She was very shockable, and as a kid shockable people were my ideal playmates.
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The proportion of cardiac arrests involving non-shockable rhythms increases with age.
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None of the elderly patients with non-shockable rhythms and unwitnessed arrests survived hospitalization.
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In about 25 percent of cardiac arrests that occur outside of hospitals, the irregular rhythm is potentially shockable.
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"An older person in good physical condition who has a shockable rhythm — it can work," Dr. Druwé said.
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In this multinational sample, almost 90 percent of the CPR attempts on patients over 80 involved non-shockable rhythms.
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But for patients with so-called non-shockable rhythms — whose hearts show electrical activity yet are not pumping at all — survival rates fall sharply.
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In cardiac arrest, a minority of patients have what's called a "shockable" rhythm: The heart is moving, but abnormally, and it is not pumping blood effectively.
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The study focused on 2,500 cardiac arrests that happened in a public place and were considered "shockable," or possible to treat with an automated external defibrillator (AED).
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Clinicians classify cardiac arrest into "shockable" versus "non-shockable", as determined by the ECG rhythm. This refers to whether a particular class of cardiac dysrhythmia is treatable using defibrillation. The two "shockable" rhythms are ventricular fibrillation and pulseless ventricular tachycardia while the two "non-shockable" rhythms are asystole and pulseless electrical activity.
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If the victim presents in a shockable rhythm, early defibrillation is still recommended.
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An automated external defibrillator stored in a visible orange mural support Defibrillation is indicated if a shockable rhythm is present. The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia. In children 2 to 4 J/Kg is recommended. In addition, there is increasing use of public access defibrillation.
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Within the group of people presenting with cardiac arrest, the specific cardiac rhythm can significantly impact survival rates. Compared to people presenting with a non-shockable rhythm (such as asystole or PEA), people with a shockable rhythm (such as VF or pulseless ventricular tachycardia) have improved survival rates, ranging between 21-50%.
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To be most effective, bystanders should provide CPR immediately after a patient collapses. Properly performed CPR can keep the heart in a shockable rhythm for 10–12 minutes longer.
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These devices can analyse the heart rhythm by themselves, diagnose the shockable rhythms, and charge to treat. This means that no clinical skill is required in their use, allowing lay people to respond to emergencies effectively.
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The diagnosis is confirmed by finding no pulse. While a cardiac arrest may be caused by heart attack or heart failure, these are not the same. Prevention includes not smoking, physical activity, and maintaining a healthy weight. Treatment for cardiac arrest includes immediate cardiopulmonary resuscitation (CPR) and, if a shockable rhythm is present, defibrillation.
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An AED installed outside a Vets in a rural village. Positioned for public use Automated external defibrillators are designed for use by untrained or briefly trained laypersons. AEDs contain technology for analysis of heart rhythms. As a result, it does not require a trained health provider to determine whether or not a rhythm is shockable.
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The diagnosis is confirmed by finding no pulse. While a cardiac arrest may be caused by heart attack or heart failure these are not the same. Prevention includes not smoking, physical activity, and maintaining a healthy weight. Treatment for cardiac arrest is immediate cardiopulmonary resuscitation (CPR) and, if a shockable rhythm is present, defibrillation.
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Lidocaine and amiodarone are also deemed reasonable in children with cardiac arrest who have a shockable rhythm. The general use of sodium bicarbonate or calcium is not recommended. The use of calcium in children has been associated with poor neurological function as well as decreased survival. Correct dosing of medications in children is dependent on weight.
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Survival rates in a cardiac arrest patient with asystole are much lower than a patient with a rhythm amenable to defibrillation; asystole is itself not a "shockable" rhythm. Even in those cases where an individual suffers a cardiac arrest with asystole and it is converted to a less severe shockable rhythm (ventricular fibrillation, or ventricular tachycardia), this does not necessarily improve the person's chances of survival to discharge from the hospital, though if the case was witnessed by a civilian, or better, an EMT, who gave good CPR and cardiac drugs, this is an important confounding factor to be considered in certain select cases. Out-of-hospital survival rates (even with emergency intervention) are less than 2 percent. The term is from 1860, from Modern Latin, from Greek privative a "not, without" + systolē "contraction"..
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Early cardiopulmonary resuscitation (CPR) is essential to surviving cardiac arrest with good neurological function. It is recommended that it be started as soon as possible with minimal interruptions once begun. The components of CPR that make the greatest difference in survival are chest compressions and defibrillating shockable rhythms. After defibrillation, chest compressions should be continued for two minutes before a rhythm check is again done.
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Precordial thump is a medical procedure used in the treatment of ventricular fibrillation or pulseless ventricular tachycardia under certain conditions. The procedure has a very low success rate, but may be used in those with witnessed, monitored onset of one of the "shockable" cardiac rhythms if a defibrillator is not immediately available. It should not delay cardiopulmonary resuscitation (CPR) and defibrillation, nor should it be used in those with unwitnessed out-of-hospital cardiac arrest.
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True electrical and mechanical capture Transcutaneous pacing (also called external pacing) is a temporary means of pacing a patient's heart during a medical emergency. It should not be confused with defibrillation (used in more serious cases, in ventricular fibrillation and other shockable rhythms) using a manual or automatic defibrillator, though some newer defibrillators can do both, and pads and an electrical stimulus to the heart are used in transcutaneous pacing and defibrillation. Transcutaneous pacing is accomplished by delivering pulses of electric current through the patient's chest, which stimulates the heart to contract. The most common indication for transcutaneous pacing is an abnormally slow heart rate.
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Asystole is different from very fine occurrences of ventricular fibrillation, though both have a poor prognosis, and untreated fine VF will lead to asystole. Faulty wiring, disconnection of electrodes and leads, and power disruptions should be ruled out. Asystolic patients (as opposed to those with a "shockable rhythm" such as ventricular fibrillation or ventricular tachycardia, which can potentially be treated with defibrillation) usually present with a very poor prognosis. Asystole is found initially in only about 28% of cardiac arrest cases in hospitalized patients, but only 15% of these survive, even with the benefit of an intensive care unit, with the rate being lower (6%) for those already prescribed drugs for high blood pressure.
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