Cardiopulmonary Emergencies

Emergencies of the cardiovascular and respiratory systems are common causes of death and disability. Virtually all illnesses can culminate in disorders of these two systems. This chapter will review some of the most common causes of cardiovascular and respiratory failure that occur in hospitalized patients. It will review the systematic primary and secondary survey approach to rapidly identify life-threatening organ failure and provide a framework for initial resuscitation.

Pharmacists on the Emergency Cardiopulmonary Resuscitation Team: Their Responsibilities, Training, and Attitudes

Pharmacist involvement on the cardiopulmonary resuscitation (CPR) team is associated with lower mortality rates. Despite this finding, pharmacists respond to cardiopulmonary emergencies in only 32% of institutions. The objective of this study was to determine the responsibilities and training of pharmacists as CPR team members and to assess their attitudes toward this role. A total of 1290 adult, acute-care hospitals were randomly surveyed nationwide. A total of 1108 questionnaires were received from 40% (517/1290) of institutions surveyed. Thirty-seven percent (189/517) of the institutions indicated that pharmacists participate on their CPR teams. Pharmacists' responsibilities at cardiopulmonary emergencies included recording medications administered (73.7%), medication preparation (96.6%), providing drug information (97.7%), and calculating doses (98.2%). The most common training methods were BLS certification (79%), the buddy system (59.4%), and continuing education programs (53.6%). Training methods that positively affected perceived qualification in the primary responsibilities were BLS/ACLS certification (P < 0.001) and training programs provided by the institution (P < 0.05). Positive attitudes toward participation on the CPR team were associated with the following factors: years of experience, BLS/ACLS certification, and the pharmacist's perception that he or she was adequately trained (P < 0.001). The results indicate that CPR team pharmacists should be proficient in providing drug information, preparing medications, recording medications administered, and calculating doses. Furthermore, because adequate training positively influenced pharmacists' attitudes toward participation and their perceived qualifications, we recommend that all pharmacists on CPR teams be required to obtain BLS/ACLS certification and participate in educational programs provided by their institution.