ABC of resuscitation

Description

ABC of Resuscitation is a practical, illustrated guide to the latest resuscitation advice for the non-specialist and provides the core knowledge on the treatment of cardiopulmonary arrest. This edition provides a guide to the European Resuscitation Council Guidelines for Resuscitation 2010 and the Resuscitation Council (UK) 2010 Resuscitation Guidelines. It Includes: the causes and prevention of cardiac arrestbasic and advanced life support for adults, children and newbornsresuscitation in a range of contexts (in-hospital and out-of-hospital, including drowning, pregnancy, sport and trauma)important aspects of implementation of guidelines including human factors and education  ABC of Resuscitation, 6th Edition is ideal for all healthcare professionals including junior doctors, medical students, general practitioners, paramedics and nurses. It is also useful for pre-hospital care practitioners, emergency medicine trainees, resuscitation officers and all those who teach resuscitation. ABC of Resuscitation Contents List of Contributors Foreword Chapter 1 Cardiac Arrest and the Chain of Survival Epidemiology of cardiac arrest The chain of survival Early CPR Early defibrillation Post resuscitation care Resuscitation guidelines Further reading Chapter 2 Sudden Cardiac Death Introduction Causes of sudden cardiac death How do people present? Inherited cardiac conditions Prevention of sudden cardiac death Coronary atheroma and ischaemic heart disease Heart failure and left ventricular systolic impairment Long QT syndromes Severe aortic stenosis Atrio-ventricular block Wolff–Parkinson–White syndrome Further reading Chapter 3 Causes and Prevention of Cardiac Arrest in Hospital Introduction Demographics of IHCA Outcome following in-hospital cardiac arrest Predisposing factors Structuring systems to prevent patient deterioration and cardiac arrest in hospital The first ring of the chain of prevention: staff education The second ring of the chain of prevention: monitoring The third ring of the chain of prevention: recognition The fourth ring of the chain of prevention: call for help The fifth ring of the chain of prevention: response The role of ‘do not attempt cardiopulmonary resuscitation’ decisions in reducing the cardiac arrest rate in hospital Suggested guidelines for the prevention of in-hospital cardiac arrest Further reading Chapter 4 Basic Life Support Introduction Diagnosing cardiac arrest Circulatory support Ventilatory support Risks to rescuer and patient Adult basic life support sequence Compression-only CPR CPR in children Further reading Chapter 5 Advanced Life Support Introduction ALS algorithm (Figure 5.1) Shockable rhythms (Box 5.1) Non-shockable rhythms (Box 5.2) During CPR (Box 5.3) Airway and ventilation Vascular access Drugs Ultrasound Post-resuscitation care Stopping resuscitation and confirmation of death Informing the next of kin following a failed resuscitation attempt Further reading Chapter 6 Defibrillation Introduction Defibrillators Factors influencing defibrillation Transthoracic impedance Shock waveform Shock energy Shock sequence Electrode position Chest compressions Safety Accidental electrocution Safe use of oxygen Cardiac pacemakers and implantable cardioverter-defibrillators (ICD) Internal defibrillation Further reading Chapter 7 Airway Management and Ventilation Introduction Causes of airway obstruction Recognition of airway obstruction Choking Basic techniques for opening the airway Adjuncts to basic airway techniques Oxygen Ventilation Self-inflating bag Supraglottic airway devices Laryngeal mask airway (LMA) The ProSeal LMA I-gel airway Laryngeal tube Tracheal intubation Confirmation of correct tracheal tube placement Cricothyroidotomy Further reading Chapter 8 Post-Resuscitation Care Introduction The post-cardiac arrest syndrome Optimising organ function Airway and breathing Circulation Brain Prognostication Organ donation Further reading Chapter 9 Paediatric Resuscitation Introduction Paediatric basic life support Unresponsive? Shout for help Open the airway Five rescue breaths No signs of life? Chest compressions Two breaths followed by 15 chest compressions When to stop Automated external defibrillator (AED) use in children Paediatric advanced life support Step 1 Step 2 Step 3 Parental presence Choking Recognition of choking Further reading Chapter 10 Resuscitation at Birth Introduction Equipment and temperature control Procedure at delivery Keeping the baby warm Assessment of the newborn baby Resuscitation procedure Airway Breathing (aeration breaths and ventilation) Circulation Pre-term babies Saturation monitoring Further reading Chapter 11 Out-of-Hospital Resuscitation Introduction Emergency Medical System (EMS) response EMS dispatch Initial assessment Pre-hospital interventions Performance National guidelines Chain of survival Early access Early CPR Early defibrillation Early advanced life support Post-resuscitation care Termination of resuscitation attemp Further reading Chapter 12 In-Hospital CPR Introduction Recognising cardiac arrest Agonal breathing Start resuscitation Activate the emergency resuscitation team Continue high-quality CPR Defibrillation Handover to the resuscitation team Resuscitation team Planning for the emergency response Clinical staff training Emergency drills Further reading Chapter 13 Peri-arrest Arrhythmias Introduction Adverse features Tachyarrhythmia Tachycardia with adverse features Tachycardia without adverse features Broad-complex tachycardia Narrow-complex tachycardia Bradyarrhythmia Pharmacological treatment for bradycardia Cardiac pacing for bradycardia Acknowledgement Further reading Chapter 14 Pacemakers and Implantable Cardioverter-Defibrillators Introduction Indications for pacing and ICDs Methods of pacing Non-invasive pacing Concepts in pacing and internal cardiacd efibrillation Pace threshold Pacing mode The magnet mode Troubleshooting devices Failure to pace Failure of therapy to terminate VT or VF Inappropriate ICD therapy Tracking of atrial arrhythmias Further reading Chapter 15 Cardiorespiratory Arrest in Advanced Pregnancy Introduction Physiological changes Airway Breathing Circulation Cardiopulmonary resuscitation guidelines 2010 Drugs Defibrillation Chest compression Perimortem caesarean section Timing Post-cardiac arrest care Maternal collapse Other rare causes of maternal collapse and cardiopulmonary arrest Drug toxicity Maternal Early Warning Systems (MEWS) Further reading Chapter 16 Drowning Introduction Definition The need for oxygen The drowning victim Basic life support Cervical spine injury Defibrillation Advanced life support Hypothermia and drowning Stopping CPR Further reading Chapter 17 Trauma Introduction Airway management Current practice Further considerations Cervical spine immobilisation Breathing Current practice Further considerations Circulation and haemorrhage control Current practice Further considerations Disability Current practice Further considerations Traumatic cardiac arrest Further reading Chapter 18 Human Factors Introduction Nature of accidents The error chain Communication Failure to escalate Situation awareness Summary Further reading Chapter 19 CPR Devices The importance of high-quality cardiopulmonary resuscitation Cardiopulmonary resuscitation feedback and prompt devices Mobile phones Mechanical chest compression devices AutoPulse LUCAS Current status Active compression–decompression CPR Impedance threshold device Further reading Chapter 20 Resuscitation in Sport Resuscitation in sport Non-traumatic cardiac arrest Hypertrophic cardiomyopathy (HCM) Congenital coronary artery anomalies (CCAA) Arrhythmogenic right ventricular cardiomyopathy (ARVC) Coronary artery disease (CAD) Ion channel disorders (channelopathies) Heat stroke Role of automated external defibrillators Initial management of a collapsed athlete due to presumed cardiac cause Cardiac arrest associated with trauma in sport Management of a cardiac arrest secondary to trauma Commotio cordis Summary Further reading Chapter 21 Improving Outcomes from Cardiac Arrest: Quality, Education and Implementation Introduction Measuring patient outcomes Patient safety incident reporting Education and implementation Compression-only CPR Checklists Mock codes Post-event debriefing Further reading Chapter 22 Decisions Relating to Resuscitation Introduction Ethical principles Applying ethical principles When are decisions about CPR appropriate? When CPR will not re-start the heart Refusal of CPR When CPR is considered not to be in the person’s best interests Communication Communication between healthcare professionals Further reading Index