining to their efficacy. Overall, mCPR appears to be at least equivalent to high-quality manual CPR in large trials. There is potential utility for mCPR devices in the military context to ensure uninterrupted quality CPR following a medical cardiac arrest. Particular utility may be in a prohibitive operational environment, where manpower is limited or where timelines to definitive care are stretched resulting in a requirement for prolonged resuscitation. mCPR can also act as a bridge to advanced endovascular resuscitation techniques should they become more mainstream therapy.


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