Cardiac Arrest

Cardiac Arrest: Lab Test

2nd order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-for differential diagnostic workup Small blood count Inflammatory parameters – CRP (C-reactive protein). Electrolytes – potassium, magnesium Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) High-sensitivity cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – exclusion of myocardial infarction … Cardiac Arrest: Lab Test

Cardiac Arrest: Drug Therapy

Therapeutic target Return of spontaneous circulation (ROSC). Therapy recommendationsActive ingredients (main indication) Active ingredient groups Active ingredients Special features Oxygen Oxygen As much and as early as possible Sympathomimetics Epinephrine Standard vasopressor In asystole (cardiac arrest)/PEA (pulseless electrical activity) administration as soon as possible! Therapy of first choice: Treatment of cardiac arrest due to ventricular … Cardiac Arrest: Drug Therapy

Cardiac Arrest: Diagnostic Tests

Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of electrical activity of the heart muscle) [Prolonged QT interval equals risk factor for sudden cardiac death; caveat: QT-prolonging medications] Point-of-care ultrasonography – patients with cardiac arrest to assess prognosis [little agreement on sonographic assessment of cardiac arrest]. Echocardiography (echo; cardiac ultrasound) – for suspected structural heart disease. … Cardiac Arrest: Diagnostic Tests

Cardiac Arrest: Prevention

To prevent cardiac arrest/sudden cardiac death, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Ingredients of energy drinks (prolongations of the QTc interval) ? Micronutrient deficiency (vital substances). Low potassium Low magnesium Stimulant consumption Alcohol excesses at the weekend → accumulation of sudden deaths on Monday. Tobacco (smoking)* – men … Cardiac Arrest: Prevention

Cardiac Arrest: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate cardiac arrest: Leading symptoms Respiratory arrest Unconsciousness Drop in blood pressure Pulselessness Pale skin, bluish lips Wide non-reactive pupils Prodromal symptoms (precursor symptoms) One in two patients had precursor symptoms four weeks earlier (in half, in the days before the event; 93% also had symptoms the day before … Cardiac Arrest: Symptoms, Complaints, Signs

Cardiac Arrest: Causes

Pathogenesis (development of disease) Pathogenesis depends on the particular cause of cardiac arrest or sudden cardiac death (PHT). A large autopsy study (postmortem examination; cadaver dissection) demonstrates that in approx. 40 percent of patients with sudden cardiac death had a prior unrecognized myocardial infarction/heart attack (silent infarction); in three-quarters of cases, PHT was related to … Cardiac Arrest: Causes

Cardiac Arrest: Therapy

Reanimation (resuscitation) First aid for cardiac arrest, ie, attempt of resuscitation by first responders before the arrival of emergency physicians has a major impact on the chance of survival. According to one study, patients with attempted resuscitation by first responders were still alive after 30 days in 10.5% of cases, whereas patients without attempted resuscitation … Cardiac Arrest: Therapy

Cardiac Arrest: Medical History

The case history (medical history) represents an important component in the diagnosis of cardiac arrest/sudden cardiac death. Follow-up history based on interview with a family member (extraneous history). Family history Is there a family history of hereditary diseases associated with sudden cardiac death (eg, prolonged QT syndrome, hypertrophic cardiomyopathy)? Social history What was the patient’s … Cardiac Arrest: Medical History

Cardiac Arrest: Complications

The following are the major conditions or complications that may be contributed to by cardiac arrest: Injuries, poisoning, and certain other sequelae of external causes (S00-T98). Trauma (injury) After fall (29% of injuries): head and neck injuries (88%; intracranial hemorrhage, severe nosebleeds, fractures of cervical vertebrae, and fractures of the facial skull); extremity fractures (12%) … Cardiac Arrest: Complications

Cardiac Arrest: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination-uncertain signs of death: Pulse (pulselessness)/auscultation (listening) of the heart. Pupillary reaction (wide pupils?) Absence of central reflexes Cave: Only sure signs of death such as livor mortis, rigor mortis and putrefaction allowdeath certificate. Since this condition usually does not present … Cardiac Arrest: Examination