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Additional resources for A Resuscitation Room Guide Banerjee
A rise to normal or high levels implies effective CPR. Persistently low CO2 means a poor cardiac output from either poor technique or an underlying cause such as massive pulmonary embolism. Absent endotracheal CO2 may indicate inadvertent oesophageal intubation, which should be checked by immediate laryngoscopy. • Improving acid-base status, as measured by rising venous or arterial blood pH. Central or mixed venous pH is more meaningful than arterial pH. • Metabolic acidosis is invariably present after all but the briefest cardiac arrest, with raised base deficit and plasma lactate.
The little, ring and middle fingers lift the chin and thrust the jaw forwards • The other hand is used to compress the bag • With two person ventilation, one person can use both hands to maintain an air-tight seal • If the patient has dentures, they are best retained to ensure a better fit. Although described separately here, assessment of breathing and respiratory adequacy is often made alongside airway assessment as the two are closely interrelated. The priority is to ensure adequate oxygenation with saturation of 90-95%.
Features • A rapid onset of symptoms • Laryngeal oedema, laryngospasm and bronchospasm; stridor (upper and/or lower airway obstruction) • Cardiovascular collapse: profound hypotension and marked tachycardia • Skin signs: redness, intense itching, urticaria, angioedema of the face and oral mucosa • Nausea, vomiting, diarrhoea and abdominal pain • Reduced level of consciousness • Diagnostic problems arise from a lack of consistent clinical manifestations, and varying combinations of the listed features can occur.
A Resuscitation Room Guide Banerjee by Hargreaves