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Medical: 5

Cardiology: 2 ════════════════════════════════════════════════════════════════════════════════════ ══════════════════════════

      • g.

        Alkalinizing agent

      • h.

        Other

  • F.

    Transport

    • 1.

      Refusal

    • 2.

      No other indications for no transport

  • G.

    Support and communications strategies

    • 1.

      Explanation for patient, family, significant others

    • 2.

      Communications and transfer of data to the physician

XIII.

Cardiac arrest

A.

B.

Pathophysiology

  • 1.

    Precipitating causes

    • a.

      Trauma

    • b.

      Medical conditions (for example)

      • (1)

        End stage renal disease

      • (2)

        Hyperkalemia with renal disease

Initial assessment

Unresponsive

Apneic

Heart rate/ rhythm

(1)

Ventricular fibrillation

(2)

Ventricular tachycardia

(3)

Asystole

(4)

PEA

1.

Critical findings

a. b. c .

C.

D.

  • d.

    Peripheral pulses

    • (1)

      None

Focused history

  • 1.

    Witnessed event

  • 2.

    Witnessed by EMS personnel

  • 3.

    Bystander cardiopulmonary resuscitation (CPR)

  • 4.

    Time from discovery to activation of CPR

  • 5.

    Time from discovery to activation of EMS

  • 6.

    Past medical history

Management

  • 1.

    Related terminology

    • a.

      Resuscitation - to provide efforts to return spontaneous pulse and breathing to the patient in full cardiac arrest

    • b.

      Survival - patient is resuscitated and survives to hospital discharge

    • c.

      Return of spontaneous circulation (ROSC) - patient is resuscitated to the point of having pulse without CPR; may or may not have return of spontaneous respirations; patient may or may not go on to survive

  • 2.

    Indications for NOT initiating resuscitative techniques

    • a.

      Signs of obvious death

      • (1)

        For example - rigor; fixed lividity; decapitation

    • b.

      Local protocol

      • (1)

        For example - out-of-hospital advance directives

  • 3.

    Advanced airway management and ventilation

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────────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

32

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