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She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular lifesupport (ACLS). 1) There are a limited number of antitussives on the US market which include benzonatate, codeine, dextromethorphan, diphenhydramine, and hydrocodone. What are the treatment options for a benzonatate overdose?
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. 1] Table from Hamam et al. 9] Figure from Clemency et al.
CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. The take home message: “Irrespective of presenting rhythm, in patients with cardiac arrest, there is no conclusive evidence that administration of calcium during cardiopulmonary resuscitation (CPR) improves survival.”
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. Kirkegaard H, Soreide E, de Haas, I et al. De Fazio C, Skrifvars MB, Soreide E et al. 2017.8978.
The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. Reference: Hirsch KG, Abella BS, Amorim E, et al; American Heart Association, Neurocritical Care Society. 2023 Dec 1.
He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. He was started on Extracorporeal LifeSupport ("VA ECMO") Here is the ECG on ECMO: Very low voltage On Day 3, the EF recovered (that seems quick!) Here they are: Learning Points: 1.
E: Exposure and Environmental Control: Fully expose to check for other life-threatening injuries while maintaining normothermia. This case meets the threshold for CT head within 1 hour, and given the mechanism and inability to clear the cervical spine due to the patients GCS guidance would suggest imaging this.
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