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Cardiac dysrhythmia management in the radiology department
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
As radiologists assume pivotal roles in increasingly complex and occasionally hazardous procedures, they must also accept the clinical responsibility for both successful and adverse outcomes. This philosophy is shared by the Society of Cardiovascular and Interventional Radiology: The radiologist cannot rely on others to recognize and manage the problems that arise in his or her patient’s care.’1 While the majority of these events will be minor, many will be significant and some even life threatening. There is significant comorbidity in some radiology patient populations, particularly those with cardiovascular and pulmonary disease. In a study of factors that influence long-term percutaneous transluminal angioplasty (PTA) success,2 Capek found that at the time of presentation for femoral-popliteal PTA, 50 per cent of patients were hypertensive, 90 per cent smoked more than one pack per day, 33 per cent were diabetic and 18 per cent showed evidence of generalized cardiovascular disease. In patients presenting with intermittent claudication, Hertzer3 found that 27 per cent had severe coronary artery disease (CAD), as did 29 per cent of those presenting with rest pain or gangrene.3 In addition, some procedures are performed on critically ill patients, e.g. transjugular intrahepatic porto-systemic (TIPS) shunt, bronchial arterial embolization, inferior vena cava (IVC) filters and pulmonary angiography. Thus it becomes increasingly important for radiologists to become familiar not only with the specific complications that may be encountered during procedures, but with some basic principles concerning the recognition and treatment of other acute adverse events. The importance of early recognition and treatment of pre hospital sudden cardiac arrest and an integrated ‘chain of survival’ concept has significantly improved survival rates in out-of-hospital cardiac arrest,4–9 and many of these principles can be applied to radiology departments. This chapter deals with aspects of recognition and management of cardiac dysrhythmias. For acquisition of cardiac resuscitative skills, the practitioner is urged to complete the American Heart Association’s Advanced Cardiac Life Support (ACLS) course.
Precautions & Possible Therapeutic Approaches of Health Hazards of Astronauts in Microgravity
Published in The International Journal of Aerospace Psychology, 2021
Nikita Pal, Shambaditya Goswami, Rajveer Singh, Tejpal Yadav, Ravindra Pal Singh
Improper cardiac rhythm or arrhythmia in space flight could occur due to hypokalemia, changes in the autonomic nervous system, and physical stress. Bag-valve mask ventilation (100% O2), endotracheal intubation, and respiratory ventilation should be given in this situation. Advanced Life Support Pack (ALSP) and Advanced Cardiac Life Support (ACLS) drugs are epinephrine, lidocaine, and atropine, which must be given in severe conditions. Some astronauts need radiofrequency catheter ablation for atrial arrhythmias (Anzai et al., 2014; Marshburn, 2008).