Explore chapters and articles related to this topic
Inventory Resources and Risks for Recovery
Published in Sandra Rasmussen, Developing Competencies for Recovery, 2023
We often think of recovery as activities after formal treatment. However, recovery-oriented activities and approaches offer a full continuum of care. A ROSC creates an infrastructure, a system of care with the resources to e address the full range of substance use problems within communities. The ROSC offers a continuum of substance use disorder care (prevention, early intervention, treatment, continuing care, and recovery) in partnership with other disciplines, such as mental health and primary care. ROSC services are individualized, person-centered, and strength-based. ROSC provides individuals and families with options with which to make informed decisions regarding their care. Services are designed to be accessible, welcoming, and easy to navigate. A ROSC involves people, their families, and their community in recovery, especially access to and quality of services.
Amniotic Fluid Embolism
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Zaid Diken, Antonio F. Saad, Luis D. Pacheco
Post cardiac arrest management is of paramount importance [40]. After ROSC, patients are often hemodynamic unstable, and management is mainly based on administration of fluids, vasopressors, and inotropes. Mean arterial blood pressure of 65–70 mmHg should be maintained [40]. To decrease ischemia-reperfusion injury, fever should be avoided and aggressively treated. Hyperoxia should be avoided for the same reason and administration of 100% oxygen to patients after survival of cardiac arrest is not recommended. This is achieved by weaning the inspired fraction of oxygen to sustain pulse oximetry values of 94–98% [41]. As standard of care in any critically ill patient, serum glucose levels should be maintained between 140 and 180 mg/dL with implementation of an insulin drip if needed.
Recognition and management of cardiopulmonary arrest
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Following a successful resuscitation, as determined by a return of spontaneous circulation (ROSC), the patient will need to be transferred to an intensive care unit or high-dependency facility for close monitoring and further management. This process usually takes some time and, while awaiting transfer, the patient should be monitored and managed, using the ABCDE approach. The aim of this is to optimise oxygenation and tissue perfusion while looking for, identifying and treating any complications, such as hypoglycaemia or convulsions. During this time, a member of the medical team will usually remain with the patient.
AMI in (bi)ventricular pacing – do not discard the ECG
Published in Acta Clinica Belgica, 2023
T. Versyck, D. Devriese, S. Smith, P. Calle, C. Borin
A pre-hospital emergency physician-staffed team was sent to a 67-year-old woman complaining of chest pain. The pain started 30 minutes earlier. For the patient this type of pain was similar to a previous episode of angina pectoris. She had a mechanical aortic valve prosthesis and received haemodialysis. Her vital signs were: pulse, 100 bpm; blood pressure, 145/80 mmHg; oxygen saturation, 96%. The ECG showed a biventricular paced rhythm with a right bundle branch block (RBBB)-morphology (Figure 4). The patient was treated with aspirin 250 mg IV and isosorbide mononitrate 5 mg SL. Once in the hospital, the patient developed ventricular fibrillation, while waiting for the results of the cardiac enzymes. After two cycles of cardiopulmonary resuscitation and one shock delivered, ROSC was achieved. A couple of minutes later the monitor showed torsades de pointes, for which the patient received a second shock. The patient was transferred to the cardiac catheterisation laboratory and the coronary angiogram revealed a thrombotic occlusion of the LAD. Flow was restored successfully after multiple balloon dilatations, tirofiban and eventually two DES in the mid- and distal LAD. The patient had a complete neurological recovery following ROSC, but her echocardiography 3 days after presentations showed an ischemic cardiomyopathy with akinesis of the apex and anterior wall and an ejection fraction of 10%. After 12 days, she was able to leave the hospital. An echocardiography 3 months later showed an improvement of the cardiac function with an ejection fraction of 20%.
Comparison of Out-of-Hospital Cardiac Arrests Occurring in Schools and Other Public Locations: A 12-Year Retrospective Study
Published in Prehospital Emergency Care, 2022
Brian Haskins, Ziad Nehme, Jocasta Ball, Emily Mahony, Laura Parker-Stebbing, Peter Cameron, Steve Bernard, Karen Smith
This study uses the recommended definitions as per the Utstein guidelines (34). Public locations are locations to which the general public has access, including workplaces, airports, public buildings, shopping areas etc. they do not include medical clinics or nursing homes. Cardiac arrest etiology is determined from information in the patient care record and is presumed to be of cardiac origin when no other etiology or obvious cause is recorded. EMS treated patients are classified as those receiving any attempt at cardiopulmonary resuscitation (CPR) and/or defibrillation by EMS personnel and those that receive a shock from a PAD not achieving a return of spontaneous circulation (ROSC). Bystander CPR is any attempt at chest compression by non-dispatched responders, with or without ventilations. Bystander application of an AED is the placement of AED pads without defibrillation. PAD is the delivery of a shock using a public accessible AED. ROSC is the return of a palpable pulse during the resuscitation attempt, event survival is the presence of a pulse on arrival at the hospital and survival to hospital discharge is the patients discharge from acute hospital care.
Usefulness of F2-isoprostanes in early prognostication after cardiac arrest: a topical review of the literature and meta-analysis of preclinical data
Published in Biomarkers, 2020
George Karlis, Anastasia Kotanidou, Georgios Georgiopoulos, Stefano Masi, Nikolaos Magkas, Theodoros Xanthos
Prognostication for cardiac arrest patients with ROSC is of utmost clinical importance.The role of biomarkers has not been thoroughly explored. To date, NSE represents the guidelines' favoured biomarker for outcome prediction, although its performance in the immediate post-ROSC period is poor.We identified 8-iso-PGF2a as a potentially novel biomarker for prognostication, that demonstrates a hyperacute profile after cardiac arrest in preclinical models.This molecule reflects the burden of global ischaemia-reperfusion injury and therefore may predict best the severity of post-cardiac arrest syndrome.