5: Resuscitation Flashcards
What is the most common cause of sudden death?
Coronary heart disease
i.e MI
What is clinical death?
Absence of circulation and respiration with brain arrest
Lasts 3 - 6 minutes
Reversible
How long does clinical death last without CPR?
3 - 6 mins
Clinical death is (reversible / irreversible).
reversible
What does clinical death progress to if not reversed?
Biologic death
which isn’t reversible
How long does clinical death last in the absence of CPR?
3 - 6 minutes
Then becomes biologic death (which is irreversible)
What is agonal breathing?
Dodgy breathing indicative of cardiac arrest
At what depth should you do chest compressions?
5 - 6cm
At what rate should you do chest compressions?
100 - 120bpm
You should avoid ___ during CPR.
any interruptions
outcome is worse
In which situations should you do rescue breaths before chest compressions?
Paediatric CPR
Non-cardiac causes of cardiac arrest e.g drowning
Which arrhythmias are
a) shockable
b) not shockable?
a) VT / VF
b) PEA / Asystole
What should be given after 3 rounds of CPR and every 3 rounds thereafter?
IV adrenaline
IV amiodarone
What antiarrhythmic drug should be given alongside adrenaline for shock-resistant cardiac arrest?
IV amiodarone
What are the criteria for
a) tachycardia
b) bradycardia?
a) HR > 100 bpm
b) HR < 60 bpm
What are the 4 Hs and 4 Ts of reversible cardiac arrest?
Hypoxia, hypovolaemia, hypothermia, hyperkalaemia
Tamponade, tension pneumothorax, thrombus, toxins
Which investigation is crucial for diagnosing hyperkalaemia?
ECG - tall, tented T waves; flattened QRS complexes
How is hyperkalaemia managed acutely?
IV calcium gluconate
IV insulin and dextrose
Also consider salbutamol NEB
What abnormal movements accompany agonal breathing in cardiac arrest?
Myoclonus
jerky, irregular muscle movements
During CPR, you should allow the chest to ___.
recoil
Where should you place your hands during chest compressions?
Centre of the chest at the level of the nipples
In which case should you not give amiodarone for shock-resistant cardiac arrest?
Polymorphic VT associated with long QT syndrome
Amiodarone makes it worse
When would you start CPR with 2 rescue breaths rather than 30 chest compressions?
In children
Non-cardiac causes of cardiac arrest (e.g drowning)
Is VF or VT compatible with a heartbeat?
No
So the patient will not have a pulse
What is polymorphic ventricular tachycardia also known as?
In which inherited cardiac condition is it commonly seen?
Torsades de pointes
Long QT syndrome
Where are the limb electrodes of an ECG placed?
Ride your green bike
Red - right arm
Yellow - left arm
Green - left leg
Blue - right leg
Where are the chest electrodes of an ECG placed?
V1 - right sternal border, 4th intercostal space
V2 - left sternal border, 4th intercostal space
V4 - left 5th intercostal space, midclavicular line
V3 - between V2 and V4
V5 - left 5th intercostal space, anterior axillary line
V6 - left 5th intercostal space, midaxillary line
How do you calculate the heart rate off an ECG when the rhythm is regular?
HR = 300 / No. of large boxes between QRS complexes
How do you calculate the heart rate off an ECG when the rhythm is irregular?
HR = (No. of QRS complexes in 30 small boxes) x 10
Which arrhythmia can torsade de pointes progress to?
VF
Which is an emergency
