Cardiac arrest means the heart has either quit beating or
the activity of the myocardium is insufficient to maintain a reasonable perfusing blood
pressure. There are many reasons one would experience cardiac arrest, but by far the
most common are related to myocardial arrhythmia's (disturbances in the normal
electrical rhythm of the heart).
1. When the heart has
stopped this is called asystole (in the movies...flatline). This means that there is no
pulse. Treatment of asystole is CPR and IV or intracardiac epinephrine (dosage depends
on the age and weight of the victim).
2. Ventricular
fibrillation or VF, this may be "coarse" or "fine" VF. Treatment consists of
defibrillation with a defibrillator and CPR.
3. Ventricular
tachycardia or VT, may be pulseless VT or VT with a pulse. Treatment consists of
defibrillation, CPR, and anti-arrythmics like IV Bretylium or Lidocaine. Note that in
patients in VT that have a palpable pulse, the pulse will not last and in a few seconds
(not minutes) the pulse will be lost.
4. Supraventricular
tachycardia or SVT. Treatment consists of medications first (too many to list),
defibrillation, then CPR if the above have failed.
Note
that AED's or automated external defibrillators are ONLY used for VF. Also note that
pacemakers have absolutely nothing to do with cardiac arrest but may be used later if
the patients condition indicates pacing, which is quite rare.
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