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Cardiac arrest is diagnosed by the inability to find a pulse in an unresponsive patient. [4] [1] The goal of treatment for cardiac arrest is to rapidly achieve return of spontaneous circulation using a variety of interventions including CPR, defibrillation, and/or cardiac pacing.
Asystole is the most serious form of cardiac arrest and is usually irreversible. Also referred to as cardiac flatline , asystole is the state of total cessation of electrical activity from the heart , which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.
Transcutaneous pacing is no longer indicated for the treatment of asystole (cardiac arrest associated with a "flat line" on the ECG), with the possible exception of witnessed asystole (as in the case of bifascicular block that progresses to complete heart block without an escape rhythm). [4]
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Following a cardiac flatline a fast intervention is a priority and can affect individual outcomes and recovery. Treatment [14] for cardiac flatline or asystole can involve: CPR (cardiopulmonary resuscitation) Administering a vasopressin such as epinephrine; Trying to identify what could be causing the cardiac flatline in the first place. [15]
In 1955 D.G. Melrose suggested ‘’elective cardiac arrest’’, a technique already used for other purposes, in order to protect the heart from ischemia- since cardiac muscle is not working, oxygen demands should be low. In the 1960’s other groups introduced ice slur applied all over the heart’s surface.
Injections of atropine are used in the treatment of symptomatic or unstable bradycardia. Atropine was previously included in international resuscitation guidelines for use in cardiac arrest associated with asystole and PEA but was removed from these guidelines in 2010 due to a lack of evidence for its effectiveness. [22]
Sympathomimetic drugs are used to treat cardiac arrest and low blood pressure, or even delay premature labor, among other things. These drugs can act through several mechanisms, such as directly activating postsynaptic receptors, blocking breakdown and reuptake of certain neurotransmitters, or stimulating production and release of catecholamines.