Cardiopulmonary Resuscitation in Special Circumstances

Abstract

Cardiopulmonary resuscitation (CPR) in special circumstances includes the emergency intervention for special causes, special environments and special patients. Special causes cover the potential reversible causes of cardiac arrest that must be identiied or excluded during any resuscitation, divided into two groups, 4Hs and 4Ts: hypoxia, hypo-/hyperkalaemia and other electrolyte disorders, hypo-/hyperthermia, hypervolemia, tension pneumothorax, tamponade (cardiac), thrombosis (coronary or pulmonary) and toxins. The special environments section includes recommendations for the treatment of cardiac arrest occurring in speciic locations: cardiac surgery, catheterisation laboratory, dialysis unit, dental surgery, commercial airplanes or air ambulances, ield of play, diicult environment (e.g. drowning, high altitude, avalanche and electrical injuries) or mass casualty incident. CPR for special patients gives guidance for the patients with severe comorbidities (asthma, heart failure with ventricular assist devices, neurological disease and obesity) and pregnancy women or elderly people.

Cardiopulmonary Resuscitation: Recent Advances

“…The traumatic arrest is one of the etiologies of cardiac arrest with a very poor outcome [86][87][88][89][90][91][92]. To improve its outcome, there is a need to draw our attention to the possible reversible causes of traumatic cardiac arrest [93].…”

“…It can either be achieved by immediate needle decompression or thoracotomy. In the case of positive pressure ventilation, thoracostomy is a preferred technique as it is more effective than needle decompression and less time-consuming that chest tube insertion [86]. Whereas, in the case of needle decompression, there can be technical difficulties like kinking, dislodgment, insufficient length of needle leading to insufficient decompression [100].…”