Torsades de pointes is a form of polymorphic VT that is associated with a prolonged heart rate–corrected QT interval when the rhythm is normal and VT is not present. 2. Thus, the confidence in the prognostication of the diagnostic tests studied is also low. Time taken for rhythm analysis also disrupts CPR. Closed on Sundays. Patient selection, evaluation, timing, drug selection, and anticoagulation for patients undergoing rhythm control are beyond the scope of these guidelines and are presented elsewhere.1,2. Can we identify consistent NSE and S100B thresholds for predicting poor neurological outcome after overdose with naloxone? Nondihydropyridine calcium channel antagonists and IV β-adrenergic blockers should not be used in patients with left ventricular systolic dysfunction and decompensated heart failure because these may lead to further hemodynamic compromise. Emergent coronary angiography and PCI have also been also associated with improved neurological outcomes in patients without STEMI on their post-ROSC resuscitation ECG.4,12 However, a large randomized trial found no improvement in survival in patients resuscitated from OHCA with an initial shockable rhythm in whom no ST-segment elevations or signs of shock were present.13 Multiple RCTs are underway. The 2020 AHA Guidelines Science In-Service is an online course designed to provide healthcare providers information on new science and key changes published in the 2020 AA Guidelines for CPR and ECC. There are no RCTs evaluating alternative treatment algorithms for cardiac arrest due to anaphylaxis. Cardiac arrest survivors, like many survivors of critical illness, often experience a spectrum of physical, neurological, cognitive, emotional, or social issues, some of which may not become apparent until after hospital discharge. Whether treatment of seizure activity on EEG that is not associated with clinically evident seizures affects outcome is currently unknown. Initial management of wide-complex tachycardia requires a rapid assessment of the patient’s hemodynamic stability. These include activation of the emergency response, provision of high-quality CPR and early defibrillation, ALS interventions, effective post-ROSC care including careful prognostication, and support during recovery and survivorship. The link provided below is for convenience only, and is not an endorsement of either the linked-to entity or any product or service. 1. Unfortunately, different studies define highly malignant EEG differently or imprecisely, making use of this finding unhelpful. It may be reasonable to use audiovisual feedback devices during CPR for real-time optimization of CPR performance. Most opioid-associated deaths also involve the coingestion of multiple drugs or medical and mental health comorbidities.4–7. View and download this document in 17 languages. 2. Customer Service Existing evidence suggests that the potential harm from CPR in a patient who has been incorrectly identified as having cardiac arrest is low.1 Overall, the benefits of initiation of CPR in cardiac arrest outweigh the relatively low risk of injury for patients not in cardiac arrest. Cardiac arrest results in heterogeneous injury; thus, death can also result from multiorgan dysfunction or shock. In some observational studies, improved outcomes have been noted in victims of cardiac arrest who received conventional CPR (compressions and ventilation) compared with those who received chest compressions only. Circulation. Is the IO route of drug administration safe and efficacious in cardiac arrest, and does efficacy vary by IO site? Care Science With Treatment Recommendations (CoSTR).1. 4. There are also no specific alterations to ACLS for patients with cardiac arrest from asthma, although airway management and ventilation increase in importance given the likelihood of an underlying respiratory cause of arrest. 1. When performed with other prognostic tests, it may be reasonable to consider reduced gray-white ratio (GWR) on brain computed tomography (CT) after cardiac arrest to support the prognosis of poor neurological outcome in patients who remain comatose. 3. What is the effect of hypocarbia or hypercarbia on outcome after cardiac arrest? Epinephrine should be administered early by intramuscular injection (or autoinjector) to all patients with signs of a systemic allergic reaction, especially hypotension, airway swelling, or difficulty breathing. What combination of features can identify patients with no chance of survival, even if rewarmed? Resuscitation from cardiac arrest caused by β-adrenergic blocker or calcium channel blocker overdose follows standard resuscitation guidelines. Benzodiazepine overdose causes CNS and respiratory depression and, particularly when taken with other sedatives (eg, opioids), can cause respiratory arrest and cardiac arrest. Tension pneumothorax is a rare life-threatening complication of asthma and a potentially reversible cause of arrest. In addition to defibrillation, several alternative electric and pseudoelectrical therapies have been explored as possible treatment options during cardiac arrest. Shout for nearby help/activate the resuscitation team; the provider can activate the resuscitation team at this time or after checking for breathing and pulse.