- Especially large-area burns disrupt the insulating function of the skin and cause loss of liquid , electrolyte and heat.
- In addition, hypoxia occurs when the airways are severely damaged by the effects of heat, toxic and irritant substances from the trachea to the alveoli.
- In the 4 months following the burn, succinylcholine may cause a hyperkalemic response.
- Nondepolarizing muscle relaxants should be given in higher doses, because they show delayed and reduced effect due to excess distribution volume, higher binding to plasma proteins, loss from the burn surface, and depression of response at the neuromuscular junction.
- It is not used in burns, since the liver enzyme level rises, causing a high rate of metabolism of halothane and an increase in toxic metabolites.
Universal algorithm for emergency cardiac intervention in adults
during CPR
Check electrode positions and contact.
Seek to ensure the openness, verification and security of the airway.
Confirm open IV line
In patients with a VF/VT rhythm unresponsive to initial shocks:
- 1mg of epinephrine intravenously every 3-5 minutes
or
- Single dose of 40 U IV vasopressin, single administration
In patients with non-VF/VT rhythms:
- 1 mg of epinephrine intravenously every 3-5 minutes
Consider: antiarrhythmics
Investigate and fix reversible causes
Consider potentially reversible causes
hypovolemia
Tablets (drug overdose, accidents)
hypoxia
tamponade, cardiac
hydrogen ion-acidosis
Tension pneumothorax
Hyper-/hypokalaemia, other metabolic events
Thrombosis, coronary (acute coronarys.)
hypothermia
Thrombosis, pulmonary (embolism)