Advanced resuscitation is a crucial part of medical training.
Traditionally, advanced resuscitation skills training is conducted in small groups to ensure active participation by all students. However, the increasing number of students in medical schools and other training centers has made this difficult.
To counter this issue, a study was conducted to compare peer-led resuscitation training with expert-led resuscitation training.
The participants in the study were sixth-year medical students. The expert instructors included senior and middle grade doctors and a registered nurse certified in advanced life support.
Table of Contents
Basic Life Support
Advanced cardiovascular life support, or ACLS, refers to the clinical guidelines for managing life-threatening cardiovascular conditions.
It involves the use of advanced medical techniques, medications, and procedures. It is more complicated than basic life support, and should only be used in the most critical of situations.
Whether a person is a professional or a layperson, there are many advantages to being trained in basic and advanced resuscitation. These courses improve communication and the chances of survival for the patient.
While some healthcare providers may have more advanced skill in the field, many will still need to know these procedures in the event of a cardiac emergency.
Basic life support involves the first aid procedures and is often performed by healthcare providers, paramedics, and qualified bystanders.
These procedures increase the likelihood of survival until an advanced resuscitation team arrives. These techniques are most commonly used in cases of cardiac arrest, respiratory distress, and obstructed airways.
The effectiveness of these two methods of care can be compared by using two databases. The PubMed database and the CRD database were used to conduct a literature search.
In addition to PubMed and preMEDLINE, the researchers searched CINAHL, the Cochrane database, and the Cochrane database for systematic reviews.
In addition, Google Scholar was used to search for gray literature. The search period was 1995-2008, and all languages were included. The keywords used to search the literature were basic and advanced life support, thrombolytic therapy, and paramedics.
Basic life support includes CPR and AED. Cardiopulmonary resuscitation (CPR) involves giving chest compressions to a supine patient.
The CPR ratio depends on the age and health of the patient. Those who perform CPR must keep in mind that they can only provide compressions for a short period of time.
CPR certification is an excellent first step toward BLS certification. These courses involve more advanced practices and include more detailed techniques. They also involve maintaining an airway, administering oxygen, and ensuring blood circulation and oxygen.
In addition to basic CPR skills, BLS certifications are useful for people who want to help save lives in safe environments.
Infants and children require different CPR techniques. Children are less likely to be victims of cardiac incidents, but are at higher risk of respiratory failure or poisoning.
When performing CPR on children, remember to use the palm of the hand and fingers. During CPR on a child, it is vital to apply high quality rescue breaths.
Both CPR and BLS certificates are valid for two years, so you should keep up with recertification every year. The initial certification course lasts two days, and includes a practical and written exam.
You can also take a condensed eight-hour course to stay current. However, remember that most hospitals do not recognize grace periods.
Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation is a form of advanced resuscitation that combines a blood pump with an oxygenator to restore pulmonary and cardiac function.
It is often referred to as “E-CPR” and is an adjunct to standard cardiopulmonary resuscitation. Recent advances in ECMO technology have enabled the delivery of partial and full cardiorespiratory support even in cases of refractory cardiac arrest.
Extracorporeal membrane oxygenation is currently considered investigational for most cases of cardiogenic shock. Nonetheless, it may have a lifesaving effect in some patients.
Although ECMO is not recommended for use during surgery, it may be beneficial for patients in need of short-term support.
The process removes carbon dioxide from the blood, allowing oxygen-rich blood to travel directly to tissues. Because the oxygen-rich blood bypasses the heart and lungs, the process is more effective than standard cardiopulmonary resuscitation and can last days or even weeks.
The procedure is used only after standard treatments have failed to improve the patient’s condition.
In advanced resuscitation, ECMO is often a last resort, but it can be an important part of a patient’s recovery.
It can help with respiratory or cardiac failure, and it provides a temporary support system while doctors focus on treating the underlying condition.
A large number of prospective studies are currently underway or planned. These studies will determine whether ECPR is an option for advanced resuscitation in out-of-hospital cardiac arrest.
The London Sub 30 study, for example, aims to establish whether E-CPR can be administered within 30 minutes of OHCA. This study will also compare the results of ECPR performed at prehospital and hospital settings.
Extracorporeal membrane oxygenation can be performed using a cardiopulmonary bypass circuit device. ECMO machines have been cleared by the FDA through the 510(k) process. Other components of the circuit, including the arterial filter, reservoir, tubing, and ECMO-compatible pumps, are regulated by the FDA.
Extracorporeal membrane oxygenation (ECMO) is used for a variety of conditions in advanced resuscitation.
It can be used to improve the condition of organs before surgery, a bridge to a lung transplant, or to support a high-risk cardiac procedure. It can also improve a patient’s chances of survival and recovery.
Hypothermia
Hypothermia is a serious condition that may lead to cardiac arrest and can cause a variety of symptoms.
It is most often the result of exposure to a cold environment, but it can also occur due to toxin exposure, metabolic derangement, and infections. Hypothermia can be mild, moderate, or severe, and treatment options vary widely.
They range from noninvasive passive external warming to active core rewarming and extracorporeal blood warming.
In most clinical settings, mild to moderate hypothermia is treated with supportive care. In patients with severe hypothermia, the treatment process becomes more difficult. This is why prevention is critical to reduce hypothermia mortality.
Patients must be carefully monitored to ensure that they remain stable and are not dying.
Patients should be evaluated for signs of pain and agitation. If the patient is unresponsive, endotracheal intubation may be indicated.
Intubation serves two functions during hypothermia management: to facilitate effective ventilation of warm oxygen and to isolate the airway, which reduces the risk of aspiration.
Hypothermia can occur in patients with a number of medical conditions, such as malnutrition, vascular problems, or coma.
Additionally, it can be caused by a reduction in blood volume. Some medications can impair the body’s ability to detect colds. A reduction in blood volume can result in cardiac arrest, or even death.
The most effective way to diagnose hypothermia is to determine the core temperature. The body’s external parts cool faster than its core, so it is best to measure the core temperature near vital organs.
Despite this, some patients will still experience a degree of consciousness despite a core temperature of 24 degC. Despite the risk of cardiac arrest, hypothermia can be treated effectively.
In general, the goal of advanced resuscitation is to stabilize the patient’s core temperature, and prevent further heat loss. It is important to avoid jerky movement of a severely hypothermic patient because it may precipitate ventricular fibrillation.
In this case, cardiac resuscitation is unlikely to be successful.
If you or a loved one is stranded in a car accident or other disaster and the temperature drops below zero, you’ll want to be prepared. According to the Centers for Disease Control, you should have a winter survival kit that includes nonperishable food, blankets, and medications, along with a first aid kit.
Additionally, you should have weather-stripping and insulated doors to protect against cold. It is also important to move all items from the trunk into the interior of the car to conserve heat.
Research has shown that resuscitation outcomes are improved when mild hypothermia is used. Prehospital induction of therapeutic hypothermia is safe and effective, but larger studies are needed to evaluate whether early cooling improves neurological outcomes.
Out-of-hospital cardiac arrest is a common complication and has a poor prognosis. About two-thirds of out-of-hospital cardiac arrest patients will develop postresuscitation disease within the first four to 24 hours. In addition, severe anoxic brain injury may result in death.
Takeaway
Advanced resuscitation is the process of restoring cardiac function and preventing further heat loss in a patient with hypothermia.
The most effective way to diagnose hypothermia is to determine the core temperature. Despite the risk of cardiac arrest, hypothermia can be treated effectively.
In general, the goal of advanced resuscitation is to stabilize the patient’s core temperature, and prevent further heat loss
