Advanced Cardiac & Special Circumstances Flashcards
What are the 4 H’s in reversible causes of cardiac arrest?
Hypoxia
Hypovolaemia
Hyperthermia/hypothermia
Hyper/hypokalaemia
What is agonal breathing?
Abnormal pattern of breathing/ last dying breaths
Describe ways to correct Hypoxia as a cause of cardiac arrest.
Ensure good airway management
Oxygenation
Ventilation
Describe how to correct hypovolaemia as a cause of cardiac arrest
Bolus of 20ml/kg of saline IV/IO
Describe how to correct hypo/hyperkalaemia calcaemia (metabolic disorder) as a cause of cardiac arrest
2.5ml/kg of 10% IV Dextrose to a maximum of 100ml
Describe how to correct hypo/hyperthermia as a cause of cardiac arrest
Commence passive warming or cooling
What are the 4 T’s in relation to correctable causes of cardiac arrest?
Tamponade
Tension pneumothorax
Toxins
Thrombosis
Describe corrective measures of tension pneumothorax in CA
Bilateral chest decompressions (thoracocentesis) in the presence do asthma and chest trauma
Which causes of cardiac arrest need to be managed at the hospital
Tamponade- mechanism of injury/history
Toxins- mechanism of injury/history
Thrombosis- as above
Resuscitation attempts need to be modified for special circumstances in cardiac arrest. Name the 5 circumstances
Hypothermia Drowning Asthma Anaphylaxis Pregnancy
What is management for a patient in CA due to hypothermia?
Remove from cold environment
Commence with passive warming
Handle patient with care to prevent VF
Temp 30.
Double intervals between dose until temp reaches 35.
Defibrillation is unlikely or be successful in the hypothermic heart.
Cardiac arrest in drowning occurs secondary to hypoxia/hypothermia. Describe how to manage.
Initial resuscitation Consider c spine precautions O2 and fluid therapy Consider regurgitation following resusc and maintain airway Consider hypovolaemia and manage
Pre hospital cardiac arrest in asthmatics is usually due to hypoxia as a result of severe bronchospasm and mucous plugging or bilateral pneumothorax. How to manage?
Moderate ventilation at 4-6 breaths per minute.
If chest hyper inflating during ventilations consider chest compressions to relieve trapped air.
Consider (paramedic) bilateral needle chest decompression if suspected tension pneumothorax are the cause for arrest.
Patient often hypovolaemic- treat with fluid therapy.
Anaphylaxis can lead to death from respiratory arrest, due to airway compromise and distributive shock. Describe treatment for anaphylaxis cardiac arrest
Remove allergen.
Due to possible airway obstruction, early cricothyrotomy may be indicated.
Adrenalin dosages should not be altered if IM adrenalin has already been administered.
How to modify resuscitation for a woman over 20 weeks pregnant?
Left lateral tilt is required.
Likelihood of regurgitation is increased, so secure airway required.
Chest compressions should be performed higher on the sternum due to upward displacement of the diaphragm and the abdominal contents.
Ventilation volumes may need reducing because of the mother’s elevated diaphragm.