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A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). Date: December 6th , 2018 Reference: Perkins et al.
Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. Bystander high-quality CPR can buy you some time until defibrillation.
Data from the AHA and the Pediatric AdvancedLifeSupport (PALS) guidelines consistently report neurologic intact survival from pediatric cardiac arrest to be 3% for infants and 10% for children. Bystander CPR, 2. Telephone CPR (T-CPR), and 3. By Peter Antevy, MD. On-scene EMS resuscitation.
I recerted CPR, ACLS (Advanced Cardiac LifeSupport) and PALS (Pediatric AdvancedLifeSupport) late in December. When you are doing CPR and running cardiac arrests on a regular basis, it seems unnecessary to sit through a 2 hour class on CPR and 4 hour classes on ACLS and PALS.
Meyer MD Clinical Scenario You are dispatched to a 57-year-old male with a witnessed cardiac arrest and bystander CPR being performed. Your partner deploys the cardiac monitor and while CPR is continued you turn your attention to establishing vascular access. On arrival to the scene, you find the patient pulseless and apneic.
CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. Resuscitation Plus, 12 , 1-9.
1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Interventions during the acute phase of treatment post return of spontaneous circulation (ROSC) are therefore critical.
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