Part 14: Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Monica E. Kleinman,Leon Chameides,Stephen M. Schexnayder,Ricardo A. Samson,Mary Fran Hazinski,Dianne L. Atkins,Marc D. Berg,Allan R. de Caen,Ericka L. Fink,Eugene B. Freid,Robert W. Hickey,Bradley S. Marino,Vinay M. Nadkarni,Lester T. Proctor,Faiqa Qureshi,Kennith Sartorelli,Alexis A. Topjian,Elise W. van der Jagt,Arno Zaritsky +18 more
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TLDR
In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause, more often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest.Abstract:
In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause. More often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest. Asphyxia begins with a variable period of systemic hypoxemia, hypercapnea, and acidosis, progresses to bradycardia and hypotension, and culminates with cardiac arrest.1
Another mechanism of cardiac arrest, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), is the initial cardiac rhythm in approximately 5% to 15% of pediatric in-hospital and out-of-hospital cardiac arrests;2,–,9 it is reported in up to 27% of pediatric in-hospital arrests at some point during the resuscitation.6 The incidence of VF/pulseless VT cardiac arrest rises with age.2,4 Increasing evidence suggests that sudden unexpected death in young people can be associated with genetic abnormalities in myocyte ion channels resulting in abnormalities in ion flow (see “Sudden Unexplained Deaths,” below).
Since 2010 marks the 50th anniversary of the introduction of cardiopulmonary resuscitation (CPR),10 it seems appropriate to review the progressive improvement in outcome of pediatric resuscitation from cardiac arrest. Survival from in-hospital cardiac arrest in infants and children in the 1980s was around 9%.11,12 Approximately 20 years later, that figure had increased to 17%,13,14 and by 2006, to 27%.15,–,17 In contrast to those favorable results from in-hospital cardiac arrest, overall survival to discharge from out-of-hospital cardiac arrest in infants and children has not changed substantially in 20 years and remains at about 6% (3% for infants and 9% for children and adolescents).7,9
It is unclear why the improvement in outcome from in-hospital cardiac arrest has occurred, although earlier recognition and management of at-risk patients on general inpatient units …read more
Citations
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European Resuscitation Council Guidelines for Resuscitation 2015
Gavin D. Perkins,Gavin D. Perkins,Anthony J. Handley,Rudolph W. Koster,Maaret Castrén,Michael Smyth,Theresa M. Olasveengen,Koenraad G. Monsieurs,Koenraad G. Monsieurs,Violetta Raffay,Jan-Thorsten Gräsner,Volker Wenzel,Giuseppe Ristagno,Jasmeet Soar,Leo Bossaert,Antonio Caballero,Pascal Cassan,Cristina Granja,Claudio Sandroni,David Zideman,Jerry P. Nolan,Ian Maconochie,Robert Greif +22 more
TL;DR: This chapter contains guidance on the techniques used during the initial resuscitation of an adult cardiac arrest victim and the use of an automated external defibrillator (AED).
Journal ArticleDOI
Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Monica E. Kleinman,Erin E. Brennan,Zachary D. Goldberger,Robert A. Swor,Mark Terry,Bentley J. Bobrow,Raúl J. Gazmuri,Andrew H. Travers,Thomas D. Rea +8 more
TL;DR: This 2015 Guidelines Update is based on the systematic reviews and recommendations of the 2015 International Consensus on CPR and ECC Science With Treatment Recommendations, “Part 3: Adult Basic Life Support and Automated External Defibrillation.”
Journal ArticleDOI
Cardiopulmonary resuscitation quality: Improving cardiac resuscitation outcomes both inside and outside the hospital: A consensus statement from the American heart association
Peter A. Meaney,Bentley J. Bobrow,Mary E. Mancini,Jim Christenson,Allan R. de Caen,Farhan Bhanji,Benjamin S. Abella,Monica E. Kleinman,Dana P. Edelson,Robert A. Berg,Tom P. Aufderheide,Venu Menon,Marion Leary +12 more
TL;DR: This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient's response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels.
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TL;DR: This tutorial simplifies the process of installing batteries and bringing the 4-in-1 sensor within direct range of your Z-Wave gateway controller to ensure the device has been successfully excluded.
Journal ArticleDOI
Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Allan R. de Caen,Marc D. Berg,Leon Chameides,Cheryl K. Gooden,Robert W. Hickey,Halden F. Scott,Robert M. Sutton,Janice A. Tijssen,Alexis A. Topjian,Elise W. van der Jagt,Stephen M. Schexnayder,Ricardo A. Samson +11 more
TL;DR: New data show that prolonged cardiopulmonary resuscitation is not futile: 12% of patients receiving CPR in IHCA for more than 35 minutes survived to discharge, and 60% of the survivors had a favorable neurologic outcome.
References
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Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock
Emanuel P. Rivers,Bryant Nguyen,Suzanne Havstad,Julie Ressler,Alexandria Muzzin,Bernhard P. Knoblich,Edward L. Peterson,Michael C. Tomlanovich +7 more
TL;DR: This study randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit.
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Heart Disease and Stroke Statistics—2010 Update A Report From the American Heart Association
Donald M. Lloyd-Jones,Robert J. Adams,Todd M. Brown,Mercedes R. Carnethon,Shifan Dai,Giovanni de Simone,T. Bruce Ferguson,Earl S. Ford,Karen L. Furie,Cathleen Gillespie,Alan S. Go,Kurt J. Greenlund,Nancy Haase,Susan M. Hailpern,P. Michael Ho,Virginia J. Howard,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Lynda D. Lisabeth,Ariane Marelli,Mary M. McDermott,James B. Meigs,Dariush Mozaffarian,Michael E. Mussolino,Graham Nichol,Véronique L. Roger,Wayne D. Rosamond,Ralph L. Sacco,Paul D. Sorlie,Randall S. Stafford,Thomas Thom,Sylvia Wasserthiel-Smoller,Nathan D. Wong,Judith Wylie-Rosett +34 more
TL;DR: The Statistical Update brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update each year.
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Thrombolysis with Alteplase 3 to 4.5 Hours After Acute Ischemic Stroke
Werner Hacke,Markku Kaste,Erich Bluhmki,Miroslav Brozman,Antoni Dávalos,Donata Guidetti,Vincent Larrue,Kennedy R. Lees,Zakaria Medeghri,Thomas Machnig,Dietmar Schneider,Rüdiger von Kummer,Nils Wahlgren,Danilo Toni +13 more
TL;DR: As compared with placebo, intravenous alteplase administered between 3 and 4.5 hours after the onset of symptoms significantly improved clinical outcomes in patients with acute ischemic stroke; altePlase was more frequently associated with symptomatic intracranial hemorrhage.
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Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia
A. B Ernard,Imothy W. G Ray,D. B Uist,M. J Ones,W Illiam S Ilvester,G Eoff G Utteridge,K Aren S Mith +6 more
TL;DR: This randomized, controlled trial compared the effects of moderate hypothermia and normothermia in patients who remained unconscious after resuscitation from out-of-hospital cardiac arrest to survive to hospital discharge and be discharged to home or to a rehabilitation facility.
Journal ArticleDOI
Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest
Michael Holzer,Fritz Sterz,J. M. Darby,S. A. Padosch,Karl B. Kern,Bernd W. Böttiger,Kees H. Polderman,Armand R. J. Girbes,Michael Holzer,Stephen Bernard,M. D. Buist,Peter Safar,Patrick M. Kochanek +12 more
TL;DR: In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation, therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality.
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Part 8: Adult Advanced Cardiovascular Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa)
Ian N. Jacobs,Vinay M. Nadkarni,J. Bahr,Robert A. Berg,John E. Billi,Leo Bossaert,Pascal Cassan,Ashraf Coovadia,Kate D'Este,Judith Finn,Henry R. Halperin,Anthony J. Handley,Johan Herlitz,Robert W. Hickey,Ahamed H. Idris,Walter Kloeck,Gregory Luke Larkin,Mary E. Mancini,Pip Mason,Gregory Mears,Koenraad G. Monsieurs,William H. Montgomery,Peter T. Morley,Graham Nichol,Jerry P. Nolan,Kazuo Okada,Jeffrey M. Perlman,Michael Shuster,Petter Steen,Fritz Sterz,J. Tibballs,Sergio Timerman,Tanya Lane Truitt,D. Zideman +33 more