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Thursday, 26 December 2013

Resuscitation Part 3: Circulation/Drugs

In circulation component of the resuscitation, we looked at the CPR, CPR mechanical devices, drugs, fluids and use of AED.

Firstly, we look at CPR based on AHA 2010 Guidelines. This video showed layman CPR. In the hospital context, ACLS guidelines will apply.
For better quality and consistent CPR, mechanical CPR devices had been implemented in pre hospital and hospital environment. Singapore National Resuscitation council discussed various CPR devices here.
In Khoo Teck Puat hospital, mechanical CPR Life Stat have been used.
The two rhythms shock-able are pulse less ventricular tachycardia and ventricular fibrillation. See notes here and below presentation
AED or automated external defibrillators are designed for layman to give life saving shocks to the patients who in cardiac arrests and are either in pulse-less ventricular tachycardia or ventricular fibrillation
In hospital, we use biphasic defibrillators who are capable to monitor, defibrillate and pace the patient's heart with extension of AED, known as Philips Code Master.

Advanced life support drugs are also given to assist in organ per fusion, facilitate defribillation, etc. Notes and video here.

There are other special situations who require additional steps to take during cardiac arrest scenarios such as drowning, poisoning and pregnancy. You may refer to the notes here

Post resuscitation care to maintain coronary per fusion cannot be neglected and the author in this presentation described this well.

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