7c. Pulseless Electrical Activity and Asystole, Advanced Cardiac Life Support (ACLS) (2020) - OLD скачать в хорошем качестве

7c. Pulseless Electrical Activity and Asystole, Advanced Cardiac Life Support (ACLS) (2020) - OLD

The third lesson in chapter 7 discusses Pulseless Electrical Activity and Asystole. Specifically, this lesson explains the rules to recognize each of these. The differences are outlined and each ECG type is defined. It is important to note the differences in rules between each. The guidelines provided in this lesson are designed to ensure proper care when using ECGs. "Pulseless electrical activity, or PEA, and asystole are related cardiac rhythms in that they are both life-threatening and unshockable. Asystole is a flat-line ECG. There may be a subtle movement away from baseline (which is considered drifting flat-line), but there is no perceptible cardiac electrical activity. Always ensure that a reading of asystole is not a user or technical error. Make sure patches have good contact with the individual, leads are connected, the gain is set appropriately, and the power is on. PEA is one of many waveforms by ECG (including sinus rhythm) without a detectable pulse. PEA may include any pulseless waveform with the exception of VF, VT, or asystole. Hypovolemia and hypoxia are the two most common causes of PEA. They are also the most easily reversible and should be at the top of any differential diagnosis. If the individual has return of spontaneous circulation (or ROSC), proceed to post-cardiac arrest care. Atropine is no longer recommended in cases of PEA or asystole. The rules for PEA and asystole include the rhythm as a nearly flat line. There is no rate, and there are no P waves present. The PR interval is unable to be measured due to no P waves. There are no QRS complexes present either. You should always verify that a reading of asystole is not equipment failure. Make sure patches make good contact with the individual, all cables are connected, the gain is set appropriately, and the power is on. The reversible causes of cardiac arrest are the H’s and the T’s. The H’s include hypovolemia, hypoxia, H+ or acidosis, hypo- and hyperkalemia, hypoglycemia, and hypothermia. The T’s include tension pneumothorax, tamponade, toxins, coronary thrombosis, pulmonary thrombosis, and unrecognized trauma. Now, let’s move onto drugs and dosages. Do not administer atropine during PEA or asystole. Although there is no evidence that atropine has a detrimental effect during bradycardic or asystolic cardiac arrest, routine use of atropine during PEA or asystole has not been shown to have a therapeutic benefit. Therefore, the AHA has removed atropine from the cardiac arrest guidelines. You may only administer a standard dose of epinephrine or vasopressin. Preliminary research suggested that epinephrine in higher doses may produce improved results in resuscitation. However, research conducted after the 2010 guidelines publication failed to show any benefit over standard dose of 1 mg epinephrine. Likewise, the 2010 AHA guidelines offered an alternative vasopressor, called vasopressin, which could be used instead of or after the first dose of epinephrine. Subsequent research showed that vasopressin offered no benefit over standard dose epinephrine. Without a demonstration of superiority, both high-dose epinephrine and vasopressin have been removed, simplifying the ACLS algorithm." Need certified or rectified in ACLS, visit https://disquefoundation.org/acls-cou... ************************************** Follow us on social media! Facebook:   / disquefoundation   Twitter:   / disquefndn   Instagram:   / savealifeinitiative   Pinterest:   / disquefoundation   LinkedIn:   / disque-foundation   Website: https://disquefoundation.org/ To find out more about the Save a Life Initiative and the Disque foundation please visit our site or email us at [email protected] Together, let’s save lives.