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1. ACLS and asystole well defined BUT according to guidelines 2005 , its absolute indication to administer 45 mins CPR unless someone is labelled DNR wihich means do not resustitae when we think prolonging patients life wont do any better like in cancer terminal patients and the list is huge very rare but patient actually revived by CPR so we dont take risk by leaving them
Many people have pointed out flaws inconsistencies and the ridiculous in the autopsy report on this site. The rare cervical bone C7 was my first clue that it could not be real. That's why I had the idea of rearranging letters in names in the Coroners case report and other hoax names.I posted a thread on TMZ live 25-06-2010 Part 1-4 Hash v Pot.In Part 2 Harvey in answering a question, invites questioning of the autopsy report .
Asystole and Pulseless Electrical Activity (Box 9)PEA encompasses a heterogeneous group of pulseless rhythms that includes pseudo-electromechanical dissociation (pseudo-EMD), idioventricular rhythms, ventricular escape rhythms, postdefibrillation idioventricular rhythms, and bradyasystolic rhythms. Research with cardiac ultrasonography and indwelling pressure catheters has confirmed that pulseless patients with electrical activity have associated mechanical contractions, but these contractions are too weak to produce a blood pressure detectable by palpation or noninvasive blood pressure monitoring. PEA is often caused by reversible conditions and can be treated if those conditions are identified and corrected. The survival rate from cardiac arrest with asystole is dismal. During a resuscitation attempt, brief periods of an organized complex may appear on the monitor screen, but spontaneous circulation rarely emerges. As with PEA, the hope for resuscitation is to identify and treat a reversible cause. Because of the similarity in causes and management of these two arrest rhythms, their treatment has been combined in the second part of the ACLS Pulseless Arrest Algorithm. Patients who have either asystole or PEA will not benefit from defibrillation attempts. The focus of resuscitation is to perform high-quality CPR with minimal interruptions and to identify reversible causes or complicating factors. Providers should insert an advanced airway (eg, endotracheal tube, Combitube, LMA). Once the airway is in place, 2 rescuers should no longer deliver cycles of CPR (ie, compressions interrupted by pauses when breaths are delivered). Instead the compressing rescuer should give continuous chest compressions at a rate of 100 per minute without pauses for ventilation. The rescuer delivering ventilation provides 8 to 10 breaths per minute. The 2 rescuers should change compressor and ventilator roles approximately every 2 minutes (when the rhythm is checked) to prevent compressor fatigue and deterioration in quality and rate of chest compressions. When multiple rescuers are present, they should rotate the compressor role about every 2 minutes. Rescuers should minimize interruptions in chest compressions while inserting the airway and should not interrupt CPR while establishing IV or IO access. If the rhythm check confirms asystole or PEA, resume CPR immediately. A vasopressor (epinephrine or vasopressin) may be administered at this time. Epinephrine can be administered approximately every 3 to 5 minutes during cardiac arrest; one dose of vasopressin may be substituted for either the first or second epinephrine dose (Box 10). For a patient in asystole or slow PEA, consider atropine (see below). Do not interrupt CPR to deliver any medication. Give the drug as soon as possible after the rhythm check. After drug delivery and approximately 5 cycles (or about 2 minutes) of CPR, recheck the rhythm (Box 11). If a shockable rhythm is present, deliver a shock (go to Box 4). If no rhythm is present or if there is no change in the appearance of the electrocardiogram, immediately resume CPR (Box 10). If an organized rhythm is present (Box 12), try to palpate a pulse. If no pulse is present (or if there is any doubt about the presence of a pulse), continue CPR (Box 10). If a pulse is present the provider should identify the rhythm and treat appropriately (see Part 7.3: "Management of Symptomatic Bradycardia and Tachycardia"). If the patient appears to have an organized rhythm with a good pulse, begin postresuscitative care. When Should Resuscitative Efforts Stop? The resuscitation team must make a conscientious and competent effort to give patients a trial of CPR and ACLS, provided that the patient has not expressed a decision to forego resuscitative efforts. The final decision to stop efforts can never be as simple as an isolated time interval. Clinical judgment and respect for human dignity must enter into decision making. There is little data to guide this decision. Emergency medical response systems should not require field personnel to transport every victim of cardiac arrest to a hospital or emergency department (ED). Transportation with continuing CPR is justified if interventions are available in the ED that cannot be performed in the field, such as cardiopulmonary bypass or extracorporeal circulation for victims of severe hypothermia (Class IIb). Unless special situations are present (eg, hypothermia), for nontraumatic and blunt traumatic out-of-hospital cardiac arrest, evidence confirms that ACLS care in the ED offers no advantage over ACLS care in the field. Stated succinctly, if ACLS care in the field cannot resuscitate the victim, ED care will not resuscitate the victim. Civil rules, administrative concerns, medical insurance requirements, and even reimbursement enhancement have frequently led to requirements to transport all cardiac arrest victims to a hospital or ED. If these requirements are nonselective, they are inappropriate, futile, and ethically unacceptable. Cessation of efforts in the out-of-hospital setting, following system-specific criteria and under direct medical control, should be standard practice in all EMS systems.
Yes, I heard Harvey say it was Hash instead of Pot on TMZ live. He said his source absolutely knew what he was talking about, haha. Didn't the autopsy report mention Marihuana was found and not Hash? I'm not sure, I can't check it here at work.
@ hazzely 1. I already mention where the person suggesting something odd doesnt seems odd to me , except the part with the body samples under various alias could be a another possibilty to explain , that is his samples were sent to lab with assumed names to have unbiased result s , i think same goes with his histology slides 2. as far as i remember there was somthing mention about avulsion of olfactory lobes leading to anosmia a condition patient cant smell but it happens after significant head trauma and skull fractures i cant see in this report3.i thought scar would be mention not because burn scalp but the fact he had discoid lupus leading to scarring aloplecia ( baldness) i know what most of you might be thinking right now after reading the post its hard for me to write it even because i know many of you might get hurt but i think i clear up your doubts , please keep an open mind and i know you all do . please take care
Quote from: "mjj_fan"@ hazzely 1. I already mention where the person suggesting something odd doesnt seems odd to me , except the part with the body samples under various alias could be a another possibilty to explain , that is his samples were sent to lab with assumed names to have unbiased result s , i think same goes with his histology slides 2. as far as i remember there was somthing mention about avulsion of olfactory lobes leading to anosmia a condition patient cant smell but it happens after significant head trauma and skull fractures i cant see in this report3.i thought scar would be mention not because burn scalp but the fact he had discoid lupus leading to scarring aloplecia ( baldness) i know what most of you might be thinking right now after reading the post its hard for me to write it even because i know many of you might get hurt but i think i clear up your doubts , please keep an open mind and i know you all do . please take carenumber 2! Avulsion of Olfactory Bulb...I wrote about this a long time ago...This could have happend to MJ during nose procedures, especially if they cracked his nasal bone, but it would have caused complete lack of smell! Even taste! This could be why he didn't eat.