Cardiac Arrest and Resuscitation Flashcards Preview

CLASP - Sudden Death > Cardiac Arrest and Resuscitation > Flashcards

Flashcards in Cardiac Arrest and Resuscitation Deck (19)
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1
Q

How soon after “clinical” death does biological death usually occur?

A

3-6 mins

2
Q

How is cardiac arrest confirmed?

A
  • patient response (shake and shout)
  • open airway and check for normal breathing and pulse in 10s
  • check for signs of life (movements etc)
3
Q

What makes CPR high quality?

A
  • 30:2
  • chest compressions of 5-6cm
  • full recoil
  • 2 per second (100-120 bpm)
  • switch CPR provider every 2 mins
4
Q

What should be avoided in CPR?

A
  • spending too much time off the chest
  • leaning over the patient (Shoulders should be above patients sternum)
  • Over ventilating (should mimic normal breaths - otherwise complications => gastric inflation)
  • Delayed use of DeFib
5
Q

What can Waveform Capnography be used to assess?

A
  • patients CO2 output during CPR
  • measured by anaesthetist
  • should be around 2-2.5kPa in high quality CPR
  • If patient is shocked back to life, this increases to 5-5.5kPa
6
Q

What should you do to maximise the amount of energy transferred from the AED to the patient?

A
  • correct pad placement
  • make sure pads are stuck securely with no air trapping
  • remove hair on chest if necessary
  • more energy may be required in larger patients, patients with specific disease etc due to higher resistance
7
Q

Describe the main differences between VF and pVT

A

VF - bizzare irregular waveform, no QRS complexes recognisable, random amplitudes

pVT - monomorphic = broad but consistent QRS complexes, rapid rate
polymorphic = torsades de pointes

8
Q

What is the main difference between a manual DeFib and AED that can minimise time off the chest?

A

Manual DeFib allows CPR to continiue whilst the Defibrillator is charging

9
Q

What drug should be given after the 3rd shock from the defibrillator?

A

Adrenaline IV (1mg)

Amiodarone may also be given - only slightly better than controls in studies

10
Q

Describe the appearance of asystole

A
  • absent ventricular activity (no QRS complexes)

- P waves (atrial activity) may still be present

11
Q

How are asystole and PEA treated if patients cannot be shocked with the defib?

A

High quality CPR

adrenaline 1mg IV every 3-5 mins

12
Q

If vascular access cannot be achieved intravenously, where can blood be taken from in an emergency?

A

Intraosseous

13
Q

HOw can metabolic disturbances (hypo/hyperkalaemia) be tested for at the bedside?

A

ABG (after arterial stab)

14
Q

What treatment is given in hyperkalaemia?

A

calcium gluconate FIRST TO PROTECT HEART

insulin - to lower potassium
dextrose - to counteract insulin and prevent

15
Q

What treatment/intervention is given if a patient has a tension pneumothorax compressing their heart and causing cardiac arrest?

A

Needle decompression or thoracotomy

16
Q

How is cardiac tamponade treated?

A

Pericardiocentesis or thoracotomy

17
Q

How is cardiac arrest due to toxins treated?

A

antidote

18
Q

How are patients treated for a PE and why should CPR continue for up to 90 mins after treatment is given?

A
  • fibrinolytic therapy can take 60-90 mins to work

=> mechanical CPR given for 90 mins

19
Q

What are the 6 stages of ECG interpretation?

A
Electrical activity present?
Rate?
Rhythm? (irreg./reg)
Narrow or broad QRS?
Atrial activity (P waves) present?
Is atrial activity related to ventricular activity (does QRS follow P waves)?