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
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
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