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Asystole

Aka: Asystole
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  1. See Also
    1. Cardiopulmonary Resuscitation
    2. Ventricular Fibrillation
    3. Pulseless Ventricular Tachycardia
  2. Causes
    1. See Reversible Causes of Cardiopulmonary Arrest (5H5T)
  3. Management: Adults and Children (Asystole and PEA management are identical)
    1. Continue CPR with high quality Cardiac Compressions
    2. Atropine is no longer recommended in the 2010 Guidelines
    3. Adjunctive measures
      1. Endotracheal Intubation immediately
      2. Obtain IV Access
    4. Evaluate rhythm
      1. Confirm Asystole in more than one lead
      2. Consider Asystole causes as above
    5. Epinephrine every 3-5 minutes
      1. Child
        1. IV/IO: 0.01 mg/kg (0.1 ml/kg of 1:10,000)
        2. ET: 0.1 mg/kg (0.1 ml/kg of 1:1000)
      2. Adult
        1. IV/IO: Epinephrine 1 mg
        2. Consider Vasopressin as alternative to Epinephrine
          1. Dose 40 Units IV for single, one time dose in place of first or second Epinephrine dose
          2. Considered superior to Epinephrine in Asystole
          3. Zepf (2003) N Engl J Med 350:105-13
    6. Consider immediate Transcutaneous pacing
      1. Indicated if reversible cause with decisive management (e.g. revascularization for acute MI)
      2. Pediatric electrodes indicated if <15 kg
    7. Consider termination of efforts
      1. Asystole refractory to above measures
      2. No reversible causes identified
  4. References
    1. Pediatric Resucitation
      1. http://pediatrics.aappublications.org/content/126/5/e1361.full.html
      2. (2010) Pediatrics 126(5): e1361
    2. Cardiopulmonary Resuscitation Guidelines
      1. http://www.circulationaha.org
      2. (2010) Guidelines for CPR and ECC
      3. (2005) Circulation 112(Suppl 112):IV
      4. (2000) Circulation, 102(Suppl I):86-9

Cardiac Arrest (C0018790)

Definition (NCI) Sudden cessation of the pumping function of the heart, with disappearance of arterial blood pressure, connoting either ventricular fibrillation or ventricular standstill.
Definition (NCI) A disorder characterized by cessation of the pumping function of the heart.
Definition (MEDLINEPLUS)

The heart has an internal electrical system that controls the rhythm of the heartbeat. Problems can cause abnormal heart rhythms, called arrhythmias. There are many types of arrhythmia. During an arrhythmia, the heart can beat too fast, too slow, or it can stop beating. Sudden cardiac arrest occurs when the heart develops an arrhythmia that causes it to stop beating. This is different than a heart attack, where the heart usually continues to beat but blood flow to the heart is blocked.

There are many possible causes of cardiac arrest. They include coronary heart disease, heart attack, electrocution, drowning, or choking. There may not be a known cause to the cardiac arrest.

Without medical attention, the person will die within a few minutes. People are less likely to die if they have early cardiopulmonary resuscitation (CPR) and defibrillation. Defibrillation is delivering an electric shock to restore the heart rhythm to normal.

NIH: National Heart, Lung, and Blood Institute
Definition (CSP) cessation of the heart beat.
Definition (NCI) Sudden cessation of the pumping function of the heart, with disappearance of arterial blood pressure, connoting either ventricular fibrillation or ventricular standstill.
Definition (MSH) Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.
Concepts Pathologic Function (T046)
MSH D006323
ICD9 427.5
ICD10 I46, I46.9
SnomedCT 155372006, 251189000, 195090009, 309810002, 397829000, 30298009, 195085006, 397912004, 410429000
English Arrest, Heart, Asystole, Asystoles, Heart Arrest, ARREST CARDIAC, ASYSTOLIA, Arrest, Cardiac, CARDIAC ARREST, CARDIAC ASYSTOLE, HEART ARREST, VENTRICULAR ASYSTOLIA, heart arrest, STANDSTILL CARDIAC, Cardiac arrest - asystole, Cardiac arrest, unspecified, CA - Cardiac arrest, Cardiac Arrest, cardiac arrest, cardiac arrest (diagnosis), asystole (diagnosis), asystole, Asystole (finding), Cardiac arrest, unspecified (disorder), Arrest cardiac, Heart arrest, Ventricular asystole, Asystolia, Ventricular asystolia, Asystolic, Standstill cardiac, ARREST, CARDIAC, ASYSTOLE, Heart Arrest [Disease/Finding], arrest [as an cardiac arrest], asystolia, ventricular asystole, cardiac asystole, arrest, arrested, Cardiac standstill, Asystole (disorder), heart; arrest, heart; stoppage, stoppage; heart, ventricular; arrest, arrest; cardiac, arrest; ventricular, Cardiac arrest, Cardiac arrest (disorder)
French ARRET CARDIAQUE, Asystolie, Arrêt des contractions du coeur, Asystole ventriculaire, Asystolique, Arrêt du coeur, Asystole, ASYSTOLIE VENTRICULAIRE, ASYSTOLIE, Pause cardiaque, Arrêt cardiaque, Arrêt cardio-circulatoire, Arrêt cardiocirculatoire
Portuguese PARADA CARDIACA, Assístolia, Assistólico, Paralisia Cardíaca, ASSISTOLIA VENTRICULAR, ASSISTOLIA, Assistolia ventricular, Paragem cardíaca, Assistolia, Parada Cardíaca, Parada Cardiorrespiratória
Spanish PARO CARDIACO, ASISTOLIA, Asistólico, Paro cardiaco, Asístole, Cardiac arrest, Asystole, Paro Cardiorrespiratorio, Parada Cardiopulmonar, Parada Cardiorrespiratoria, Parada Cardíaca, Paralisis Cardiaca, Parálisis Cardíaca, Parada Cardiaca, ASISTOLIA VENTRICULAR, Cardiac arrest, unspecified, asistolia (trastorno), asistolia, asístole, paro cardíaco, no especificado (trastorno), paro cardíaco, no especificado, Asistolia ventricular, Parada cardiaca, paro cardíaco (trastorno), paro cardíaco, Asistolia, Paro Cardíaco, Paro Cardiaco
German HERZSTILLSTAND, Asystolisch, Stillstand Herz, ASYSTOLIE, Herzstillstand, nicht naeher bezeichnet, VENTRIKULAERE ASYSTOLIE, ventrikulaere Asystolie, Asystolie, Herzstillstand, Kardialer Stillstand
Italian Asistole ventricolare, Asistolico, Asistolia, Asistolia ventricolare, Asistole, Arresto cardiaco
Dutch asystolie, ventriculaire asystolie, stilstand van het hart, asystole, asystolisch, hart; stilstand, hart; stoppen, stilstand; hart, stilstand; ventriculair, stoppen; hart, ventriculair; stilstand, Hartstilstand, niet gespecificeerd, hartstilstand, ventriculaire asystole, Arrest, cardiaal, Asystolie, Hartstilstand, Stilstand, hart-
Japanese 心室無収縮, ｼﾝｼﾂﾑｼｭｳｼｭｸ, ｼﾝﾃｲｼ, 心肺停止, 心拍停止, 不全収縮期, ｼﾝｾｲｼ, 心静止, 心臓停止, 心停止
Swedish Hjärtstopp
Czech srdce - zástava, Srdeční zástava, Asystolie, Zástava srdce, Komorová asystolie
Finnish Sydämenpysähdys
Russian ASISTOLIIA, SERDTSA OSTANOVKA, SERDTSA I DYKHANIIA OSTANOVKA, АСИСТОЛИЯ, СЕРДЦА И ДЫХАНИЯ ОСТАНОВКА, СЕРДЦА ОСТАНОВКА
Korean 심장정지, 상세불명의 심장정지
Croatian SRČANI ZASTOJ
Polish Zatrzymanie czynności serca, Asystolia, Nagłe zatrzymanie krążenia
Hungarian Ventricularis asystole, Asystole, Asystoliás, Szívmegállás, Szív nem működik, Asystolia, Szív megállása, Cardialis leállás, Ventricularis asystolia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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