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in electric shock and lightning strike injuries, 155 Abdominal thrusts in foreign-body airway obstruction, 28, 29, 162 Acidosis, bicarbonate therapy in, 81– 82 in definitions of neonate, infant, and child, 13, 14, 157 and recommendations for resuscitation, 13, 14 –15 angiotensin-converting enzyme inhibitors in, 102 Air bag–related injuries of children, 156 automatic transport ventilators in, 25, 48 rescue breathing and chest compressions in, 13, 14, 23, 24, 25, emergency medical services in, 20, 89 –92 fibrinolytic therapy in. See Fibrinolytic therapy, in acute coronary in drug-induced emergencies, 126endotracheal intubation in, 52, 53–55 glucose-insulin-potassium therapy in, 102 esophageal-tracheal Combitube in, 52–53 glycoprotein IIb/IIIa inhibitors in, 101–102 in foreign-body airway obstruction, 28 –29, 162 major adverse coronary events (MACE) in, 89, 94, 95 in pediatric advanced life support, 167–169 in pediatric basic life support, 157–158, 163 non–ST-segment elevation in. See Non–ST-segment elevation myo- in submersion victims, 133–134, 163, 199 percutaneous coronary interventions in. See Percutaneous coronary in electric shock and lightning strike injuries, 155 ST segment in. See ST segment in acute coronary syndromes in supraventricular tachycardia, 72–73, 74 Allergic reactions, anaphylaxis in, 143–145, 197 Adrenal insufficiency, postresuscitation, 86 Alteplase, 99. See also Fibrinolytic therapy in supraventricular tachycardia, 72, 73, 75 Anesthetics, inhaled, in asthma therapy, 140 Angina. See also Non–ST-elevation myocardial infarction and unstable Advanced cardiovascular life support, 3, 4, 51– 87 B-6
Subject Index
B-7
glycoprotein IIb/IIIa inhibitors in, 101–102 Atrioventricular nodal tachycardia, reentrant, 72, 74, 76 Automated external defibrillation, 12, 35–39 Anistreplase, 99. See also Fibrinolytic therapy in adult basic life support, 19 –20, 27 in hospital setting, 35, 39in hypothermia, 137 integration with CPR, 12, 19 –20, 27, 35–36 lay rescuer use of, 12, 19 –20, 27, 37–38 in public access defibrillation programs, 12, 19 –20, 37–38 shock first versus CPR first protocols in, 27, 35, 207 Automatic transport ventilators, 25, 47– 48 Back slaps in foreign-body airway obstruction, 28 compared with endotracheal intubation, 52 Barrier devices in rescue breathing, 24, 159 benefits of early interventions in, 19, 20 –21 breathing and ventilation in, 14, 15, 21, 22–25 in electric shock and lightning strike injuries, 154, 155, 198 defibrillation in, 27, 162emergency medical services in in foreign-body airway obstruction, 28 –29 in acute coronary syndromes, 20, 91, 95, 97–98 differentiated from anaphylaxis, 143–144 sequence of actions in, 21–27, 157–162 in submersion and drowning, 27–28, 133–134 in electric shock and lightning strike injuries, 154 B-8
Subject Index
Biomarkers, cardiac, in acute coronary syndromes, 94 Biphasic defibrillation, 36, 37, 40, 207–208 new recommendations on, 3, 12, 13, 14, 23, 206 –207 number of breaths per minute in, 14, 23, 25, 26 and stroke risk in fibrinolytic therapy, 99 with oxygen-powered manually triggered devices, 25, 48 in submersion and drowning, 27, 133–134, 199 –200 and magnesium serum levels, 123, 124, 125, 151 and potassium serum levels, 121, 124, 125 Braunwald risk stratification in acute coronary syndromes, 95, 96 Breathing and ventilation, 14, 22–25, 51–55 in advanced airways, 13, 14, 23, 24 –25, 26, 52 automatic transport ventilators in, 25, 47– 48 bag-mask devices in. See Bag-mask ventilation Canadian Neurologic Scale in stroke assessment, 115 compression-to-ventilation ratio in, 161, 207 compression-to-ventilation ratio in, 13, 26 –27 new recommendations on, 3, 14, 15–16, 206 –207 gastric inflation in, 23, 51, 159 –160, 168 in children. See Children, cardiac arrest in defibrillation in, 27. See also Defibrillation Subject Index
B-9
sequence of actions in, 13–14, 21–27, 157–162 sequence of actions in, 60 – 61, 174, 208 hypothermia as therapy in, 4, 49, 84 – 85 in electric shock and lightning strike injuries, 154, 155 shock first versus CPR first protocols in, 4, 35, 60, 207 survival rates in, 4, 12, 19, 20, 27, 206 in shock first versus CPR first protocols, 35, 207 termination of resuscitation in, 61– 62 nasal, for oxygen therapy in children, 160 drugs for maintenance of, 79 – 82, 180 –181 transtracheal, for ventilation support in children, 169 Cardiopulmonary resuscitation, 2–3, 12–16 active compression-decompression technique, 48 Cerebrovascular disorders, 111–118. See also Stroke advanced. See Advanced cardiovascular life support automatic transport ventilators in, 25, 47– 48 Charcoal, activated, as first aid for ingestions, 200 in active compression-decompression technique, 48 first, compared with shock-first protocol, 4, 35, 60, 207 in advanced airways, 13, 14, 23, 24 –25 for lay rescuers and healthcare providers, comparison of, 12–15 in children, 14 –15, 157, 159, 160 –161, 170 number per minute, 159, 160, 161, 170, 175 new recommendations for, 3– 4, 12–15, 206 –209 oxygen-powered manually triggered devices in, 25, 48 in 1-shock versus 3-shock protocols, 4, 16, 36, 60, 208 in shock first versus CPR first protocols, 4, 35, 60, 207 drug therapy sequence in, 60 – 61, 174, 208 B-10
Subject Index
foreign-body airway obstruction in, 28, 162 guidelines for resuscitation in, 3, 13, 209 sequence of resuscitation in, 14, 157–162 in 1-shock versus 3-shock protocols, 4, 16, 36, 60, 208 with special healthcare needs, 162–163, 178 submersion and drowning of, 134, 156 –157, 163, 199 by lay rescuer and healthcare provider, comparison of, 12, 13, 14, 15 in multiple rescuers, 13, 14, 24 –25, 26 Choking in foreign-body airway obstruction, 28 –29 push hard, push fast/often recommendation, 3, 16, 25, 160, 207 Cincinnati Prehospital Stroke Scale, 111, 113 in pediatric advanced life support, 169 –170 Classification of recommended interventions, 1–2 recommendations for, 3, 14, 15–16, 206 –207 Clopidogrel in acute coronary syndromes, 100 Cold applications in musculoskeletal trauma, 199 Coma, postresuscitation care in, 84, 85, 181 Compression of chest. See Chest compressions Chest thrusts in foreign-body airway obstruction, 28, 29 Conduction disorders, drug-induced, 127, 130 Conflict of interest issues, 3, 204 –205 Children. See also Infants; Newborns advanced cardiovascular life support in, 13, 167–181 Coronary artery disease, 20. See also Acute coronary syndromes in adrenal insufficiency, postresuscitation, 86 breathing and ventilation in, 14, 158 –160, 161 compression-to-ventilation ratio in, 161, 207 Creatine kinase-MB isoenzyme in acute coronary syndromes, 94 automated external defibrillation in, 39, 157 Cyanide levels in nitroprusside therapy, 81 chest compressions in, 14 –15, 157, 159, 170 defibrillation in, 13, 39, 162, 173–175 automated external, 13, 39, 157, 161–162, 174 in adult basic life support, 19 –20, 27 automated external. See Automated external defibrillation biphasic. See Biphasic defibrillation family presence during resuscitation of, 9, 181 in 1-shock versus 3-shock protocols, 4, 36, 60, 208 in shock first versus CPR first protocols, 4, 35, 60, 207 Subject Index
B-11
in children. See Children, defibrillation in drug therapy sequence in, 60 – 61, 174, 208 in electric shock and lightning strike injuries, 154, 155 electrode placement in, 38 –39, 40, 174 energy levels in. See Energy levels in defibrillation ventricular arrhythmias in, 76, 127, 129 –130 in acute coronary syndromes, 97–99, 100 –103 antiarrhythmic. See Antiarrhythmic drugs implantable cardioverter-defibrillator affecting, 39, 40 integration with CPR, 4, 12, 16, 19 –20, 27, 35–36 monophasic. See Monophasic defibrillation in cardiac arrest, 58, 60 – 61, 62– 64 1-shock versus 3-shock protocols in, 4, 16, 36, 60, 207–208 sequence of actions in, 60 – 61, 174, 208 in pulseless arrest, 60 – 61, 174 –175 in children. See Children, drug therapy in recurrence of ventricular fibrillation after, 36 and synchronized cardioversion, 41– 42, 71 fibrinolytic. See Fibrinolytic therapy in polymorphic ventricular tachycardia, 73, 74 waveforms in. See Waveforms in defibrillation anticipation of neonatal resuscitation in, 188 initial assessment and management of newborn in, 188 –192 Durable power of attorney for health care, 6 Diabetes mellitus, hyponatremia in, 123Dialysis Edema, laryngeal, in anaphylaxis, 143, 144, 145 in active compression-decompression CPR, 48 Diazepam in drug-induced tachycardia, 129 in supraventricular tachycardia, 72, 73, 74 in telephone instructions from emergency medical dispatch, 20 Disease transmission during resuscitation, 16, 24, 159 Dispatch system in emergency medical services, 20 cardioversion, 41– 42. See also Cardioversion defibrillation, 35– 41. See also Defibrillation pacing, transcutaneous, 42– 43, 64, 68, 69 DNAR (Do Not Attempt Resuscitation) orders, 7– 8, 162 in acute coronary syndromes, 20, 89, 93–97 Donation, organ and tissue, ethical issues in, 9 –10 DOPE mnemonic on deterioration in endotracheal intubation, 141, 169 Drowning. See Submersion and drowning acute coronary syndromes in, 127, 129, 178 B-12
Subject Index
Enoxaparin in acute coronary syndromes, 101 Electroencephalography, postresuscitation, 87 Electrolytes, 121–125. See also specific electrolytes Esophageal detector devices monitoring tracheal tube placement, 54 Emergency Cardiovascular Care Committee, conflict of interest issues in acute coronary syndromes, 20, 89 –92 in foreign-body airway obstruction, 28, 29 in withholding and withdrawing CPR, 7– 8, 181 shock first versus CPR first protocols in, 35, 207 conflict of interest policy in, 3, 204 –205 confirmation of placement in, 54, 169drug administration by, 170 confirmation of placement in, 52, 53–55, 141 present during resuscitative efforts, 9, 181 exhaled carbon dioxide detectors in, 54, 169, 191 in acute coronary syndromes, 92–93, 98 –99 DOPE mnemonic on causes of deterioration in, 141, 169 esophageal-tracheal Combitube compared with, 53 with left bundle branch block, 91, 98, 99 with right ventricular infarction, 100with ST-segment elevation, 94, 98 –99 interruption of chest compressions for, 53 Energy levels in defibrillation, 36, 37, 39 – 40 with biphasic waveform defibrillators, 37, 40 Finger sweep in foreign-body airway obstruction, 29, 162 with monophasic waveform defibrillators, 40 in polymorphic ventricular tachycardia, 73–74 Subject Index
B-13
Health Insurance Portability and Accountability Act (1966), 10 Heimlich maneuver in foreign-body airway obstruction, 28, 29, 162 Helium and oxygen mixture in asthma, 140, 141 in electric shock and lightning strike injuries, 155 Heparin in acute coronary syndromes, 100, 101 Foreign-body airway obstruction, 28 –29 HMG coenzyme A reductase inhibitors in acute coronary syndromes, 102 finger sweep in, 29, 162recognition of, 28, 162 responsiveness of victims in, 28, 29, 162 active compression-decompression CPR in, 48 automatic transport ventilators in, 25, 47, 48 with automated external defibrillators, 35, 39 withholding and withdrawing of CPR in, 7– 8 in acute coronary syndromes, 92–93of children, 181 interposed abdominal compression CPR technique in, 47 Gastric inflation from rescue breathing, 23, 51 affecting neonatal resuscitation decisions, 193 Hypersensitivity reactions, anaphylaxis in, 143–145, 197 in drug-induced emergencies of children, 179 in drug-induced emergencies, 179in hyperkalemia, 121 Glycoprotein IIb/IIIa inhibitors in acute coronary syndromes, 101–102 Guardians as surrogate decision makers, 6 Hand-held devices assisting in chest compressions, 48, 49 B-14
Subject Index
Joint Commission for the Accreditation of Healthcare Organizations, 16 Kidney disorders, postresuscitation, 87, 181 in cardiac arrest, 4, 49, 84 – 85in children, 181 Labetalol in hypertensive emergencies, 129Laryngeal edema in anaphylaxis, 143, 144, 145 in submersion and drowning, 133, 134, 137 in adult basic life support, 19 –20, 21 emergency medical dispatch instructions to, 20 and automated external defibrillation, 12, 19 –20, 27, 37–38 in pediatric basic life support, 157, 158, 161 Hysterotomy, emergency, in pregnancy and cardiac arrest, 152 in foreign-body airway obstruction, 162pulse check not required, 160 compared with healthcare providers, 12–15 in pediatric postresuscitation care, 180, 181 in advance directives and living wills, 6, 8 in Health Insurance Portability and Accountability Act (1966), 10 in Patient Self-Determination Act (1991), 6 emergency delivery in cardiac arrest, 152 in ventricular fibrillation/tachycardia, 75, 102, 129 Living wills, 6, 8 –9Load-distributing band CPR, 48 – 49 Lone rescuer CPR. See One-rescuer CPR Lorazepam in drug-induced tachycardia, 129 Los Angeles Prehospital Stroke Screen, 111, 114 Infection transmission in resuscitation, 20, 24, 159 in drug-induced emergencies of children, 179 in torsades de pointes, 63– 64, 73, 75, 124, 129, 175 International Consensus Conference on CPR and ECC Science With Manual resuscitators, oxygen-powered flow-limited, 25, 48 International Liaison Committee on Resuscitation (ILCOR), 1, 204, 205 Interventions recommended, classification of, 1–2 in bag-mask ventilation, 24, 51, 52, 159. See also Bag-mask ventilationin laryngeal mask airway, 53, 167, 191 Median nerve somatosensory evoked potentials, postresuscitation, 87 Methylxanthines in asthma, 140Metoprolol, 75 in pediatric postresuscitation care, 180, 181 Subject Index
B-15
Mobitz types of atrioventricular blocks, 68 in acute coronary syndromes, 20, 80, 91, 98 Monophasic defibrillation, 36, 37, 40, 207, 208 in pediatric postresuscitation care, 180 –181 Non–ST-elevation myocardial infarction and unstable angina, 89 –110 early invasive strategies in, 95, 97electrocardiographic presentation, 89, 93 fibrinolytic therapy contraindicated in, 94 glycoprotein IIb/IIIa inhibitors in, 101–102 Mouth-to– barrier device breathing, 24, 159 and major adverse coronary events (MACE), 95 percutaneous coronary intervention in, 99 Myocardial infarction, acute, 20, 89. See also Acute coronary Narrow-complex tachycardia, 71–72, 74, 75 automated external defibrillation in, 12–13, 14 National Institutes of Health Stroke Scale, 115 National Registry of Cardiopulmonary Resuscitation, 16 and compression-to-ventilation ratio, 207 in pregnancy, respiratory depression in newborns from, 192 Organ and tissue donation, ethical issues in, 9 –10 emergency medical services in. See Emergency medical services ethical issues in, 8 –9first aid in, 196 –200 Oxygen-powered flow-limited resuscitators, 25, 48 positive-pressure ventilation in, 190 –191 recommendations for resuscitation in, 4, 13, 15, 188, 209 temperature management in, 188 –189, 193 B-16
Subject Index
Public access defibrillation, 12, 19 –20, 37–38Pulse checks, 13, 25, 78, 208 Pacemaker implants affecting defibrillation, 40 interruption of chest compressions for, 4, 208 Panic disorder differentiated from anaphylaxis, 144 Patient Self-Determination Act of 1991, 6 Pedestrian injuries in childhood, prevention of, 156 Percutaneous coronary interventions, 92–93, 99 –100 in ST-segment elevation myocardial infarction, 94 Peripheral venous catheterization, 58, 170 Phentolamine in drug-induced acute coronary syndromes, 129 Pulseless ventricular tachycardia/fibrillation, 59, 60 – 61 Physostigmine in drug-induced tachycardia, 129 Pneumothorax in trauma, 146, 147Poison control centers, 200 in polymorphic ventricular tachycardia, 73 in synchronized cardioversion, 41– 42, 71 Position of rescuer in chest compressions, 25 in polymorphic ventricular tachycardia, 73 in out-of-hospital fibrinolytic therapy, 91 Quality of life in resuscitation decisions, 6 –7, 8 Recommended interventions, classification of, 1–2 Reentry supraventricular tachycardia, 71–72, 74, 75, 76 Reperfusion therapies in acute coronary syndromes, 98 –99 fibrinolytic therapy in. See Fibrinolytic therapy, in acute coronary percutaneous coronary interventions in. See Percutaneous coronary in electrical and lightning strike injuries, 154, 198 Presumed consent in research involving newly dead, 10 in foreign-body airway obstruction, 28, 29, 162 Subject Index
B-17
Reteplase, 99. See also Fibrinolytic therapy Rewarming techniques in hypothermia, 28, 85, 136, 137, 199 in acute coronary syndromes, 93–97, 209 basic life support in, 27–28, 133–134 of children, 134, 156 –157, 163, 199definitions of, 133 in defibrillation and fire hazard, 40, 41 in disease transmission during resuscitation, 16, 24, 159 in electric shock and lightning strike injuries, 154, 155, 198 Supraventricular tachycardia, 71–72, 73 synchronized cardioversion in, 42, 71, 177, 178 Surrogate decision makers, ethical issues in, 6 Synchronized cardioversion, 41– 42, 71, 72, 73 Slow-code resuscitation, 9Snakebites, first aid in, 199 T wave in acute coronary syndromes, 93–94 Somatosensory evoked potentials, postresuscitation, 87 initial evaluation and treatment of, 69 –71 advanced life support for children with, 178 in electric shock and lightning strike injuries, 154 motion restriction and immobilization in, 21–22, 199 supraventricular. See Supraventricular tachycardia synchronized cardioversion in, 42, 71, 72, 73 ST segment in acute coronary syndromes. See also Non–ST-elevation ventricular. See Ventricular fibrillation/tachycardia myocardial infarction and unstable angina instructions from emergency medical dispatchers in, 20 percutaneous coronary interventions in, 99 Statin therapy in acute coronary syndromes, 102 postresuscitation management of, 84 – 85, 208 Tenecteplase, 99. See also Fibrinolytic therapy Streptokinase, 99. See also Fibrinolytic therapy Termination of resuscitation, 7, 8, 9, 61– 62 Thiocyanate levels in nitroprusside therapy, 81 emergency medical services in, 20 –21, 111–113 in fibrinolytic therapy for acute coronary syndromes, 99 fibrinolytic therapy in. See Fibrinolytic therapy, in stroke in heparin therapy for acute coronary syndromes, 101 in acute coronary syndromes, 20, 91, 92, 93 and fibrinolytic therapy, 91, 92, 93, 98 –99 B-18
Subject Index
and percutaneous coronary interventions, 99 Troponin levels in acute coronary syndromes, 94 and benefits of early interventions, 19, 20 –21, 35 in interval between chest compression and defibrillation, 40, and compression-to-ventilation ratio, 207 and fibrinolytic therapy, 20, 21, 111, 115 TIMI studies of risk factors in acute coronary syndromes, 95, 97 ventilation with advanced airway in, 13, 24 –25, 26, 52 Tissue donation, ethical issues in, 9 –10 Vagal maneuvers in supraventricular tachycardia, 72, 176 Valsalva maneuver in supraventricular tachycardia, 72, 176 Vasoactive drugs, 62– 63, 79 – 82, 86 magnesium therapy in, 63– 64, 73, 75, 124, 129, 175 Vasopressors in cardiac arrest, 59, 62– 63, 208 Vasovagal reactions differentiated from anaphylaxis, 144 Ventilation. See Breathing and ventilation Toxicology in emergency cardiovascular care, 126 –132 Tracheal intubation. See Endotracheal intubation Training. See Education and training Transdermal medications affecting automated external defibrillation, defibrillation in, 27. See also Defibrillation 1-shock versus 3-shock protocol in, 4, 16, 36, 60, 207–208 endotracheal tube displacement in, 54 –55 in electric shock and lightning strike injuries, 155 shock first versus CPR first protocols in, 4, 35, 60, 207 advanced cardiovascular life support in, 146, 147–149, 178 basic life support in, 146 –147, 154, 163 in shock first versus CPR first protocols, 35 in submersion and near-drowning, 27–28, 133–134 Warming techniques in hypothermia, 28, 85, 136, 137, 199 Tricyclic antidepressant toxicity, 128, 129, 130 affecting automated external defibrillation, 39 Subject Index
B-19
submersion and drowning in, 27–28, 133–134, 199 –200 Withdrawal of resuscitation. See Termination of resuscitation Waveforms in defibrillation, 36 –37, 40 biphasic. See Biphasic defibrillation monophasic. See Monophasic defibrillation

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David Esposito [email protected] Objective: Employment with a cutting edge, dynamic company with room for creativity and opportunity for promotion, allowing use of software engineering, systems design and testing skills while utilizing an expert understanding of hardware and code optimization. Education: Georgia Institute of Technology 2010 – 2012 Double major in

Doi:10.1016/j.jaad.2005.10.004

Allen N. Sapadin, MD, and Raul Fleischmajer, MDTetracyclines are broad-spectrum antibiotics that act as such at the ribosomal level where they interferewith protein synthesis. They were first widely prescribed by dermatologists in the early 1950s when it wasdiscovered that they were effective as a treatment for acne. More recently, biologic actions affectinginflammation, proteolysis, angiogenesis

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