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| | *If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas" | | | *If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas" |
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| | Hypovolemia, hemorrhage, anemia||Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma||"*Give fluids
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| | *Transfuse pRBCs if hemorrhage or profound anemia is present
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| | *Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min"
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| | Hypoxia||Consider in all patients with cardiac arrest||Reassess technical quality of cardiopulmonary resuscitation, oxygenation, and ventilation; reconfirm ETT placement
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| | Hypomagnesemia||Alcohol abuse, burns, DKA, severe diarrhea, diuretics, drugs (eg, cisplatin, cyclosporine, pentamidine)||Give 1-2 g magnesium sulfate intravenously over 2 min
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| | Myocardial infarction||Consider in all patients with cardiac arrest, especially those with a history of coronary artery disease or prearrest acute coronary syndrome||Consider definitive care (eg, thrombolytic therapy, cardiac catheterization or coronary artery reperfusion, circulatory assist device, emergency cardiopulmonary bypass)
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| | Poisoning||Alcohol abuse, bizarre or puzzling behavioral or metabolic presentation, classic toxicologic syndrome, occupational or industrial exposure, and psychiatric disease||Consult toxicologist for emergency advice on resuscitation and definitive care, including appropriate antidote
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| | ||||Prolonged resuscitation efforts may be appropriate; immediate cardiopulmonary bypass should be considered, if available
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| | Hyperkalemia||Metabolic acidosis, excessive administration of potassium, drugs and toxins, vigorous exercise, hemolysis, renal disease, rhabdomyolysis, tumor lysis syndrome, and clinically significant tissue injury||If hyperkalemia is identified or strongly suspected, treat with all of the following: 10% calcium chloride (5-10 mL by slow intravenous push; do not use if hyperkalemia is secondary to digitalis poisoning), glucose and insulin (50 mL of 50% dextrose in water and 10 units of regular insulin intravenously), sodium bicarbonate (50 mmoL intravenously; most effective if concomitant metabolic acidosis is present), and albuterol (15-20mg nebulized or 0.5mg by intravenous infusion)
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| | Hypokalemia||Alcohol abuse, diabetes, use of diuretics, drugs and toxins, profound gastroinstestinal losses, hypomagnesemia||If profond hypokalemia (<2-2.5 mmoL of potassium per liter) is accompanied by cardiac arrest, initiate urgent intravenous replacement (2 mmoL/min intravenously for 10-15 mmoL), then reassess
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| | Pulmonary embolism||Hospitalized patient, recent surgical procedure, peripartum, known risk factors for venous thromboembolism, history of venous thromboembolism, or prearrest presentation consistent with diagnosis of acute pulmonary embolism||"*Administer fluids; augment with vasopressors as necessary
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| | *Confirm diagnosis, if possible; consider immediate cardiopulmonary bypass to maintain patient's viability
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| | *Consider definitive care (eg, thrombolytic therapy, embolectomy by interventional radiology or surgery)"
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| | Tension pneumothorax||Placement of central catheter, mechanical ventilation, pulmonary disease (including asthma, chronic obstructive pulmonary disease, and necrotizing pneumonia), thoracentesis, and trauma||Needle decompression, followed by chest-tube insertion
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| |} | | |} |
