Cardiopulmonary resuscitation (CPR) is an essential link in the chain of survival for treating cardiac arrest.
Reversible Causes of Cardiac Arrest
Continually, during CPR consider and correct reversible causes of the cardiac arrest based on the history of the event and any clues that are found during resuscitation.
These factors are remembered as the 4Hs and 4Ts:
- Hypoxia is a prime cause of cardiac arrest in childhood and is key to successful resuscitation
- Hypovolaemia may be significant in arrests associated with trauma, anaphylaxis and sepsis and requires infusion of crystalloid.
- Hyperkalaemia, hypokalaemia, hypocalcaemia and other metabolic abnormalities may be suggested by the patient’s underlying condition (e.g. renal failure), tests taken during the resuscitation or clues given in the ECG.
- Hypothermia is associated with drowning incidents and requires particular care: a low reading thermometer must be used to detect it.
- Tension pneumothorax and cardiac tamponade are especially associated with pulseless electrical activity (PEA) and found in trauma cases.
- Toxic substances either as a result of accidental or deliberate overdose or from a iatrogenic mistake may require specific antidotes.
- Thromboembolic phenomena are much less common in children than in adults.
- Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD; American Heart Association Emergency Cardiovascular Care Committee. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation. 2008 Apr 22;117(16):2162-7. [Medline]
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, Samson RA, Kattwinkel J, Berg RA, Bhanji F, Cave DM, Jauch EC, Kudenchuk PJ, Neumar RW, Peberdy MA, Perlman JM, Sinz E, Travers AH, Berg MD, Billi JE, Eigel B, Hickey RW, Kleinman ME, Link MS, Morrison LJ, O'Connor RE, Shuster M, Callaway CW, Cucchiara B, Ferguson JD, Rea TD, Vanden Hoek TL. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S640-56. [Medline]
- Travers AH, Rea TD, Bobrow BJ, Edelson DP, Berg RA, Sayre MR, Berg MD, Chameides L, O'Connor RE, Swor RA. Part 4: CPR overview: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84. [Medline]
Created Aug 03,2011.
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