Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA
High-quality cardiopulmonary resuscitation (CPR) is the single most important determinant of intact survival in cardiac arrest, and it is critical that all healthcare workers are able to perform this lifesaving technique effectively. Despite the conceptual simplicity of CPR, the reality is that many providers perform it incorrectly, resulting in suboptimal survival outcomes for their patients. This video looks at the essential elements of high-quality CPR, discusses the physiologic basis for each step, and describes how to optimize them in order to enhance survival outcomes. Appropriate prioritization of interventions in cardiac arrest and methods for optimizing resuscitation performance are covered as well.
Emergency Medicine and Critical Care
Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA
High-quality cardiopulmonary resuscitation (CPR) and defibrillation are the most important interventions for patients with cardiac arrest, and should be the first steps that rescuers perform. This is reflected in the American Heart Association's new "CAB" mnemonic. While rescuers were once taught the "ABCs" of cardiac arrest, they now learn "CAB" - circulation first, followed by airway and breathing. Only once CPR is underway (and defibrillation has been performed, if a defibrillator is available) do we consider providing respiratory support. This video will describe the correct technique for providing respiratory support to a patient in cardiac arrest, and how to continue basic life support over the period of time until help arrives.
This video assumes that all the steps described in "Basic Life Support Part I: Cardiopulmonary Resuscitation and Defibrillation" have already been completed. This video does NOT depict the initial steps taken when arriving at the scene of a cardiac arrest.
Emergency Medicine and Critical Care
Source: Julianna Jung, MD, FACEP, Associate Professor of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA
For unstable patients requiring urgent administration of medications, fluids, or blood products, establishing vascular access quickly is essential. However, there are many factors that can complicate placement of a peripheral intravenous cannula (PIV), and it is extremely common for PIV attempts to fail. PIV placement may be technically challenging in small children, injection drug users, obese people, people with chronic illnesses necessitating frequent vascular access, and in those with burns and other skin conditions. Furthermore, for patients in shock, blood is shunted away from the periphery in order to compensate for impaired perfusion of vital organs, making peripheral vessels difficult to find and cannulate. In these situations, intraosseous (IO) needle placement is an extremely effective alternative to PIV placement, allowing rapid and technically straightforward access to the highly vascularized intramedullary space inside the long bones. From here, medications and fluids are readily absorbed into the bloodstream, permitting stabilization of critically ill patients.
Emergency Medicine and Critical Care
