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  • Image not available. High-quality cardiopulmonary resuscitation with minimal interruptions in chest compressions should be emphasized in all patients following cardiac arrest.
  • Image not available. Chest compressions prior to defibrillation [consistent with the cardiocerebral resuscitation (CCR) model] may lead to more successful outcomes especially with arrests that are not witnessed.
  • Image not available. The purpose of using vasopressor therapy following cardiac arrest is to augment low coronary and cerebral perfusion pressures encountered during cardiopulmonary resuscitation (CPR).
  • Image not available. Despite several theoretical advantages with vasopressin, clinical trials have not consistently demonstrated superior results over that achieved with epinephrine
  • Image not available.Amiodarone remains the preferred antiarrhythmic during cardiac arrest according to the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (or 2005 AHA guidelines) with lidocaine considered as an alternative.
  • Image not available. Successful treatment of both pulseless electrical activity (PEA) and asystole depends almost entirely on diagnosis of the underlying cause.
  • Image not available. Intraosseous administration is the preferred alternative route for administration if IV access can not be achieved.

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Upon completion of the chapter, the reader will be able to:

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  • 1. Discuss the most common causes of cardiac arrest in both adult and pediatric patients.
  • 2. Define each component of the “chain of survival,” and apply this concept to a victim of cardiac arrest.
  • 3. Discuss the importance of electrical defibrillation and its effect on survival for a patient with VF or PVT.
  • 4. Compare and contrast the principles of CCR with CRP.
  • 5. Formulate a pharmacological treatment plan for a patient with VF or PVT.
  • 6. Compare and contrast the different sympathomimetic agents used to treat VF or PVT.
  • 7. Discuss the role of vasopressin for a patient with cardiac arrest.
  • 8. Compare and contrast the antiarrhythmic agents recommended for a patient with VF or PVT.
  • 9. Discuss the role of therapeutic hypothermia for a comatose patient following cardiac arrest.
  • 10. List the common correctable causes of PEA and asystole.
  • 11. Discuss the role of atropine for a patient with asystole or PEA.
  • 12. Discuss the role of sodium bicarbonate for a patient with cardiac arrest.
  • 13. Cite the doses of the drugs used to treat a cardiac arrest.
  • 14. Discuss strategies for drug administration if IV access can not be obtained.
  • 15. Describe the treatment of cardiac arrest as it applies to special situations such as drowning, hypothermia, pregnancy, trauma, and electrical shock.
  • 16. Discuss treatment strategies that pertain to postresuscitative care following a cardiac arrest.
  • 17. Formulate a monitoring plan for the postresuscitation phase of cardiac arrest.

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Cardiac arrest is defined as the cessation of cardiac mechanical activity as confirmed by the absence of signs of circulation (e.g., a detectable pulse, unresponsiveness, and apnea).1 While there is wide variation in the reported incidence of cardiac arrest, it is estimated that there are 294,851 emergency medical services (EMS)-treated out-of-hospital cardiac arrests annually in the United States.2 Unfortunately, outcomes remain alarmingly poor with survival to hospital discharge ranging from 1.1% to 8.1% in patients who suffer out-of-hospital cardiac arrest.3...

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