Presentation
We present a case of gastric perforation in a middle-aged patient after CPR performed by his family. He eventually presented with bloody vomitus and a tympanic abdomen. [ncbi.nlm.nih.gov]
Entire Body System
- Unconsciousness
It causes the person to fall unconscious and stop breathing. Without CPR the person will die within minutes. CPR should only be used if someone is: unconscious and not breathing unconscious and not breathing normally. [bhf.org.uk]
If the person becomes unconscious, give cardiopulmonary resuscitation immediately. Here are some good informative video clips of cardiopulmonary resuscitation on adults and children. [dma.dk]
Cardiopulmonary resuscitation ( CPR ), is emergency first aid for an unconscious person on whom breathing and pulse cannot be detected. mask for performing CPR on adults and nurslings. [commons.wikimedia.org]
You should take the following steps if you’re in a situation that requires CPR: Check if the person is conscious or unconscious. If the person seems to be unconscious, tap or shake his or her shoulder and ask loudly if he’s ok. [westerncape.gov.za]
- Hypothermia
To prevent neurological damage, therapeutic hypothermia was used, and she was cooled for 24 hours. After therapeutic hypothermia, her Glasgow coma score was 15, fortunately no sequela appeared. [ncbi.nlm.nih.gov]
- Falling
This case shows the importance of analysing the circumstances of a fall, considering the possibility of two concomitant diagnoses and prioritising investigations and treatment. [ncbi.nlm.nih.gov]
Watch chest fall. Remove your mouth from the patient’s and look along the chest, watching the chest fall. Repeat steps five and six once. Photo: Ruth Jenkinson, Lizzie Orme 7. Repeat chest compressions and rescue breaths. [readersdigest.ca]
Keeping their head tilted and chin lifted, take your mouth away and watch for the chest to fall as air comes out. Take another breath and repeat this sequence 4 more times. [nhs.uk]
Seeing his enemy fall, he returned quietly home, and left the apparently dead body in the roadway. [web.archive.org]
- Fatigue
Fatigue occurred bilaterally and time was the most important factor. Fatigue began at 2 minutes. Rescuers exert muscular countervailing forces in order to maintain effective compressions. [ncbi.nlm.nih.gov]
If you are not able to position yourself correctly and lock your elbows, it means you are too low relative to the patient and this may lead to less effective compressions and greater rescuer fatigue. [jove.com]
[…] prescription heart medicine Chest pain that happens with any or all of the following (additional) symptoms of a heart attack: Sweating, cool, clammy skin, or paleness Shortness of breath Nausea or vomiting Dizziness or fainting Unexplained weakness or fatigue [uhhospitals.org]
- Hypoxemia
Most frequent suspected cardiac arrest causes were hypotension (n=98; 32.5%), multiple (19.2%) and hypoxemia (17.5%). Sixty (19.9%) cardiac arrests had do not resuscitate orders. [ncbi.nlm.nih.gov]
The mechanism of cardiac arrest in neurological disease is related to: loss of consciousness, causing airway obstruction, hypoxemia and respiratory arrest followed by cardiac arrest, or an increased risk of aspiration of gastric contents into the lungs [intechopen.com]
Oxygen therapy should be initiated if dyspnea, hypoxemia, or signs of heart failure or shock are present. Noninvasive monitoring of arterial blood oxygen saturation may be used to determine the need for oxygen administration. [dx.doi.org]
Respiratoric
- Aspiration
The infant most probably experienced unwitnessed aspiration with subsequent severe cardiopulmonary insufficiency. This was paralleled by incidental hypothermia, i.e. a core body temperature of 32°C at time of resuscitation. [ncbi.nlm.nih.gov]
An occasional complication, however, is regurgitation followed by aspiration of gastric contents, causing life-threatening aspiration pneumonia in resuscitated patients. [merckmanuals.com]
English Other medically significant sequelae of overdose include delirium, convulsion, coma, possible neuroleptic malignant syndrome, respiratory depression, aspiration, hypertension or hypotension, cardiac arrhythmias (< 2% of overdose cases) and cardiopulmonary [mymemory.translated.net]
- Abnormal Breathing
BACKGROUND: Emergency 9-1-1 callers use a wide range of terms to describe abnormal breathing in persons with out-of-hospital cardiac arrest (OHCA). These breathing descriptors can obstruct the telephone cardiopulmonary resuscitation (CPR) process. [ncbi.nlm.nih.gov]
Be sure to emphasize that there are two types of abnormal breathing: gasping (snoring or agonal respirations), and not breathing at all. [web.archive.org]
Cardiac arrest recognised by an unresponsive victim with absent or abnormal breathing – the signal to activate the emergency response system. “Look, listen, feel” removed from algorithm. [lifeinthefastlane.com]
It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. [educalingo.com]
they should be added in a ratio of 30 compressions to two breaths Recommendations specifically for dispatchers include the following [44] : Emergency dispatchers should be educated to identify unresponsiveness with abnormal breathing and agonal gasps [emedicine.medscape.com]
- Dyspnea
We present a case of a 46-year-old woman who developed pulseless electrical activity (PEA) after complaining of weakness and dyspnea in an ambulance, presumptively diagnosed as acute PE by bedside focused echocardiography. [ncbi.nlm.nih.gov]
Interventions that minimize suffering and pain, dyspnea, delirium, convulsions, and other terminal complications should always be provided. [eccguidelines.heart.org]
- Agonal Respiration
False-positives would likely be reduced if the question simply asked whether the patient was breathing, but then true arrest patients with agonal respirations would also be excluded. [doi.org]
Be sure to emphasize that there are two types of abnormal breathing: gasping (snoring or agonal respirations), and not breathing at all. [web.archive.org]
It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. [educalingo.com]
Gastrointestinal
- Vomiting
Complications of CPR Vomiting is the most frequently encountered complication of CPR. If the victim starts to vomit, turn the head to the side and try to sweep out or wipe off the vomit. Continue with CPR. [depts.washington.edu]
Seven bystanders stated they felt inadequately prepared to handle patients who vomited. [ncbi.nlm.nih.gov]
If a victim vomits, turn him on his side and clear out the vomit with your fingers. It's possible to crack a rib during chest compressions, especially if the victim is elderly. [consumer.healthday.com]
The effects of poisoning depend on the substance swallowed but can include vomiting, loss of conciousness, pain or a burning sensation. [hse.ie]
Cardiovascular
- Heart Disease
METHODS: Between 1984 and 2015, all patients with congenital heart disease who received in or out-of-hospital CPR were identified from the database of congenital heart disease from the University Hospitals Leuven. [ncbi.nlm.nih.gov]
Prompt CPR and rapid paramedic response can improve the chances of survival from a heart attack. CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW QUESTION In the U.S., 1 in every 4 deaths is caused by heart disease. See Answer [medicinenet.com]
A large percentage of people who die of heart disease suffer from a sudden “electrical chaos” in the heart, ventricular fibrillation, leading to cardiac arrest. [kvalitetsregister.se]
The 2015 American Heart Association report on Heart Disease and Stroke Statistics [ 1 ] states that there are more than 326,000 cardiac arrests in the United States each year. The overall survival to hospital discharge remains grim at 5.6%. [omicsonline.org]
- Tachycardia
She remained in refractory ventricular tachycardia. [ncbi.nlm.nih.gov]
Tachyarrhythmia The most common types of tachycardia in the pediatric population are sinus tachycardia, supraventricular tachycardia, and ventricular tachycardia. [emedicine.medscape.com]
Results and recommendations: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32 [neurology.org]
- Chest Pain
The pain is often described as "an elephant sitting on my chest" Pain or discomfort that spreads to the shoulders, neck, arms, or jaw Chest pain that gets worse Chest pain that doesn't go away after rest or by taking prescription heart medicine Chest [uhhospitals.org]
He visited a local hospital's emergency department complaining of chest pain and dyspnea that had started 3 days earlier. [ncbi.nlm.nih.gov]
This usually causes chest pain and leads to damage to some of the muscle of the heart. It may cause cardiac arrest, particularly in the early stages, but this is not inevitable. [resus.org.uk]
Musculoskeletal
- Fracture
Subtle fractures of the anterolateral aspects of the ribs were discovered in 8 (11%) of the 70 cases. In 7 of the 8 cases, multiple ribs were fractured (ranging up to 10 rib fractures), and in 5 of these cases, the rib fractures were bilateral. [ncbi.nlm.nih.gov]
Psychiatrical
- Suggestibility
In support of prior adult and animal investigations suggesting that basic CPRR is often performed poorly and at inappropriately slow rates, audio- prompted rate guidance during CPR in children resulted in higher PETCO2, suggesting improved CPR performance [ncbi.nlm.nih.gov]
Neurologic
- Stroke
Many courses are offered in collaboration with the Red Cross, the Lifesaving Society and the Heart and Stroke Foundation, to be able to recognize emergencies and react in these situations. [pointe-claire.ca]
The management of patients with acute stroke regarding treatment of thromboembolism is supported by a limited evidence base. [ncbi.nlm.nih.gov]
Adequate compression depth is essential in order to provide sufficient stroke volume to perfuse the heart and brain. Shallow compressions might lead to decreased stroke volume, thus causing reduced cardiac output. [jove.com]
Med Care. 1992;30244- 551 Google Scholar Crossref 16. de Haan RJLimburg Mvan der Meulen JHJacobs HAaronson NK Quality of life after stroke: impact of stroke type and lesion location. Stroke. 1995;26402- 408 Google Scholar Crossref 17. [doi.org]
CPR-mask positioning for CPR: the strokes should be given two finger higher than the solar plexus. View of the operator of an Automatic External Defibrillator during a cardio-respiratory emergency. [commons.wikimedia.org]
Workup
Autopsy and histological workup in all three cases showed multiple circumscribed calcified and necrotic areas in progressive stages of organization within the myocardium. [ncbi.nlm.nih.gov]
X-Ray
- Pneumoperitoneum
[…] resuscitation-related visceral damage—details b Pneumothorax, n 6 2 4 Tension pneumothorax, n 1 1 — Pneumomediastinum/oesophagus haematoma, n 4 — — Pleural fluid/blood, n 1 3 3 Lung contusion/haematoma, n 1 — 1 Liver rupture, n 1 2 — Intracranial air embolism, n 1 — — Pneumoperitoneum [academic.oup.com]
Other ECG Findings
- Abnormal ECG
Patients with multisystem trauma, abnormal haemodynamics, arrhythmia or other ECG abnormalities need monitoring from the onset of chest trauma. Patients with normal ECG and echocardiogram do not require cardiac monitoring. [web.archive.org]
Treatment
Provide a detailed description of the time lapse and treatment outside the hospital. Register the effects of treatment in the form of short- and long-term survival. [kvalitetsregister.se]
Finally, two of the five PE patients treated with ECLS were discharged from inpatient treatment without neurological dysfunction. The duration of ECLS therapy depends on the patient's condition. [ncbi.nlm.nih.gov]
Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]
Prognosis
Congenital chromosomal abnormality with trisomy 13 is known to be associated with poor life prognosis and lethal. [ncbi.nlm.nih.gov]
However, the decision to transport a patient resides with the responsible emergency physician who has to evaluate the prognosis for the patient on an individual basis. [thieme-connect.com]
Etiology
For arrests of respiratory etiology, COCPR was administered in 9 of 150 patients (6%; 95% CI, 2.2%-9.8%). [doi.org]
Laboratory Techniques (instrumentation, utilization) Diagnosis, Differential Financing, Organized Humans Immunohistochemistry (instrumentation, methods, utilization) Male Nerve Tissue Proteins (genetics, isolation & purification) Skin Neoplasms (diagnosis, etiology [medvik.cz]
Among 5272 adults with out-of-hospital cardiac arrest of cardiac etiology not observed by responding emergency medical personnel, 779 were excluded because bystander CPR was provided by a health care professional or the arrest occurred in a medical facility [ncbi.nlm.nih.gov]
Epidemiology
Objective:: To study epidemiology and prognostic factors associated with cardiac arrest in the intensive care unit (ICU) in an average Brazilian center. [ncbi.nlm.nih.gov]
Topics of interest include the epidemiology of sudden death; management of ventilation; chest compression technique training; public access defibrillation; drug delivery during CPR; the latest drug therapies; and cardiac arrest in disease, pregnancy, [amazon.com]
Out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge. Ann Emerg Med 2005;46:512–22 May 2015 [resus.org.uk]
Key Words: cardiopulmonary resuscitation complications dispatcher epidemiology morbidity Received April 9, 2009; accepted September 21, 2009. [web.archive.org]
Pathophysiology
However, the pathophysiology of the delayed return of spontaneous circulation remains enigmatic. [ncbi.nlm.nih.gov]
This finding suggests that chronic conditions influence arrest pathophysiology and in turn could help guide resuscitation care. [doi.org]
"We still do not know the pathophysiological mechanism of hypothermia, which is necessary to developing the best way to rewarm hypothermia victims," Tveita explained. [eurekalert.org]
Prevention
To prevent neurological damage, therapeutic hypothermia was used, and she was cooled for 24 hours. After therapeutic hypothermia, her Glasgow coma score was 15, fortunately no sequela appeared. [ncbi.nlm.nih.gov]
automated external defibrillation, and prevention/clean-up of blood borne pathogen contamination et Teine menetluspoolapellatsioonikojas: Lehning Enterprise SARL (Sainte Barbe, Prantsusmaa en Computer application software for mobile phones, namely, [et.glosbe.com]
To prevent disease transmission during CPR, face masks and face shields are available to prevent direct contact during rescue breathing. CPR in basic life support. [healthofchildren.com]
Prevention Prevention depends on the specific cause of hypoxia. Unfortunately, hypoxia is usually unexpected. This makes the condition somewhat difficult to prevent. [mountsinai.org]