By Michael Colquhoun, Anthony J. Handley, T. R. Evans
This consultant has concise and functional info on all facets of resuscitation. New directions are only one of many adjustments to the fifth version of this ebook as a few of the chapters were thoroughly rewritten.
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Additional info for ABC of resuscitation
It results from stimuli to, or the presence of foreign material in, the oro- and laryngopharynx and may ironically occur after cardiac resuscitation as the brain stem reflexes are re-established. Recovery posture Patients with adequate spontaneous ventilation and circulation who cannot safeguard their own airway will be at risk of developing airway obstruction in the supine position. Turning the patient into the recovery position allows the tongue to fall forward, with less risk of pharyngeal obstruction, and fluid in the mouth can then drain outwards instead of soiling the trachea and lungs.
Patients with a ventricular rate of less than 100 beats/min, with no symptoms, and good peripheral perfusion constitute a low risk group. When the onset of atrial fibrillation is known to have been within the previous 24 hours anticoagulation with heparin should be undertaken before an attempt is made to restore sinus rhythm, either by pharmacological or electrical means. Two drugs are suggested, amiodarone or flecainide, which are both given by intravenous infusion. Only one drug should be used in an individual patient to minimise the risk of pro-arrhythmic effects and myocardial depression.
Dorian P, Cass D, Schwartz B Cooper R, Gelaznikas R, Bara A. Amiodarone as compared with lidocaine for shock resistant ventricular fibrillation (ALIVE). N Engl J Med 2002;34:884-90. European Resuscitation Council. European resuscitation council guidelines for adult advanced life support. Resuscitation 2001;48:211-21. International guidelines 2000 for cardiopulmonary resuscitation and emergency cardiac care—an international consensus on science. Section 5: agents for arrhythmias. Resuscitation 2000;46:135-53; Section 7C A guide to the international ACLS algorithms.