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For bradycardia caused by inferior myocardial infarction, cardiac transplant or spinal cord injury, consider giving aminophylline (100–200 mg slow intravenous injection).
Consider mechanical chest compressions only if high-quality manual chest compression is not practical or compromises provider safety.The guidelines reflect the increasing evidence for extracorporeal CPR (eCPR) as a rescue therapy for selected patients with cardiac arrest when conventional ALS measures are failing and to facilitate specific interventions (e.g. coronary angiography and percutaneous coronary intervention (PCI), pulmonary thrombectomy for massive pulmonary embolism, rewarming after hypothermic cardiac arrest) in settings in which it can be implemented. The damage given by each respective rank of the perk, as a proportion of weapon damage, is as follows:
Young adults presenting with characteristic symptoms of arrhythmic syncope should have a specialist cardiology assessment, which should include an electrocardiogram (ECG) and in most cases echocardiography and an exercise test. Emergency medical systems (EMS) should consider implementing criteria for the withholding and termination of resuscitation (TOR) taking into consideration specific local legal, organisational and cultural context ( see the Ethics Guidelines).
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For refractory VF, consider using an alternative defibrillation pad position (e.g. anterior- posterior). McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-726. severe heart failure – manifested by pulmonary oedema (failure of the left ventricle) and/or raised jugular venous pressure (failure of the right ventricle)During manual chest compressions, ‘hands-on’ defibrillation, even when wearing clinical gloves, is a risk to the rescuer. Tonya Lewis Lee is a director, producer, writer whose work often explores the personal impact of social justice issues such as civil rights and criminal justice. Tonya Lewis Lee is a director, producer, writer whose work often explores the personal impact of social justice issues. As a television producer, Tonya served as Executive Producer on the episodic series SHE’S GOTTA HAVE IT which is currently streaming on Netflix. As a film producer, Lee produced MONSTER which premiered at the 2018 Sundance Film Festival and is now available on Netflix. Consider pacing in patients who are unstable, with symptomatic bradycardia refractory to drug therapies. Adult patients with a cardiac arrest of presumed primary cardiac aetiology should be transported directly to a hospital with 24/7 coronary angiography capability. There is a greater recognition that patients with both in- and out-of-hospital cardiac arrest have premonitory signs, and that many of these arrests may be preventable.