- Defibrillator - CPR equipments

- Request/recommendation - Assessment - Background - Situation

1. CPR Flashcards by JR SV

PCAS

Post cardiac arrest syndrome

How well did you know this?

Not at all

Perfectly

Chain of survival

1) Early recognition and call for help
- to prevent cardiac arrest

2) Early CPR
- to buy time

3) Early defibrillation
- to restart the heart

4) Post CPR therapy
- to restore quality of life

How well did you know this?

Not at all

Perfectly

Call CPR team - say

1) Your name
2) What happened (ongoing cpr)

3) Where you are
- how to get there
Detailed (building, floor, corridor)

How well did you know this?

Not at all

Perfectly

CPR team devices

Defibrillator

- CPR equipments

How well did you know this?

Not at all

Perfectly

High quality chest compressions

At least 100/min (not over 120/min)
At least 5 cm deep (not over 6 cm)
Release pressure totally
Minimize interruptions (communication)

How well did you know this?

Not at all

Perfectly

CoCPR

Compression only CPR

How well did you know this?

Not at all

Perfectly

AED

Automated external defibrillator

- Cheap, easy, safe

How well did you know this?

Not at all

Perfectly

ABCDE

A: Airways
B: Breathing
C: Circulation
D: Neurological disability
E: Environment/event

How well did you know this?

Not at all

Perfectly

OMV

Oxygen, monitor, vein

How well did you know this?

Not at all

Perfectly

SBAR

Request/recommendation
Assessment
Background
Situation

How well did you know this?

Not at all

Perfectly

DNAR (BLS)

How well did you know this?

Not at all

Perfectly

ALS - when to shock

Assess rhythm every 2 minutes (shockable vs non-shockable)

How well did you know this?

Not at all

Perfectly

Shockable rhythm

Pulseless VT and VF

How well did you know this?

Not at all

Perfectly

Non-shockable rhythms

PEA and asystole

How well did you know this?

Not at all

Perfectly

Chest compressions during shocking patient

Chest compressions during charging

- Pause max 5 sec

How well did you know this?

Not at all

Perfectly

What energy of shock?

1) According to description on device!

2) If unknown;
- Biphasic defibrillator: 200J+360J (or max)
- Monophasic: all shocks 360J

How well did you know this?

Not at all

Perfectly

Max time allowed to pause chest compressions when using defibrillator

5 sec

How well did you know this?

Not at all

Perfectly

Chest compressions with advanced airway in place

Continuous

Medications to give during ALS

Adrenaline every 3-5 min

- Amiodarone after 3 shocks

Reversible causes of heart arrest

4 Hs and 4 Ts

1) Hypoxia
2) Hypovolemia
3) Hypo/hyperkalemia + metabolic
4) Hypo/hyperthermia

1) Thrombosis
2) Tension pneumothorax
3) Tamponade (cardiac)
4) Toxins

Correction of hypokalemia

Mg + K

Correction of hyperkalemiaa

Ca2+

How to recognize ptx

Auscultation

CPR devices

LUCAS

- AutoPulse

IV during ALS

- Peripheral first if not established yet | - Central line best if already established

Peripheral venous access - which veins to avoid

Distal of cubitalis or diaphragm

Intraosseous devices

- FAST (hedgehog) - BIG (gun) - EZ-IO (drill)

When and how much drug to give during ALS

Shock #3 - 1 mg epinephrine - 300 mg amiodarone Shock #5 - 1 mg epinephrine - 150 mg amiodarone Shock #7 - 1 mg epinephrine

NTS

Non-technical skills | - e.g team work, communication

RoSC

Return of spontaneous circulation

PCAS / post cardiac arrest treatment (6)

1) ABCDE 2) Aim for O2 of 94-98 % 3) Aim for normal PaCO2 4) 12-lead ECG 5) Treat precipitating cause(s) 6) Targeted temperature management

Severity of PCAS is related to

- degree of ischemia - cause of cardiac arrest - patient´s condition before cardiac arrest

Ventilation numbers

- etCO2: 35-40 mmHg | - paCO2: 40-45 mmHg

Spontaneous breathing activity =

Does NOT equal «adequate breathing»

Visible breathing =

``` Respiratory insufficiency (when ventillation makes WOB cease = adequate treatment) ```

With intubation we bypass

- The warming and moisturing function (nose) - The auto-PEEP (3-5 cmH20) - The mucociliary clearance of airways

With intubation we increase:

- Airway resistance (R~I; R~1/r^4) «straw» | - WOB (work of breathing)

Target MAP

65-90 - (-100) mmHg

Target Tcore

32-36 degrees (celcius)

Post cardiac arrest temperature control duration

24 hours

Methods of temperature control in post cardiac arrest pts

- 30 ml/ttkg - 4 degr celcius crystalloid - (1,5 degr celcius / 30min)

Use of Mg in maintenance of normothermia

Decreases shivering treshold

Maintenance of normothermia

- Sedation +/- neuromuscular blockade | - Mg (decrease shivering-treshold)