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Cardiac arrest,also known as sudden cardiac arrest,is when the heart suddenly and unexpectedly stops beating. As a result,blood cannot properly circulate around the body and there is diminished blood flow to the brain and other organs. When the brain does not receive enough blood,this can cause a person to lose consciousness. Coma and persistent vegetative state may result from cardiac arrest. Cardiac arrest is also identified by a lack of central pulses and abnormal or absent breathing.
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation,or mouth to mouth in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended for those who are unresponsive with no breathing or abnormal breathing,for example,agonal respirations.
Clinical death is the medical term for cessation of blood circulation and breathing,the two criteria necessary to sustain the lives of human beings and of many other organisms. It occurs when the heart stops beating in a regular rhythm,a condition called cardiac arrest. The term is also sometimes used in resuscitation research.
Advanced cardiac life support,advanced cardiovascular life support (ACLS) refers to a set of clinical guidelines established by the American Heart Association (AHA) for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest,using advanced medical procedures,medications,and techniques. ACLS expands on Basic Life Support (BLS) by adding recommendations on additional medication and advanced procedure use to the CPR guidelines that are fundamental and efficacious in BLS. ACLS is practiced by advanced medical providers including physicians,some nurses and paramedics;these providers are usually required to hold certifications in ACLS care.
A do-not-resuscitate order (DNR),also known as Do Not Attempt Resuscitation (DNAR),Do Not Attempt Cardiopulmonary Resuscitation (DNACPR),no code or allow natural death,is a medical order,written or oral depending on the jurisdiction,indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary in different polities. Most commonly,the order is placed by a physician based on a combination of medical judgement and patient involvement.
Life support comprises the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic and advanced life support procedures;however,basic life support is sometimes provided at the scene of an emergency by family members or bystanders before emergency services arrive. In the case of cardiac injuries,cardiopulmonary resuscitation is initiated by bystanders or family members 25% of the time. Basic life support techniques,such as performing CPR on a victim of cardiac arrest,can double or even triple that patient's chance of survival. Other types of basic life support include relief from choking,staunching of bleeding by direct compression and elevation above the heart,first aid,and the use of an automated external defibrillator.
Reperfusion injury,sometimes called ischemia-reperfusion injury (IRI) or reoxygenation injury,is the tissue damage caused when blood supply returns to tissue after a period of ischemia or lack of oxygen. The absence of oxygen and nutrients from blood during the ischemic period creates a condition in which the restoration of circulation results in inflammation and oxidative damage through the induction of oxidative stress rather than restoration of normal function.
Brain ischemia is a condition in which there is insufficient bloodflow to the brain to meet metabolic demand. This leads to poor oxygen supply or cerebral hypoxia and thus leads to the death of brain tissue or cerebral infarction/ischemic stroke. It is a sub-type of stroke along with subarachnoid hemorrhage and intracerebral hemorrhage.
The AutoPulse is an automated,portable,battery-powered cardiopulmonary resuscitation device created by Revivant and subsequently purchased and currently manufactured by ZOLL Medical Corporation. It is a chest compression device composed of a constricting band and half backboard that is intended to be used as an adjunct to CPR during advanced cardiac life support by professional health care providers. The AutoPulse uses a distributing band to deliver the chest compressions. In literature it is also known as LDB-CPR.
Deep hypothermic circulatory arrest (DHCA) is a surgical technique in which the temperature of the body falls significantly and blood circulation is stopped for up to one hour. It is used when blood circulation to the brain must be stopped because of delicate surgery within the brain,or because of surgery on large blood vessels that lead to or from the brain. DHCA is used to provide a better visual field during surgery due to the cessation of blood flow. DHCA is a form of carefully managed clinical death in which heartbeat and all brain activity cease.
The history of cardiopulmonary resuscitation (CPR) can be traced as far back as the literary works of ancient Egypt. However,it was not until the 18th century that credible reports of cardiopulmonary resuscitation began to appear in the medical literature.
Targeted temperature management (TTM) previously known as therapeutic hypothermia or protective hypothermia is an active treatment that tries to achieve and maintain a specific body temperature in a person for a specific duration of time in an effort to improve health outcomes during recovery after a period of stopped blood flow to the brain. This is done in an attempt to reduce the risk of tissue injury following lack of blood flow. Periods of poor blood flow may be due to cardiac arrest or the blockage of an artery by a clot as in the case of a stroke.
Charles Lawrence Schleien is an American pediatrician,the Philip Lanzkowsky Professor of Pediatrics and pediatrician-in-chief at Northwell Health as of May 1,2012.
The Arctic Sun Temperature Management System is a non-invasive targeted temperature management system. It modulates patient temperature by circulating chilled water in pads directly adhered to the patient's skin. Using varying water temperatures and a computer algorithm,a patient's body temperature can be better controlled. It is produced by Medivance,Inc. of Louisville,Colorado.
Lazarus syndrome,also known as autoresuscitation after failed cardiopulmonary resuscitation,is the spontaneous return of a normal cardiac rhythm after failed attempts at resuscitation. It is also used to refer to the spontaneous return of cardiac activity after the patient has been pronounced dead. Its occurrence has been noted in medical literature at least 38 times since 1982. It takes its name from Lazarus who,according to the New Testament,was raised from the dead by Jesus.
The following outline is provided as an overview of and topical guide to emergency medicine:
Extracorporeal cardiopulmonary resuscitation is a method of cardiopulmonary resuscitation (CPR) that passes the patient's blood through a machine in a process to oxygenate the blood supply. A portable extracorporeal membrane oxygenation (ECMO) device is used as an adjunct to standard CPR. A patient who is deemed to be in cardiac arrest refractory to CPR has percutaneous catheters inserted into the femoral vein and artery. Theoretically,the application of ECPR allows for the return of cerebral perfusion in a more sustainable manner than with external compressions alone. By attaching an ECMO device to a person who has acutely undergone cardiovascular collapse,practitioners can maintain end-organ perfusion whilst assessing the potential reversal of causal pathology,with the goal of improving long-term survival and neurological outcomes.
Emergency Preservation and Resuscitation (EPR) is an experimental medical procedure where an emergency department patient is cooled into suspended animation for an hour to prevent incipient death from ischemia,such as the blood loss following a shooting or stabbing. EPR uses hypothermia,drugs,and fluids to "buy time" for resuscitative surgery. If successful,EPR may someday be deployed in the field so that paramedics can suspend and preserve patients for transport.
Benjamin S. Abella is an American physician,emergency medicine practitioner,internist,academic and researcher. He is the William G. Baxt Professor and Vice Chair of Research at University of Pennsylvania’s Department of Emergency Medicine. He directs the Center for Resuscitation Science and the Penn Acute Research Collaboration at the University. He has participated in developing international CPR guidelines.
Post-cardiac arrest syndrome (PCAS) is an inflammatory state of pathophysiology that can occur after a patient is resuscitated from a cardiac arrest. While in a state of cardiac arrest,the body experiences a unique state of global ischemia. This ischemia results in the accumulation of metabolic waste which instigate the production of inflammatory mediators. If return of spontaneous circulation (ROSC) is achieved after CPR,then circulation resumes,resulting in global reperfusion and the subsequent distribution of the ischemia products throughout the body. While PCAS has a unique cause and consequences,it can ultimately be thought of as type of global ischemia-reperfusion injury. The damage,and therefore prognosis,of PCAS generally depends on the length of the patient's ischemic period;therefore the severity of PCAS is not uniform across different patients.
References
- ↑ Davenport, Tony (October 23, 2015). "Lance Becker, MD, Named Chair of Department of Emergency Medicine at North Shore University Hospital and LIJ Medical Center". Northwell Health. Retrieved 5 April 2016.