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Cardiac arrest: Difference between revisions
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'''Cardiac arrest''' refers to when the heart stops beating, providing no or very little [[cardiac output]]. It is diagnosed when a patient is unresponsive and not breathing or breathing abnormally. As there is no cardiac output there is no pulse either, but an unconscious patient who is not breathing likely has cardiac arrest so time is not wasted feeling for a pulse. | <section begin="A&IC" />'''Cardiac arrest''' refers to when the heart stops beating, providing no or very little [[cardiac output]]. It is diagnosed when a patient is unresponsive and not breathing or breathing abnormally. As there is no cardiac output there is no pulse either, but an unconscious patient who is not breathing likely has cardiac arrest so time is not wasted feeling for a pulse. | ||
Cardiac arrest inevitebly leads to death unless successfully and rapidly managed. Management of cardiac arrest is called '''cardiopulmonary resuscitation''' (CPR). | Cardiac arrest inevitebly leads to death unless successfully and rapidly managed. Management of cardiac arrest is called '''cardiopulmonary resuscitation''' (CPR). | ||
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It is ethically and medically inappropriate to give futile medical therapy, including CPR. The worst case scenario following CPR is that ROSC is achieved but the patient has no neurological function or needs mechanical ventilation or similar for the rest of their life. | It is ethically and medically inappropriate to give futile medical therapy, including CPR. The worst case scenario following CPR is that ROSC is achieved but the patient has no neurological function or needs mechanical ventilation or similar for the rest of their life. | ||
In cases where the physician percieves a patient's odds of surviving cardiopulmonary resuscitation with good neurological outcomes as very low the physician can discuss a ''do-not-resuscitate'' order with the patient, also called a DNR or a "no code". In some countries, the physician can decide this for the patient (even if the patient disagrees); this is the case in Norway, for example. In other countries, like the USA, the patient (or guardian) must agree and sign a written form. I do not know the routine in Hungary. In most cases, when patients are informed of the poor prognosis of CPR, they understand and accept their DNR order, as most would much rather allow a natural death than surviving but risking significantly reduced functioning. | In cases where the physician percieves a patient's odds of surviving cardiopulmonary resuscitation with good neurological outcomes as very low the physician can discuss a ''do-not-resuscitate'' order with the patient, also called a DNR or a "no code". In some countries, the physician can decide this for the patient (even if the patient disagrees); this is the case in Norway, for example. In other countries, like the USA, the patient (or guardian) must agree and sign a written form. I do not know the routine in Hungary. In most cases, when patients are informed of the poor prognosis of CPR, they understand and accept their DNR order, as most would much rather allow a natural death than surviving but risking significantly reduced functioning.<section end="A&IC" /> | ||
[[Category:Intensive care]] | [[Category:Intensive care]] | ||