QUOTE: As far as looking for the reason for the arrest; in adults unless you are dealing with PEA the reason doesn't matter. Something like hypoglycemia is not going to cause V-fib.
:wakeneo: Ummm, yes, it can. Hypoglycemic patients code frequently.
QUOTE: Until the electrical activity of the heart is restored nothing else matters. PEA is different because the electrical activity still exist, the heart is still trying to beat but mechanically can't. Also remember asystole is a terminal rythmn. You can't jump start a heart.[/QUOTE]
Not entirely true either, it's both we can't live without, but it's the MECHANICAL activity of the heart that we live on.
We are taught to look for reasons for particular rhythms :
for PEA we remember PATCH4 -pulm. embolism, acidosis, cardiac tamponade, hypovolemia, hypoxia, hyperkalemia, hypothermia.
You should always be thinking about "How" this patient could have gotten in this situation...was it drug related? Accident/trauma? hypoxia due to asphyxia?? Every detail you know alters your treatment plan, and helps you better take care of your patient.
Next time you're in a code, think to yourself...OK...he's in asystole - what have we done so far...what could it be?? What's left to try??
And let's hope it never gets that far.
And no, while we don't "jumpstart" the heart, we do attempt to "restart" it in the correct rhythm, with either manual (CPR), electrical (defibrillation) or pharmacological (epi, atropine, adenosine) interventions.