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Resuscitation (Airway
protection (Head tilt chin lift, Jaw lift (head…
Resuscitation
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Venous access
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Venous access
Femoral or jugular vein via Seldinger approach
Jugular can use for central venous monitoring
Cardiac arrest
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Chemical cardioversion
Preferable via central vein
to avoid vasoconstrction,
can use interosseous if needed
Epinephrine
Acts on a-receptors to vasocontstrict, maintains DBP
1mg every 3-5 min
Vasopressin
Better than epinephrine for asystole
Dose 40IU, repeat once after 3min
Mg
Refractory VF, Torsades de Pointes,
hypo-Mg, digoxin toxicity
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CaCl
PEA if hyper-K, hypo-Ca, Ca antagonism
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Fluid challenge
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Assessing
response
CVP/PAWP
Unreliable in CV (LV/RV failure,
valve disease, pulmonary vasc disease)
NB positive response (>3mmHg) may occur in
hypovolemic patient due to vasoconstriction
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Stroke volume
Challenge increases LV filling and thus SV
Failure may be continued fluid loss,
over-filled ventricle, RHF or obstruction
(PE, tamponade, MS)
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