Resuscitation technique along with management of equipment and drugs p

Resuscitation technique along with management of equipment and drugs pdf

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"cardiopulmonary resuscitation"[MeSH Terms]

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American Heart Association adult basic advanced life support cardiac arrest algorithm 2025 resuscitation drugs equipment

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https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-g…

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mkdir -p "/tmp/workspace/resuscitation-pdf/src" "/tmp/workspace/resuscitation-pdf/output"

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python - <<'PY' from reportlab.lib import colors from reportlab.lib.enums import TA_CENTER from reportlab.lib.pagesizes import A4 from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, PageBreak, KeepTogether from reportlab.pdfbase.pdfmetrics import stringWidth from reportlab.pdfbase.ttfonts import TTFont from reportlab.pdfbase import pdfmetrics from reportlab.lib.colors import HexColor from reportlab.pdfgen import canvas from reportlab.lib import utils out='/tmp/workspace/resuscitation-pdf/output/Adult_Resuscitation_Technique_Equipment_and_Drugs.pdf' NAVY=HexColor('#12304A'); TEAL=HexColor('#087E8B'); PALE=HexColor('#E8F3F5'); RED=HexColor('#A62929'); GREY=HexColor('#4D5B66') styles=getSampleStyleSheet() styles.add(ParagraphStyle(name='TitleCustom',parent=styles['Title'],fontName='Helvetica-Bold',fontSize=22,leading=26,textColor=NAVY,spaceAfter=7)) styles.add(ParagraphStyle(name='Subtitle',parent=styles['Normal'],fontSize=9.4,leading=12,textColor=GREY,spaceAfter=12)) styles.add(ParagraphStyle(name='H1x',parent=styles['Heading1'],fontName='Helvetica-Bold',fontSize=14,leading=17,textColor=NAVY,spaceBefore=12,spaceAfter=6)) styles.add(ParagraphStyle(name='H2x',parent=styles['Heading2'],fontName='Helvetica-Bold',fontSize=11.2,leading=14,textColor=TEAL,spaceBefore=8,spaceAfter=4)) styles.add(ParagraphStyle(name='Bodyx',parent=styles['BodyText'],fontSize=8.8,leading=11.7,spaceAfter=4)) styles.add(ParagraphStyle(name='Smallx',parent=styles['BodyText'],fontSize=7.5,leading=9.2,textColor=GREY,spaceAfter=2)) styles.add(ParagraphStyle(name='Boxx',parent=styles['BodyText'],fontSize=9,leading=12,spaceAfter=0)) styles.add(ParagraphStyle(name='TableHead',parent=styles['BodyText'],fontName='Helvetica-Bold',fontSize=8,leading=9.5,textColor=colors.white)) styles.add(ParagraphStyle(name='TableCell',parent=styles['BodyText'],fontSize=7.45,leading=9.15)) P=lambda x, sty='Bodyx': Paragraph(x,styles[sty]) def footer(c,doc): c.saveState(); c.setStrokeColor(TEAL); c.setLineWidth(.5); c.line(1.4*cm,1.35*cm,19.6*cm,1.35*cm) c.setFont('Helvetica',7.3); c.setFillColor(GREY) c.drawString(1.4*cm,0.9*cm,'Adult resuscitation study guide | Educational use only') c.drawRightString(19.6*cm,0.9*cm,f'Page {doc.page}') c.restoreState() doc=SimpleDocTemplate(out,pagesize=A4,rightMargin=1.4*cm,leftMargin=1.4*cm,topMargin=1.25*cm,bottomMargin=1.7*cm) story=[] story += [P('Adult Cardiac Arrest Resuscitation','TitleCustom'),P('Technique, equipment preparation, and emergency drugs | A practical quick-reference for trained healthcare professionals','Subtitle')] warn=Table([[P('Safety and scope. This guide summarizes adult BLS/ALS principles. Follow your local protocol, scope of practice, defibrillator instructions, and current certified training. Call the emergency response system immediately. Do not delay CPR or defibrillation to obtain drugs or advanced airway equipment. Pediatric and neonatal resuscitation use different algorithms and doses.','Boxx')]],colWidths=[18.2*cm]) warn.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),HexColor('#FFF4E8')),('BOX',(0,0),(-1,-1),.7,HexColor('#D78225')),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8),('TOPPADDING',(0,0),(-1,-1),7),('BOTTOMPADDING',(0,0),(-1,-1),7)])) story += [warn,Spacer(1,8)] story += [P('1. Immediate adult cardiac-arrest sequence','H1x')] seq=[ ('1. Safety and recognition','Confirm scene safety. Check responsiveness. Shout for help. Assess breathing and pulse together for no more than 10 seconds. Agonal gasps are not normal breathing.'), ('2. Activate and obtain AED/defibrillator','Activate the emergency response/code system. Send for AED/defibrillator, oxygen, suction and resuscitation cart. Start CPR immediately if no definite pulse.'), ('3. High-quality CPR','Supine on a firm surface. Hands on the lower half of sternum. Compress at 100-120/min, depth 5-6 cm (2-2.4 in), allow full recoil, minimize pauses, and avoid excessive ventilation. Change compressor about every 2 minutes.'), ('4. Ventilation','Without an advanced airway: 30 compressions : 2 breaths; each breath over 1 second with visible chest rise. With advanced airway: continuous compressions and 1 breath every 6 seconds (10/min). Use bag-mask with 100% oxygen when available.'), ('5. Rhythm and shock','Apply pads without interrupting CPR. Analyze every 2 minutes. For VF/pulseless VT, shock promptly, then resume CPR immediately for 2 minutes. For PEA/asystole, do not shock: continue CPR, give epinephrine promptly, and seek reversible causes.'), ('6. ROSC care','Pulse/rhythm check if an organized rhythm is seen or a sudden ETCO2 rise occurs. Optimize airway, oxygenation and ventilation; treat hypotension and the precipitating cause; obtain 12-lead ECG when appropriate and transfer for post-arrest care.')] t=Table([[P(a,'TableCell'),P(b,'TableCell')] for a,b in seq],colWidths=[4.15*cm,14.05*cm],repeatRows=0) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),colors.white),('GRID',(0,0),(-1,-1),.28,HexColor('#B9CED3')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5),('BACKGROUND',(0,0),(0,-1),PALE)])) story += [t] story += [P('2. Rhythm-based ALS actions','H1x')] rhythm=[ [P('Rhythm','TableHead'),P('Actions while CPR continues','TableHead'),P('Drug priorities','TableHead')], [P('Shockable VF/pulseless VT','TableCell'),P('Defibrillate with biphasic device according to manufacturer recommendation. Resume compressions immediately after each shock. Recheck rhythm every 2 min. Escalate energy for subsequent shocks if appropriate.','TableCell'),P('After unsuccessful initial shocks: epinephrine. For refractory VF/pVT: amiodarone or lidocaine. Magnesium only for torsades de pointes/long-QT polymorphic VT.','TableCell')], [P('Non-shockable PEA/asystole','TableCell'),P('High-quality CPR, oxygenation/ventilation, IV/IO access, rhythm checks every 2 min. Do not defibrillate asystole/PEA. Actively search for reversible causes.','TableCell'),P('Epinephrine as soon as feasible, then every 3-5 min. Drugs do not replace correction of the cause.','TableCell')]] t=Table(rhythm,colWidths=[3.2*cm,9*cm,6*cm],repeatRows=1) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),NAVY),('GRID',(0,0),(-1,-1),.3,HexColor('#B9CED3')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5),('BACKGROUND',(0,1),(0,-1),PALE)])) story += [t,P('Reversible causes (Hs and Ts): hypovolemia, hypoxia, hydrogen ion excess/acidosis, hypo-/hyperkalemia and other metabolic derangements, hypothermia; tension pneumothorax, tamponade (cardiac), toxins, pulmonary thrombosis, coronary thrombosis.','Bodyx')] story += [P('3. Resuscitation equipment checklist','H1x')] equip=[ ('Defibrillation and monitoring','AED/manual defibrillator with adult pads; spare pads; ECG leads; charger/power check; gel/pads; pacing capability when available; BP cuff; pulse oximeter.'), ('Airway, breathing and suction','Oxygen source and tubing; bag-valve-mask with reservoir and masks; oral and nasopharyngeal airways; suction with rigid Yankauer and catheters; supraglottic airway; laryngoscope/video laryngoscope; endotracheal tubes, stylet/bougie, syringe, securing device; waveform capnography.'), ('Vascular access and fluids','Large-bore IV supplies; intraosseous kit and needles; extension sets, 3-way taps; saline flushes; pressure bag; normal saline. Use IV or IO during arrest. Endotracheal drug administration is not recommended.'), ('Medication and emergency cart','Clearly labeled, in-date medications; medication chart; syringes/needles; sharps bin; pediatric separation if mixed cart; refrigerator access if required by local stock.'), ('Team and safety','PPE, gloves, eye protection; backboard/firm surface; timer/metronome; documentation sheet; role assignment: team leader, compressor, airway, defibrillator/monitor, IV-drug provider, recorder, runner.')] t=Table([[P(a,'TableCell'),P(b,'TableCell')] for a,b in equip],colWidths=[5.1*cm,13.1*cm]) t.setStyle(TableStyle([('GRID',(0,0),(-1,-1),.28,HexColor('#B9CED3')),('BACKGROUND',(0,0),(0,-1),PALE),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)])) story += [t] story += [PageBreak(),P('4. Emergency drugs in adult cardiac arrest','H1x'),P('Confirm the drug, concentration, route, dose and local protocol before administration. Give IV/IO drugs followed by a flush and resume CPR immediately. The following doses are for adults in cardiac arrest, not for routine peri-arrest care.','Subtitle')] drugs=[ [P('Drug','TableHead'),P('Typical adult dose','TableHead'),P('When used','TableHead'),P('Key cautions','TableHead')], [P('Epinephrine','TableCell'),P('1 mg IV/IO every 3-5 min. (Usually 10 mL of 0.1 mg/mL, 1:10,000 solution.)','TableCell'),P('All rhythms. For non-shockable arrest, give as soon as feasible. For shockable arrest, use after initial defibrillation attempts have failed.','TableCell'),P('Do not delay shocks/CPR. High-dose routine use is not recommended.','TableCell')], [P('Amiodarone','TableCell'),P('300 mg IV/IO bolus for refractory VF/pVT; may give 150 mg additional dose.','TableCell'),P('Refractory shockable rhythm after defibrillation attempts.','TableCell'),P('Not a substitute for shock delivery. Follow local preparation protocol.','TableCell')], [P('Lidocaine','TableCell'),P('1-1.5 mg/kg IV/IO; then 0.5-0.75 mg/kg if needed. Maximum 3 mg/kg.','TableCell'),P('Alternative to amiodarone in refractory VF/pVT.','TableCell'),P('Use one antiarrhythmic strategy per local protocol.','TableCell')], [P('Magnesium sulfate','TableCell'),P('1-2 g IV/IO, diluted as per protocol.','TableCell'),P('Torsades de pointes/long-QT associated polymorphic VT. Not routine for ordinary VF/pVT.','TableCell'),P('Use targeted indication only.','TableCell')], [P('Sodium bicarbonate','TableCell'),P('1 mEq/kg IV/IO when specifically indicated.','TableCell'),P('Consider for severe hyperkalemia, sodium-channel blocker toxicity, or selected prolonged-arrest metabolic acidosis under protocol.','TableCell'),P('Not recommended routinely. Ensure adequate ventilation and treat the cause.','TableCell')], [P('Calcium chloride','TableCell'),P('1 g IV/IO (10 mL of 10% solution) when specifically indicated.','TableCell'),P('Hyperkalemia, hypocalcemia, or calcium-channel blocker toxicity.','TableCell'),P('Not routine in cardiac arrest. Calcium chloride is irritating: use secure IV/IO and avoid extravasation.','TableCell')]] t=Table(drugs,colWidths=[2.55*cm,4.15*cm,6.3*cm,5.2*cm],repeatRows=1) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),NAVY),('GRID',(0,0),(-1,-1),.3,HexColor('#B9CED3')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),4),('RIGHTPADDING',(0,0),(-1,-1),4),('TOPPADDING',(0,0),(-1,-1),4),('BOTTOMPADDING',(0,0),(-1,-1),4),('BACKGROUND',(0,1),(0,-1),PALE)])) story += [t] story += [P('5. Practical quality markers and post-ROSC priorities','H1x')] markers=[ ('Compression quality','Rate 100-120/min; depth 5-6 cm; full recoil; minimum interruptions; change compressor about every 2 min.'), ('Capnography','Continuous waveform capnography confirms and monitors tracheal tube placement. Low ETCO2 can indicate poor perfusion or poor compression quality; a sudden sustained rise may indicate ROSC. Do not use ETCO2 alone to terminate resuscitation.'), ('Defibrillation safety','Announce clear, visually confirm no contact with patient/bed/lines, ensure oxygen is not flowing across the chest, deliver shock, and restart compressions immediately.'), ('After ROSC','Avoid hyperoxia and hyperventilation. Titrate oxygen and ventilation to protocol, stabilize BP/perfusion, obtain ECG, identify cause, and arrange definitive post-arrest and coronary care when indicated.')] t=Table([[P(a,'TableCell'),P(b,'TableCell')] for a,b in markers],colWidths=[5*cm,13.2*cm]) t.setStyle(TableStyle([('GRID',(0,0),(-1,-1),.28,HexColor('#B9CED3')),('BACKGROUND',(0,0),(0,-1),PALE),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)])) story += [t,P('References','H1x'),P('1. American Heart Association. 2025 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Part 7 Adult Basic Life Support and Part 9 Adult Advanced Life Support. Available through AHA CPR & First Aid. Accessed 10 September 2026. 2. Roberts and Hedges’ Clinical Procedures in Emergency Medicine. Cardiopulmonary Resuscitation and Defibrillation sections. 3. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. “Drugs Used for ROSC from Cardiac Arrest.”','Smallx'),P('Evidence update: recent systematic reviews include PMIDs 41661116 and 39080740. They do not replace local resuscitation guidelines.','Smallx')] doc.build(story,onFirstPage=footer,onLaterPages=footer) print(out) PY python - <<'PY' from pypdf import PdfReader p='/tmp/workspace/resuscitation-pdf/output/Adult_Resuscitation_Technique_Equipment_and_Drugs.pdf' r=PdfReader(p) print('pages',len(r.pages),'bytes',__import__('os').path.getsize(p)) for i,page in enumerate(r.pages): print(i+1, len(page.extract_text() or '')) PY

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~/resuscitation-pdf/output

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