als Flashcards
What are the two categories of rhythms in cardiac arrest according to the 2021 Resus Council guidelines?
‘shockable’ rhythms and ‘non-shockable’ rhythms
‘shockable’ rhythms include ventricular fibrillation and pulseless ventricular tachycardia, while ‘non-shockable’ rhythms include asystole and pulseless-electrical activity.
What is the recommended ratio of chest compressions to ventilation during CPR?
30:2
This ratio applies to adult patients during CPR.
What should be done while a defibrillator is being charged?
Continue chest compressions
This is a change from earlier guidelines where compressions would pause for defibrillation.
What is the recommended action following a single shock for VF/pulseless VT?
2 minutes of CPR
This is crucial for maintaining blood flow to vital organs.
In a monitored patient, how many shocks are recommended if the cardiac arrest is witnessed?
Up to three quick successive (stacked) shocks
This is a change from the earlier guideline of one shock followed by CPR.
What is the first-line method for drug delivery during cardiac arrest?
IV access
This is preferred for delivering emergency medications.
What should be done if IV access cannot be achieved?
Drugs should be given via the intraosseous route (IO)
This method provides an alternative for drug administration when IV access is not possible.
Is delivery of drugs via a tracheal tube recommended?
No
The guidelines have changed to no longer recommend this method.
When should adrenaline be administered during non-shockable rhythms?
As soon as possible
Early administration is critical for improving outcomes.
When should adrenaline be given during a VF/VT cardiac arrest?
Once chest compressions have restarted after the third shock
This timing is important for effective resuscitation efforts.
How often should adrenaline be repeated during ALS?
Every 3-5 minutes
This helps maintain drug levels in the system.
What is the recommended dose of amiodarone for patients in VF/pulseless VT after three shocks?
300 mg
This is part of the advanced life support protocols.
What additional dose of amiodarone is recommended after five shocks?
150 mg
This is to further assist in the management of VF/pulseless VT.
What alternative drug can be used if amiodarone is not available?
Lidocaine
This can be used based on local decisions.
When should thrombolytic drugs be considered during cardiac arrest?
If a pulmonary embolus is suspected
This can be critical in cases of suspected pulmonary embolism.
How long should CPR be continued if thrombolytic drugs are given?
For an extended period of 60-90 minutes
This is to maximize the chances of successful resuscitation.
What medication is no longer recommended for routine use in asystole or pulseless electrical activity (PEA)?
Atropine
Atropine was previously used but is now considered ineffective in these situations.
Following successful resuscitation, what should oxygen be titrated to achieve?
Saturations of 94-98%
This is to prevent potential harm caused by hyperoxaemia.
What are the reversible causes of cardiac arrest categorized under ‘Hs’?
- Hypoxia
- Hypovolaemia
- Hyperkalaemia
- Hypokalaemia
- Hypoglycaemia
- Hypocalcaemia
- Acidaemia
- Other metabolic disorders
- Hypothermia
These conditions must be addressed to improve chances of survival.
What are the reversible causes of cardiac arrest categorized under ‘Ts’?
- Thrombosis (coronary or pulmonary)
- Tension pneumothorax
- Tamponade - cardiac
- Toxins
Identifying and treating these causes can reverse cardiac arrest.
