A Resuscitation Room Guide Banerjee by Hargreaves

By Hargreaves

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93 53 54 54 55 Fig. 13 Anaphylactic reactions: treatment algorithm for children by first medical responders. Reproduced with permission by the Resuscitation Council (UK). 96 Introduction • Early airway assessment and control are essential components of the respiratory management of all acutely ill patientsâ for whom oxygenation is always a crucial priority • Apart from witnessed primary cardiac arrestâ where defibrillation takes precedenceâ ensuring a patent airway and delivering oxygen into the lungs is the immediate aim, fundamental to successful patient care by preventing hypoxaemia • The clear airway may be threatened by many widely different disease processes and at different levels from the front of the face down to the bronchi • Tracheal intubation is the definitive way of securing the airway to by-pass any obstruction, permit positive pressure ventilation and regulate gas exchange with high oxygen concentrations if needed.

Procainamide 20-30mg/min to a maximum of 1g. 79 If appropriate, give oxygen, cannulate a vein, and record a 12-Lead ECG 40 41 Fig. 8 Bradycardia algorithm (includes rates inappropriately slow for the haemodynamic state). Reproduced with permission by the Resuscitation Council (UK). 80 41 42 Fig. 9 Tachycardia algorithm (with pulse). Reproduced with permission by the Resuscitation Council (UK). 81 Potentially reversible causes of cardiac arrest Four Hs • Hypoxia • Hypovolaemia 42 43 • Hyperkalaemia; hypocalcaemia; acidaemia • Hypothermia.

Magnesium sulphate • 8mmol or 2g(4mL of 50% magnesium sulphate) over 1-2min; can be repeated after 10-15min • 1mL 50% magnesium sulphate = 2mmol = 500mg. 10mmol/kg). • Two concentrations exist in ampoule form: ♦ 20mL of 20% (= 16mmol = 4g) ♦ 2mL of 50% (= 4mmol = 2g) • 4, 5 and 10mL pre-filled syringes of 50% solution are also available. g. potassium-losing diuretic therapy) • Torsade de pointes on the ECG • Digoxin toxicity. 5mg/kg) 38 39 • Additional bolus of 50mg if necessary • Not more than 3mg/kg during the first hour • This is used if amiodarone is not available and not if amiodarone has already been used.

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