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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How soon after "clinical" death does biological death usually occur?

3-6 mins


How is cardiac arrest confirmed?

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


What makes CPR high quality?

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


What should be avoided in CPR?

- 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


What can Waveform Capnography be used to assess?

- 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


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

- 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


Describe the main differences between VF and pVT

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

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


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

Manual DeFib allows CPR to continiue whilst the Defibrillator is charging


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

Adrenaline IV (1mg)

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


Describe the appearance of asystole

- absent ventricular activity (no QRS complexes)
- P waves (atrial activity) may still be present


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

High quality CPR
adrenaline 1mg IV every 3-5 mins


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



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

ABG (after arterial stab)


What treatment is given in hyperkalaemia?

calcium gluconate FIRST TO PROTECT HEART

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


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

Needle decompression or thoracotomy


How is cardiac tamponade treated?

Pericardiocentesis or thoracotomy


How is cardiac arrest due to toxins treated?



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

- fibrinolytic therapy can take 60-90 mins to work
=> mechanical CPR given for 90 mins


What are the 6 stages of ECG interpretation?

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