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===Acute Immediate Post-Cardiac Arrest Care===
__NOTOC__
{{familytree/start |summary=Post-Cardiac arrest care}}
{{CMG}}; {{AE}}; {{chetan}}
{{familytree | | | | | | | A01 | | | | | A01= '''Return of spontaneous circulation<br>(ROSC)'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A02 | | | | | A02=<div style="float: left; text-align: left; line-height: 150% "> '''Optimize [[ventilation]] and [[oxygenation]]'''<br> ❑ Maintain oxygen saturation ≥ 94% <br> ❑ Consider advanced airway and waveform [[capnography]] <br> ❑  Do not hyperventilate <br>
: ♦ Start at 10-12 breaths/min<br>
: ♦ Titrate to target PETCO<sub>2</sub> of 35-40 mmHg </div>}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A03 | | | | | A03= <div style="float: left; text-align: left; line-height: 150% ">'''Treat [[hypotension]] ([[SBP]]<90 mmHg)'''<br> ❑ IV/IO bolus <br>
: ♦ 1-2 L [[normal saline]] or [[lactated Ringer's]]  <br>
❑ [[Vasopressor]] infusion <br>
: ♦ [[Epinephrine]] IV infusion: 0.1-0.5 mcg/kg/min, or<br>
: ♦ [[Dopamine]] IV infusion: 5-10 mcg/kg/min, or<br>
: ♦ [[Norepinephrine]] IV infusion: 0.1-0.5 mcg/kg/min
-----
❑ Consider treatable causes
----
❑ 12-Lead [[ECG]] </div>}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A04 | | | | | A04= '''Follow commands?'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | |,|-|-|-|-|-|(| | | | | | }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B01 | | | | A05 | | | | | B01= No| A05= Yes|border=0}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B02 | | | | |!| | | | | | B02=❑ Consider induced [[hypothermia]]}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | |`|-|-|-|-| A06 | | | | | A06= '''[[STEMI]]''' <br>Or<br> '''High suspicion of [[AMI]]'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | |,|-|-|-|-|-|(| | | | | | }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B03 | | | | A07 | | | | | B03= Yes| A07= No|border=0 }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B04 | | | | |!| | | | | | B04=❑ Coronary reperfusion}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | |`|-|-|-|-| A08 | | | | | A08= '''Advanced critical care'''}}
{{familytree/end}}
''Adapted from 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 9.''<ref name="pmid20956225">{{cite journal| author=Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M et al.| title=Part 9: post-cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S768-86 | pmid=20956225 | doi=10.1161/CIRCULATIONAHA.110.971002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956225  }} </ref>


==Do's==


==Dont's==
==Definition==
* Do not Hyperventilate or overbag the patient, it may lead to decreased cardiac output.
Acetaaminophen is widely used as a pain medication in the U.S .  An overdose normally occurs when somebody ingests it accidentally or intentionally above the normal recommended dose .  It one of the most common poisoning  in the U.S and worldwide .  The main reason of this being that is is easily available  and people think that it is a very safe medication .  It is available in the U.S market under the following brand names .
 
*[[Tylenol]]
*Anacin-3
*Liquiprin
*Percocet
*Tempra
*Cold and flu medicines.
*Aceta
*Actimin
*Apacet
*Aspirin Free Anacin
*Atasol
*Banesin
*Dapa
*Datril Extra-Strength
*Feverall
*Fibi
*Genapap
*Genebs,
*[[Panadol]]
===Common dosage forms and strengths===
 
#Suppository: 120 mg, 125 mg, 325 mg, 650 mg
#Chewable tablets: 80 mg
#Regular strength: 325 mg
#Extra strength: 500 mg
#Liquid: 160 mg/teaspoon
#Drops: 100 mg / mL, 120 mg / 2.5 mL
 
'''mg = milligrams'''
 
Maximum advisable dosage is 4000 mg of acetaminophen a day .  A severe overdose can happen if taken more than 7000 mg / day .
 
==Causes/Pathophysiology==
After ingestion of an excessive amount of acetaminophen a toxic metabolite called '''N-acetyl-p-benzoquinonimine (NAPQI)''' is formed in excess and hence the normal pathways of conjugating by glutathione are saturated .  This results in glutathione depletion which leads to liver injury .
 
==Management==
Most of the patients who have an overdose of acetaminophen are asymptomatic . A few however who are symptomatic show symptoms only after 12 hrs of ingestion.
 
==References==
 
[[Category:Toxicology]]
[[Category:Medicine]]
[[Category:Primary care]]
[[Category:Resident survival guide]]
 
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{{WikiDoc Sources}}

Revision as of 17:11, 10 January 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Chetan Lokhande, M.B.B.S [2]


Definition

Acetaaminophen is widely used as a pain medication in the U.S . An overdose normally occurs when somebody ingests it accidentally or intentionally above the normal recommended dose . It one of the most common poisoning in the U.S and worldwide . The main reason of this being that is is easily available and people think that it is a very safe medication . It is available in the U.S market under the following brand names .

  • Tylenol
  • Anacin-3
  • Liquiprin
  • Percocet
  • Tempra
  • Cold and flu medicines.
  • Aceta
  • Actimin
  • Apacet
  • Aspirin Free Anacin
  • Atasol
  • Banesin
  • Dapa
  • Datril Extra-Strength
  • Feverall
  • Fibi
  • Genapap
  • Genebs,
  • Panadol

Common dosage forms and strengths

  1. Suppository: 120 mg, 125 mg, 325 mg, 650 mg
  2. Chewable tablets: 80 mg
  3. Regular strength: 325 mg
  4. Extra strength: 500 mg
  5. Liquid: 160 mg/teaspoon
  6. Drops: 100 mg / mL, 120 mg / 2.5 mL

mg = milligrams

Maximum advisable dosage is 4000 mg of acetaminophen a day . A severe overdose can happen if taken more than 7000 mg / day .

Causes/Pathophysiology

After ingestion of an excessive amount of acetaminophen a toxic metabolite called N-acetyl-p-benzoquinonimine (NAPQI) is formed in excess and hence the normal pathways of conjugating by glutathione are saturated . This results in glutathione depletion which leads to liver injury .

Management

Most of the patients who have an overdose of acetaminophen are asymptomatic . A few however who are symptomatic show symptoms only after 12 hrs of ingestion.

References


Template:WikiDoc Sources