By Michael Colquhoun, Anthony J. Handley, T. R. Evans

This consultant has concise and functional details on all elements of resuscitation. New directions are only one of many adjustments to the fifth variation of this booklet as some of the chapters were thoroughly rewritten.

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4th ed. London: Resuscitation Council (UK), 2000 If cardioversion proves impossible or atrial fibrillation recurs, amiodarone will provide ventricular rate control. It is also a useful drug to increase the chances of successful cardioversion in patients with adverse features such as poor left ventricular function. Further reading ● ● ● ● ● Chamberlain DA. The periarrest arrhythmias. Br J Anaesthesia 1997;79:198-202. Dorian P, Cass D, Schwartz B Cooper R, Gelaznikas R, Bara A. Amiodarone as compared with lidocaine for shock resistant ventricular fibrillation (ALIVE).

The orderly control of ventricular rate and rhythm that exists during normal sinus rhythm is lost and the ventricular rate is determined by the refractory period of the AV node. When this is short a rapid ventricular rate may result, which further reduces cardiac output. The treatment of atrial fibrillation centres on three key objectives: to control ventricular rate, to restore sinus rhythm, and to prevent systemic embolism. Thrombus forms in the left atrium, particularly in the atrial appendage, as a result of the disturbed blood flow.

Ventilation masks The use of a ventilation mask during expired air resuscitation, especially when it has a non-rebreathing valve or filter, offers the rescuer protection against direct patient contact. The rescuer seals the mask on the patient’s face using a firm 28 Life key and face shield Airway control, ventilation, and oxygenation two-handed grip and blows through the mask while lifting the patient’s jaw. Transparent masks with well-fitting, air-filled cuffs provide an effective seal on the patient’s face and may incorporate valves through which the rescuer can conduct mouth-to-mask ventilation.

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