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Summary Emergency Medicine

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Emergency Medicine Section I Critical Care Emergencies Cardiopulmonary Resuscitation Initial Approach Diagnosis 1. Cardiopulmonary resuscitation (CPR) is required if a collapsed person is unresponsive, not breathing, and has no palpable pulse in a large artery such as the carotid or femoral. i. The following may also be seen: a. occasional, ineffectual (agonal) gasps b. pallor or cyanosis c. dilated pupils d. brief tonic grand mal seizure. 2. Sudden cardiac arrest still causes over 60% of deaths from coronary heart disease in adults. Management 1. This is based on the International Liaison Committee on Resuscitation (ILCOR) 2015 International Consensus on CPR and ECC Science with Treatment Recommendations (CoSTR). i. The first person calls for help to arrange arrival of additional people and equipment, then assists with the resuscitation. ii. The second person on the scene stays with the patient, checks for danger and commences resuscitation, making a note of the time. 2. Immediate actions The aim is to maintain oxygenation of the brain and myocardium until a stable cardiac output is achieved. i. Lay the patient flat on a hard surface such as a trolley. If the patient is on the floor and enough people are available, lift the patient onto a trolley to facilitate the resuscitation procedure. ii. Rapidly give a single, sharp precordial thump within the first few seconds of the onset of a witnessed or monitored arrest, where the rhythm is pulseless

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,Emergency Medicine

Anthony F. T. Brown


Mike D. Cadogan

, CRC Press
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