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Then as guided by arterial blood gases (ABGs). (15) Non-shockable rhythms: asystole or pulseless electrical activity See Fig. 1 for a rapid overview of treatment. (i) Asystole is absence of any cardiac electrical activity. (a) check appropriate ECG lead selection and gain setting. Never just rely on a gel pad–paddle combination to diagnose asystole (b) make sure the ECG leads are not disconnected or broken by observing the cardiac compressions artefact on the ECG screen during CPR (c) continue chest compressions and ventilation if there is any difficulty in differentiating from fine VF, in an attempt to ‘coarsen’ unsuspected VF.
E. every other loop of the algorithm in Fig. 1. ✓ Tip: if venous access is impossible, give adrenaline (epinephrine) 3 mg via the endotracheal tube, that is 30 mL of 1 in 10 000, or 3 mL of 1 in 1000 adrenaline (epinephrine) in at least 10 mL of sterile water and give up to 5 respirations. (16) Potentially reversible causes: the 4 Hs and the 4 Ts Always look out for the following conditions, which may precipitate cardiorespiratory arrest or decrease the chances of successful resuscitation (see Fig.
Both 12-hourly. v. as a bolus, followed by an infusion at 1000 units/h for patients over 80 kg, or 800 units/h for patients weighing less. (a) UF heparin may be preferred in hospitals likely to offer coronary angioplasty (PCI) within 24–36 hours of symptom onset, so check your local policy (b) titrate the UF heparin infusion to an activated partial thromboplastin time (aPTT) of 50–70 seconds by 6 hours post infusion. (4) Admit all patients. The final diagnosis of NSTEMI (rise in troponin and CK-MB cardiac biomarkers), UA (smaller rise in troponin, normal CK-MB) or non-cardiac chest pain (normal cardiac biomarkers, normal ECGs, normal stress test) takes time to establish.