Fibrillation cardiopulmonary resuscitation

CPR, cardiopulmonary resuscitation D5W, 5% dextrose in water PEA, pulseless electrical activity PVT, pulseless ventricular tachycardia ROSC, return of spontaneous circulation VF, ventricular fibrillation. 

A 13-year-old girl developed tonic-clonic seizures followed by ventricular fibrillation after subcutaneous infiltration of extensive skin abrasions with 30 mg (0.5 mg/kg) of bupivacaine over about 1 hour. She was successfully resuscitated with cardiopulmonary resuscitation and intubation, intravenous diazepam, adrenaline, and sodium bicarbonate (14). 

Cobb LA, Fahrenbruch CE, Walsh TR, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999 281 1182-1188. 

Wik L, Hansen TB, FylUng F, et al. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hosptial ventricular fibrillation A randomized trial. JAMA 2003 289 1389-1395. 

The common ventricular arrhythmias include (1) premature ventricular complexes (PVCs), (2) ventricular tachycardia, and (3) ventricular fibrillation. Again, these arrhythmias may result in a wide variety of symptoms. PVCs often cause no symptoms or only mild palpitations. Ventricular tachycardia may be a life-threatening situation associated with hemodynamic collapse or be totally asymptomatic. Ventricular fibrillation, by definition, is an acute medical emergency necessitating cardiopulmonary resuscitation (CPR). 

Lidocaine is used in the therapy of non-life-threatening ventricular arrhythmias, such as non-sustained ventricular tachycardia and frequent premature ventricular beats. It is also used as an adjunct to defibrillation and cardiopulmonary resuscitation (CPR) in patients with ventricular tachycardia and/or fibrillation. 

A. For ventricular fibrillation, give 5 mg/kg iV over 1 minute (in addition to cardiopulmonary resuscitation and defibrillation). If not effective, administration may be repeated with 10 mg/kg. 

Because respiratory arrest and fibrillation are common effects, knowledge of cardiopulmonary resuscitation (CPR) is essential for those who work with electrical circuits and equipment. Without immediate treatment for these injuries, chances of survival are minimal. 

Bassuk, J.A., Wu, D., Lozano, H. et al. 2008. Non-selective cyclooxygenase inhibition before periodic acceleration (pGz) cardiopulmonary resuscitation (CPR) in a porcine model of ventricular fibrillation. Resuscitation 77(2) 250-257. 

Indik, J.H., Hilwig, J.H., Zuercher, M., Kern, K.B., Berg, M.D., Berg, R.A. 2009. Preshock cardiopulmonary resuscitation worsens outcome from circulatory phase ventricular fibrillation with acute coronary artery obstruction in swine. Circ. Arrhythm. Electrophysiol. 2(2) 179-184. 

Ventricular fibrillation is by definition hemodynamically unstable, due to the absence of pulse and blood pressure. Initial management includes provision of basic life support, including calling for help and initiation of cardiopulmonary I resuscitation (CPR).48 Oxygen should be administered as soon... 

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