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Cardiopulmonary Resuscitation Room

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Introduction

Liudvikas Jagminas, MD, FACEP, chief of service at BID-Plymouth, Massachusetts, Department of Emergency Medicine, recounted the following story on emergencycareforyou.org (Jagminas L, 2016):

"I was called to our resuscitation room to treat a 78-year-old man who was out shovelling snow and after not returning to his home for over 45 minutes his wife went outside and found him slumped over a snow mound. EMS reported they found him cyanotic (blue color of skin), without a pulse and not breathing. They started CPR, put a breathing tube in his windpipe, placed him on a monitor, which showed Asystole (no electrical activity of the heart) and brought him to our emergency department. I checked the breathing tube placement, checked the …show more content…

Recently, many physicians and medical journals have voiced their disapproval with the above guideline, stating that the treatment plan is outdated, ineffective, or even detrimental to the patient. For example, the algorithm recommends administering 1mg of epinephrine every 3-5 minutes through an intravenous (IV) or intraosseous (IO) line after commencing cardiopulmonary resuscitation (CPR), a practice implemented since 1896 (Medscape, 2016). However, according to the World Journal of Emergency Medicine, epinephrine has not been shown to improve long-term survival rates for patients or improve neurological outcomes after recovery. In fact, the opposite is inferred (World Journal of Emergency Medicine, 2013). Despite the best efforts of the American Heart Association, no guideline is universally agreed upon as being optimal for the treatment of Asystole. Therefore, it is necessary to compile a guideline that is supported by the latest research and the opinions of physicians and medical journals …show more content…

This is because, as is demonstrated by (ACLS, 2015), Asystole is not treatable via the universally-accepted method of defibrillation and as such is more complicated to manage. Before continuing, it is important to identify the characteristics of Asystole. Asystole is a life-threatening heart rhythm characterized by an absence of all electrical activity and cardiac output. It is determined through the use of an Electrocardiogram and presents as a straight or flat line. This condition will lead to death if it is not treated and reversed immediately (AHA, 2016).

Figure 2 – (EKG, 2014). The Electrocardiogram presentation of Aystole
Due to the complexity of the disorder, many laypersons (and in fact medical personnel) are unaware of the optimal treatment plan. This is demonstrated by a book entitled ‘Cardiac Arrest: The Science and Practice of Resuscitation Medicine’. The authors found that in a study of six resuscitation programs, each program 'took a different approach to the problem of cardiac emergencies' (Normon A, 2007). Therefore, it can definitively be seen that a single and ideal treatment plan should be offered.

This plan will be determined by analyzing the benefits of the following treatment plans already in use:

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