Limited animal data and rare case reports suggest possible utility of calcium to improve heart rate and hypotension in -adrenergic blocker toxicity. Is there a role for prophylactic antiarrhythmics after ROSC? Cardiopulmonary resuscitation (CPR): First aid - Mayo Clinic Peer reviewer feedback was provided for guidelines in draft format and again in final format. For patients with severe hypothermia (less than 30C [86F]) with a perfusing rhythm, core rewarming is often used. Protocols for management of OHCA in pregnancy should be developed to facilitate timely transport to a center with capacity to immediately perform perimortem cesarean delivery while providing ongoing resuscitation. If this is not known, defibrillation at the maximal dose may be considered. In patients who remain comatose after cardiac arrest, it is reasonable to perform multimodal neuroprognostication at a minimum of 72 hours after normothermia, though individual prognostic tests may be obtained earlier than this. Minimizing disruptions in CPR surrounding shock administration is also a high priority. For patients with a sinus tachycardia (heart rate greater than 100/min, P waves), no specific drug treatment is needed, and clinicians should focus on identification and treatment of the underlying cause of the tachycardia (fever, dehydration, pain). No trials to date have found any benefit of either higher-dose epinephrine or other vasopressors over standard-dose epinephrine during CPR. In 2015, approximately 350 000 adults in the United States experienced nontraumatic out-of-hospital cardiac arrest (OHCA) attended by emergency medical services (EMS) personnel.1 Approximately 10.4% of patients with OHCA survive their initial hospitalization, and 8.2% survive with good functional status. Cardiac arrest survivors, their families, and families of nonsurvivors may be powerful advocates for community response to cardiac arrest and patient-centered outcomes. For a patient with suspected opioid overdose who has a definite pulse but no normal breathing or only gasping (ie, a respiratory arrest), in addition to providing standard BLS and/or ACLS care, it is reasonable for responders to administer naloxone. 2. Case reports have rarely described damage to the heart due to external chest compressions. Cough CPR is described as a repetitive deep inspiration followed by a cough every few seconds before the loss of consciousness. All patients with evidence of anaphylaxis require early treatment with epinephrine. Along with providing standard BLS and ALS treatment, next steps include preventing additional evaporative heat loss by removing wet garments and insulating the victim from further environmental exposures. 3. Should severely hypothermic patients in cardiac arrest receive epinephrine or other resuscitation The use of an airway adjunct (eg, oropharyngeal and/or nasopharyngeal airway) may be reasonable in unconscious (unresponsive) patients with no cough or gag reflex to facilitate delivery of ventilation with a bag-mask device. The systems-of-care approach to cardiac arrest includes the community and healthcare response to cardiac arrest. Quantitative waveform capnography - If Petco 2 <10 mm Hg, attempt to improve CPR quality. Incorrect placement, however, can cause an airway obstruction by displacing the tongue to the back of the oropharynx. CPR with an Advanced Airway - National CPR Association Does the treatment of nonconvulsive seizures, common in postarrest patients, improve patient 5. 2. Lidocaine is not included as a treatment option for undifferentiated wide-complex tachycardia because it is a relatively narrow-spectrum drug that is ineffective for SVT, probably because its kinetic properties are less effective for VT at hemodynamically tolerated rates than amiodarone, procainamide, or sotalol are.
