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CARDIAC ARREST (CLINICAL FEATURES (lose consciousness within 10-15sec…
CARDIAC ARREST
CLINICAL FEATURES
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the rhythm abnormality varies, reflecting the underlying metabolic insult and determines prognosis
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MANAGEMENT
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rhythm shockable in pulseless VT/VF, not shockable in aystole/PEA
if can't shock can get IV access adrenaline every 3-5mins (this is after initial CPR or in case of having been shocked, give after second shock)
[VF/PULSELESS VT] - after initial shock give 2 mins CPR IV adrenaline after if fails. anti arrhythmic drugs poor efficacy but given if no response to defib, CPR and adrenaline
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PATHOPHYSIOLOGY
often an acute trigger such as an electrolyte imbalance eg hypokalaemia that may precipitate the onset of any one of these rhyhtms in the vulnerable pt
primary or secondary cardiac conduction problems - as a result of metabolic acidosis and tissue hypoxia (among others) - may precipitate asystole or pulseless electrical activity (PEA) in pts with normal hearts
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AETIOLOGY
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~25% are due to non cardiac causes eg PE, trauma, intracranial haemorrhage and near drowning
it is secondary to deranged electrical activity of the heart, precipitated in most cases by heart disease (80%), particularly coronary heart disease.
cardiopulmonary arrest refers to the assoc cessation of breathing which if left untreated will result in inevitable neurological injury and death within minutes
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