ALL PHYSICIANS should be experienced in the practices and procedures of Basic Life Support (BLS) and Advanced Cardiopulmonary Life Support (ACLS). Outside the hallowed hospital walls, “Is there a doctor in the house?” means you! Within the hospital, the fundamental equipment and staff are on hand, but it is the responsibility of the nearest available physician to get it right and at maximum speed. The dermatology ward is no stranger to life-threatening events: This chapter is intended as a brief refresher course for the situations that cannot wait.

The ultimate goal of resuscitation is to maintain cerebral perfusion until and after cardiopulmonary functions are restored. Most adult cardiac arrests are due to ventricular arrhythmias for which early defibrillation is critical. The emphasis is on stabilizing the patient on site so that he or she can survive to get to an intensive care unit (ICU). The critically ill patients already on the ward are still not out of trouble, because they are usually being treated with many medications, leaving them vulnerable to adverse drug reactions, toxicity, and side effects, which themselves occur more frequently in these patients due to altered hemodynamics and metabolism. The high rate and rapid initiation of complications necessitate careful monitoring of vital signs and frequent physical examinations and laboratory tests. A high index of suspicion and close attention to changing symptoms and parameters are mandatory for preventing and/or treating any newly emerging medical problem.