Resuscitation: Special Circumstances
Pregnancy
- Place patient in left lateral tilt to relieve aortocaval compression
- Early oxygen crucial as the patient’s increased oxygen consumption and reduced oxygen reserve pose higher risk of hypoxia.
- Maintain cricoid pressure until ETT inserted as the patient is prone to regurgitation from large uterus and lower esophageal sphincter tone.
- Consider C. section if gestational age is > 20 weeks and > 4mins of effective CPR. This has been shown to aid maternal survival.
Hypothermia/Drowning
- Consider alcohol, drug overdose, and trauma as potential triggers.
- Hypothermia has a protective effect on the brain therefore extend resuscitation efforts until patient is normothermic.
- Drowning requires immediate rescue breaths and securing the airway.
Overdose
- Opioids – note pinpoint pupils. Provide naloxone.
- Tricyclic antidepressants – may have had witnessed seizure. Provide sodium bicarbonate.
Next page: Anaphylaxis