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Explain Ventilation, Chest Compressions?
Even when the first three defibrillation attempts fail, the best chance of resuscitation still lies in successful defibrillation. Hence, Cardiopulmonary Resuscitation (CPR) is commenced and any underlying correctable factor is sought for and addressed - e.g., electrolyte abnormalities. Airway is secured by endotracheal intubation if skills are available or, otherwise, by a laryngeal mask airway or a combitube. Ventilation is commenced with 100 per cent oxygen. Fifteen compressions and two ventilations are given for a minute and defibrillation is tried again. Once airway is secure by intubation or a laryngeal mask airway, uninterrupted chest compressions should be carried out, without pausing for ventilations. The rate of compression should be 100/mt and ventilation should be carried out at 12 breaths/mt.
Figure: Advanced Cardiac Life Support for adults
Empiric Initial Therapy Until susceptibility results are available, empiric initial treatment consists of a 4-drug regimen of isoniazid, rifampin, pyrazinamide and ethambutol.
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