Clinical ride cardiac arrest

[Aidey]

Define unlikely. Then define whether the potential benefit might be outweighed by the potential risk. Many cardiac arrests we work have less than 1% chance of survival. Should we not treat them? Is that the philosophy that I'm hearing in these threads?

Yes, it is. If the cardiac arrests you are working have a collective 1% survival rate you are picking the wrong codes to work.

 

[VFlutter]

VF/VT from medical cause have a much higher rate, the worst reported numbers in the US I have seen is 9%.

asystole/pea arrests are no longer counted. With the exception of a few immediately identifyable and reversible causes or already in a healthcare facility with a known cause, these people are for all intents and purposes, dead. We should not waste resources trying to resuscitate them.

In the hospital it is extremely rare to see a true asystole/PEA arrest. I can remember 3 in the past year compared to ~30 V tach/Fib arrests.

1. Asystole arrest was s/p ablation....didn't make it.
2. PEA was s/p CABG and tamponded, opened the chest @ bedside with internal cardiac massage... Didn't make it.
3. PEA was a Saddle PE that was lsyed and resuscitated

In hospital cardiac arrest data
http://www.ncbi.nlm.nih.gov/pubmed/19770741

 

[TomB]

Asystole/PEA arrest is very common in the in-hospital setting compared to primary VF/VT arrest. I saw it many times when I worked in the hospital on a stepdown unit and the link you provided indicates that asystole/PEA is the first pulseless rhythm 76% of the time.

Tom

In the hospital it is extremely rare to see a true asystole/PEA arrest. I can remember 3 in the past year compared to ~30 V tach/Fib arrests.

1. Asystole arrest was s/p ablation....didn't make it.
2. PEA was s/p CABG and tamponded, opened the chest @ bedside with internal cardiac massage... Didn't make it.
3. PEA was a Saddle PE that was lsyed and resuscitated

In hospital cardiac arrest data
http://www.ncbi.nlm.nih.gov/pubmed/19770741

 

[VFlutter]

Asystole/PEA arrest is very common in the in-hospital setting compared to primary VF/VT arrest. I saw it many times when I worked in the hospital on a stepdown unit and the link you provided indicates that asystole/PEA is the first pulseless rhythm 76% of the time.

Tom

Thanks for pointing that out. I guess I just assumed based off my own personal experience. I stand corrected