lecture recording on 25 February 2025 at 22.51.49 PM

Overview of Cardiac Arrest and Resuscitation in Emergency Situations

Key Cases for Transportation by STARS

• Electrocution: High potential for survival with immediate care.

• Pediatric Cases: Especially critical; pediatric patients have a better chance of sustained resuscitation.

• Hypothermic Drowning: STARS will respond to pediatric patients found in cold water, emphasizing that no one is considered dead until they are warm and dead. Water temperatures in Alberta are classified as cold, raising urgency for cases involving submersion.

Examples of Drowning Cases

• Socomy Lake or Mackenzie Lake: High response potential due to the risk of hypothermic drowning in children.

• Elbow River Incidents: Regular annual incidents during events like Stampede where individuals have to be rescued from freezing temperatures.

Recognizing Traumatic Cardiac Arrest

• Intervention Protocols: If a patient is in traumatic cardiac arrest, it is standard to perform bilateral pleural decompression to treat potential tension pneumothorax.

• Advanced Airway Management: Patients may be intubated quickly to secure their airway during resuscitation, focusing on the utmost care and quick recognition of treatable conditions.

Types of Industrial Injuries

• Farming Accidents: Injuries from farm equipment such as grain augers and tractor rollovers, which can cause serious damage and life-threatening situations. Example: a friend getting damaged from getting caught in a grain auger.

• Rock Pickers: Equipment causing severe injuries when safety measures are bypassed. Injuries often go unreported until severe consequences occur.

Trauma Scene Considerations

• Environmental Hazards: Heat from exhaust systems and leaking fuel during incidents can pose additional risks.

• Guidelines for Resuscitation Determination: AHS guideline mnemonics for "Do Not Attempt Resuscitation" include:

  • Decapitation

  • Rigor Mortis

  • Incineration (severe burns)

  • Evisceration (abdominal contents exposed)

  • Decomposition (signs of decay)

• Dependent Lividity: Indicates post-mortem changes in the body, typically pooling of blood in the lowest parts implicating a longer duration of death.

Assessing Survivability in Cardiac Arrest

• Pupillary Reaction: Fixed and dilated pupils suggest a grim prognosis, whereas any reaction indicates some brain activity, raising hope for resuscitation.

• Airway Management: Using advanced airway techniques is critical in managing cardiac arrest. Responsiveness is essential for assessing patient viability.

Emergency Protocols in Rural Areas

• Protocol During Cardiac Events: Rural calls often reveal underlying issues like cardiac arrest compounded by other health issues (e.g., opioid overdose). Monitoring vital signs and focusing on high-quality CPR are essential.

• Electrical Safety: Always assess for risks of electrocution from downed power lines or electrified objects during emergency interventions.

Multiple Casualty Incidents (MCI)

• Prioritizing Life-Saving Measures: In MCIs, the priority is assessing Respirations, Perfusion, and Mental status (32 can do).

• Understanding Cardiac Arrest Causes: Differentiate between conditions that require immediate CPR versus those influenced by external trauma (e.g., electric shock).

Resuscitation Guidelines and Protocols

• Utilize H's and T's in Advanced Cardiac Life Support: Identify underlying causes leading to arrest, e.g., hypovolemia, tension pneumothorax, and airway complications.

• Defibrillation in Trauma: Can be performed even if spinal motion restrictions are in place and requires clear communication to ensure safety.

• Post-Resuscitation Considerations: Analyze casualty situations and their potential causes to tailor immediate medical responses appropriately.

Conclusion

• Maintenance of airway, breathing, and circulation must remain aggressive and systematic in all successful resuscitation efforts. Training and quick problem-recognition are key components for emergency medical responders considering various trauma cases and underlying conditions.