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Cardiovascular Week 5 2016/17 > 5: Managing cardiac arrest > Flashcards

5: Managing cardiac arrest Flashcards

1
Q

What is a cardiac arrest?

A

Effective cessation of the heart (no blood flow –> oxygen delivered due to pump stopping)

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2
Q

What does a patient in cardiac arrest look like?

A

Unresponsive

Not breathing normally

No pulse

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3
Q

Which arrhythmias are common in most cardiac arrests

A

Ventricular fibrillation

Ventricular tachycardia

(shockable rhythms)

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4
Q

The majority of cardiac arrests are ___.

A

reversible

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5
Q

Cardiac arrests due to arrhythmias other than VT/VF tend __ to be shockable.

A

not

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6
Q

Most cardiac arrests are preceded by ___ in a patient’s condition.

A

deterioration

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7
Q

What are some examples of deteriorations which occur before a patient goes into cardiac arrest?

A

Hypoxia

Hypotension

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8
Q

If it is inappropriate to resuscitate a person in cardiac arrest, a ___ order will have been put on them.

A

DNAR (do not attempt resuscitation)

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9
Q

An important part of preventing cardiac arrest deaths is ___ ___ of what is occurring.

A

early recognition

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10
Q

Why do patients go into cardiorespiratory arrest?

A

ABC

i.e problems with oxygen delivery

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11
Q

What does D stand for in ABCDE?

A

Disability

i.e neuro problems

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12
Q
  1. Assess effects of treatment
  2. Initial assessment
  3. Reassessment
  4. Treat life-threatening problems

Arrange 1-4 in the correct order

A

2, 4, 1, 3

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13
Q

Before commencing ABCDE, make sure someone has called for ___

A

help

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14
Q

How are a patient’s vital signs recorded by ABCDE in a hospital setting?

A

NEWS score

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15
Q

What is the gold standard test for measuring a patient’s SaO2?

A

ABGs

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16
Q

How is a patient’s [Hb] measured in hospital?

A

Full blood count

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17
Q

Why can a patient’s tongue block their airway?

A

CNS depression

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18
Q

How can a patient’s disability be measured?

A

AVPU

Glasgow Coma Score (look for difference in pupils)

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19
Q

What should be given to a patient through a cannula as part of disability in ABCDE?

A

Glucose (if hypoglycaemic)

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20
Q

What are the three criteria for someone to be in cardiac arrest?

A

Unresponsive

Not breathing

No pulse

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21
Q

What is the difference between someone in respiratory arrest and someone in cardiac arrest?

A

Respiratory arrest - unresponsive, not breathing, have a pulse

Cardiac arrest - unresponsive, not breathing, no pulse

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22
Q

Respiratory arrest tends (to last a long time / not to last very long).

A

doesn’t last long

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23
Q

A patient in respiratory arrest, if untreated, will go into ___ ___ soon after.

A

cardiac arrest

24
Q

Which pulse should be taken while you check for breathing?

A

Carotid pulse

25
Which type of breathing may be seen in cardiac arrest?
**Agonal breathing**
26
In a hospital setting, if a cardiac arrest has been confirmed, who should be called?
Resuscitation team
27
When swapping over with a partner while doing CPR, delay in restarting chest compressions should be no more than _ seconds.
**5**
28
What should be used to monitor heart rate in advanced life support?
**ECG**
29
Which types of arrythmia are shockable?
**Ventricular fibrillation** **Ventricular tachycardia**
30
Which arrhythmias are **non-shockable**?
**Asystole / PEA**
31
Which rhythm is this? How can you tell? Is it shockable?
**Ventricular fibrillation** Irregular, no recognisable QRS complexes, random frequencies and amplitudes Yes
32
**Which rhythm is this?** **How can you tell?** **What are the two classifications?** **Is it shockable?**
**Ventricular tachycardia** **Rapid rate, constant QRS** **Monomorphic** and **polymorphic** (varies more) **Yes**
33
What should be done if you know a patient is in VF/VT cardiac arrest and a defibrillator is **not** available?
**Precordial thump**
34
What is defibrillation?
Use of electrical current to "reset" the heart and restore sinus rhythm
35
After a shock, **CPR** should be (continued / discontinued) unless the patient shows signs of life.
**continued**
36
What should be reassessed after a shock has been delivered?
Cardiac rhythm
37
When should **adrenaline** be given in advanced life support?
**After 3rd shock**, then every alternate shock after that (5th --\> 7th...)
38
Apart from adrenaline, what other drug should be given after the 3rd shock?
**Amiodarone**
39
What rhythm is this? How can you tell? Is it shockable? What else should you do?
**Asystole** **Pretty much a straight line** **No** **Give adrenaline IV** every 2 cycles of CPR
40
**What rhythm is this?** **How can you tell?** **Is it shockable?** **How do you reverse it?**
Pulseless electrical activity (PEA) There is ECG activity but **no pulse** (heart is not contracting or CO is very low) No Treat reversible causes and IV adrenaline every 2 CPR cycles, 3-5 mins
41
What dose of adrenaline should be given in a cardiac arrest?
**1 mg**
42
Why does adrenaline help during a cardiac arrest?
**Vasoconstriction** (increases BP) **Positive inotrope** (increases heart rate)
43
What dose of amiodarone should be given during advanced life support?
**300 mg**
44
What are the four Hs (reversible causes)?
**Hypoxia** **Hypovolaemia** **Hypo- anything** (metabolic) **Hypothermia**
45
What are the four Ts (reversible causes)?
**Thrombosis** **Tension pneumothorax** **Cardiac tamponade** **Toxins**
46
What is cardiac tamponade?
**Fluid in the pericardial space, doesn't allow the heart to contract properly**
47
Does resuscitation stop after return of spontaneous circulation (ROSC)?
No
48
What approach should be taken to look after a patient after ROSC?
ABCDE
49
What treatment can actually improve outcomes (e.g limiting brain damage) in a person who is recovering from cardiac arrest?
Hypothermia (i.e cooling them down)
50
What is the name for the syndrome encompassing post-cardiac arrest brain injury, myocardial dysfunction or ischaemia?
**Post-cardiac arrest syndrome**
51
What is the target SpO2 range in a patient recovering from cardiac arrest?
**94-98%** Unless T2 resp. failure - 88-92%
52
How does the body regulate CO2 concentration in the blood if you have hypercapnia?
Hyperventilation (to blow off CO2)
53
What is the name given to 'normal CO2 concentration' i.e that aimed for in patients recovering from cardiac arrest?
Normocapnia
54
What is the target systolic BP in patients recovering from cardiac arrest?
**\> 100 mmHg**
55
Which drug can be used to elevate a patient's heart rate and improve oxygen delivery?
**Atropine**
56
What does **PEA** stand for?
**Pulseless electrical activity**

Cardiovascular Week 5 2016/17 (5 decks)

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