ILCOR = International Liaison committee on Resuscitation = conglomerate of resuscitation councils worldwide. Changes in 2010
Fluid responsiveness is an increase of stroke volume of 10-15% after the patient receives 500 ml of crystalloid over 10-15 minutes (as defined by Paul Marik). The definitive test for fluid responsiveness is a Fluid challenge
KEY FEATURES CAB rather than ABC (30:2) 2 min cycles early, high quality, uninterrupted at least 100/min (rather than around) avoid excessive ventilation early defibrillation (higher joules for cardioversion) amiodarone after 3rd shock adrenaline every 4 minutes (every 2nd cycle) capnography no atropine no ETT drugs (IV or IO) adenosine is an option for unstable, […]
Regardless of the underlying cause of the illness, the provision of meticulous supportive care is essential to the management of any critically ill patient. Back in 2005, Jean Louis Vincent popularised the FAST HUGS mnemonic for recalling the key issues to review when looking after a critically ill patient.
Cardiac arrest occurs after 0.7 – 2.9% of cardiac surgery cases. Usually preceded by physiological deterioration but can occur in previously stable patients
KEY FEATURES CAB (ERC still advocates 5 initial rescue breaths) good quality CPR in 15:2 ratio removal of ‘look, listen, feel’ de-emphasis on pulse check AED and defibrillation use encouraged (infants manual defibrillation) capnography recommended defibrillation: 4 J/kg adrenaline 10 mcg/kg = 0.1 mL/kg of 1/10,000 (immediately then every second cycle) avoid hyperoxia congenital heart […]
Pulseless electrical activity (PEA) occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left ventricular stroke volume is not sufficient to produce a clinically detectable pulse