Despite its popular portrayal, cardiorespiratory arrest is often neither sudden nor unpredictable (Resuscitation Council UK 2000). Studies over several years have shown that most cardiac arrests are avoidable if signs and symptoms are recognised and responded to (Franklin & Mathew 1994, Hodgetts et al. 2002a, Smith & Wood 1998). Patients with coronary artery disease are more likely to have a sudden cardiac arrest, often precipitated by an unstable area of ischaemic myocardium. Such events will be heralded by the onset of symptoms in many cases. At least 80% of individuals who suffer sudden cardiac death have coronary artery disease (Zipes & Wellens 1998) and so any strategy to prevent cardiac arrest must begin here. Recognising and responding to patients at risk of deterioration and cardiac arrest is a clinical priority.
This chapter introduces the principles of prevention of cardiac arrest by:
• understanding how to recognise and respond to acute coronary syndromes;
• understanding how to recognise life-threatening deterioration using structured assessment;
• discussing methods of obtaining rapid medical advice and intervention for patients whose condition is deteriorating.
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