RT Book, Section
A1 Williams, George W.
A2 Butterworth IV, John F.
A2 Mackey, David C.
A2 Wasnick, John D.
SR Print(0)
ID 1190611541
T1 Cardiopulmonary Resuscitation
T2 Morgan & Mikhail’s Clinical Anesthesiology, 7e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260473797
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1190611541
RD 2024/04/19
AB KEY  CONCEPTS  Cardiopulmonary  resuscitation  (CPR)  and  emergency  cardiovascular  care  (ECC)  should  be  considered  any  time  an  individual  cannot  adequately  oxygenate  or  perfuse  vital  organs—not  only  following  cardiac  or  respiratory  arrest.  Regardless  of  which  transtracheal  jet  ventilation  system  is  chosen,  it  must  be  readily  available,  use  low-compliance  tubing,  and  have  secure  connections.  Chest  compressions  should  not  be  delayed;  intubation  may  take  place  during  CPR  or  during  the  pulse  check.  Attempts  at  intubation  should  not  interrupt  ventilation  for  more  than  10  s.  Chest  compressions  should  begin  before  the  delivery  of  breaths  in  the  pulseless  patient.  Circulation  takes  precedence  over  airway  interventions  and  breathing  in  the  cardiac  arrest  patient.  Whether  adult  resuscitation  is  performed  by  a  single  rescuer  or  by  two  rescuers,  two  breaths  are  administered  every  30  compressions  (30:2),  allowing  3  to  4  s  for  every  two  breaths.  The  cardiac  compression  rate  should  be  100  to  120/min  regardless  of  the  number  of  rescuers.  Health  care  personnel  working  in  hospitals  and  ambulatory  care  facilities  must  be  able  to  provide  early  defibrillation  to  patients  with  ventricular  fibrillation  as  soon  as  possible.  The  time  from  collapse  to  defibrillation  is  the  most  important  determinant  of  survival.  The  chances  for  survival  decline  7%  to  10%  for  every  minute  without  defibrillation.  If  intravenous  cannulation  is  difficult,  an  intraosseous  infusion  can  provide  emergency  vascular  access  in  children  and  adults.  Lidocaine,  epinephrine,  atropine,  naloxone,  and  vasopressin  (but  not  sodium  bicarbonate)  can  be  delivered  via  a  catheter  whose  tip  extends  past  the  endotracheal  tube.  Dosages  2  to  2½  times  higher  than  recommended  for  intravenous  use,  diluted  in  5  to  10  mL  of  normal  saline  or  distilled  water,  are  recommended  for  adult  patients.  Because  carbon  dioxide,  but  not  bicarbonate,  readily  crosses  cell  membranes  and  the  blood–brain  barrier,  arterial  hypercapnia  causes  intracellular  tissue  acidosis.  A  wide  QRS  complex  following  a  pacing  spike  signals  electrical  capture,  but  mechanical  (ventricular)  capture  must  be  confirmed  by  an  improving  pulse  or  blood  pressure.