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

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