5. In-hospital resuscitation Flashcards
T/F: suspected or confirmed covid-19 infection is a contraindication to mouth-to-mouth ventilation in clinical settings
True
options for opening airway in unresponsive patient with suspected c-spine injury?
jaw thrust or chin lift in combination with manual in-line stabilisation (MILS) - if obstruction persists add head tilt small amount at a time until the airway is patent
T/F: agonal breathing is a sign of life/ circulation
false (also doesn’t indicate ROSC during chest compressions so don’t stop)
T/F: a very short period of seizure activity can occur at the start of a cardiac arrest
true
If you’re alone and encounter a patient in cardiac arrest should you
A) commence CPR
B) leave the pt to get help and equipment
B) leave the pt to get help and equipment
Correct hand position for chest compressions?
middle of the lower half of the sternum
qualities required of high quality CPR?
depth 5-6cm, full chest recoil after each compression, rate of 100-120/ min, approx same amount of time for compression and relaxation, minimise hands off time
T/F: a palpable carotid or femoral pulse is a good indicator of high quality chest compression
false - if available use a prompt or feedback device
how often should the person delivering chest compressions swap with someone else?
ideally every 2 minutes or sooner if they are unable to maintain high quality compressions (ideally during planned pauses to compressions e.g. rhythm check)
example of a supraglottic airway?
igel
correct inspiratory time when giving ventilations?
approx 1s - given enough volume to produce a visible risk of the chest wall
What is the purpose of monitoring waveform capnography in cardiac arrest?
can be used to monitor CPR quality, as an indicator of ROCS and as a prognostic indicator
How and when can continuous ventilation be used during CPR?
If tracheal intubation has been achieved
May also be possible with a supraglottic airway e.g. i-gel
Ventilate at 10 breaths at minute
Using manual defibrillation, it is possible to reduce the pause between stopping and restarting chest compressions to less than __ secs
5
T/F: for manual defibrillation, once the pads are applied, pause briefly for a rapid rhythm check (<5s)
true
once the rhythm has been checked on the manual defibrillator and it shows VT/ pVT, should you
A) restart chest compressions
B) continue to pause while charging the defib
A) restart chest compressions - but inform all other members of the team to stand clear of the patient
Once charged, stop compressions > deliver shock > restart compressions immediately
T/F: the length of the pre-shock pause and delivering a shock is inversely proportional to the change of successful defibrillation
true
if any delays are caused y difficulty in rhythm analysis or individuals touching the bed, restart compressions while a decision is made of what to do
How frequently should the cardiac rhythm be assessed?
about every 2 minutes
what to do if the patient is not breathing and has a pulse
ventilate the patient’s lungs at 10 breaths a minute and check for a pulse every minute
if any doubt of whether they have a pulse, commence chest compressions
Initial management of VF/ VT cardiac arrest that occurs in a monitoring and witnessed environment (cath lab, CCU, critical care unit, already attached to manual defbrillator)
up to 3 quick successive shocks
start check compressions and continue CPR for 2 mins if 3rd shock unsuccessful (the 3 initial shocks are considered as the 1st shock in the ALS algorithm)
T/F: precordial thumps are effective at regaining a pulse and should be used before calling for help
false - rarely work, delivery of a thump must not delay calling for help or accessing a defibrillator
