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resuscitation / procedures > CARDIAC ARREST > Flashcards

CARDIAC ARREST Flashcards

1
Q

BLS Assessment

A

Check Responsiveness: tap patient and shout “are you okay.” Scan patient for
Activate the emergency response system and obtain an AED
Circulation
Defibrillation

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2
Q

First Step Pulseless Arrest

A

Shout for Help
Activate Emergency Response

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3
Q

Second Step Pulseless Arrest

A

Start CPR
Give Oxygen
Attach Monitor / Defibrillator

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4
Q

What rhythms are not shockable

A

PEA and asystole

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5
Q

What rhythms are shockable

A

V fib and Pulseless V tach

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6
Q

Ventilation rate if NO advanced airway

A

30:2

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7
Q

Length of CPR

A

2 minutes / 5 cycles

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8
Q

Biphasic Shock energy for defibrillation

A

120-200 J

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9
Q

Dose and frequency of epinephrine

A

1 mg IV or IO followed by 20 ml NS every 3-5 minutes

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10
Q

Dose and frequency of amiodarone

A

Give after the third shock if VF or pVT
First dose 300 mg bolus followed by 20 ml NS
Second dose 150 mg bolus followed by 20 ml NS

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11
Q

Dose and frequency of Lidocaine

A

Give after 3rd round of CPR
1st dose: 1 -1.5 mg / kg
2nd dose: 0.5 - 0.75 mg / kg

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12
Q

Indications and dose of magnesium

A

Torsades do Pointes
1-2 grams diluted in 10 ml of D5W

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13
Q

List the reversible H’s of cardiac arrest

A

Hypovolemia
Hypoxia
Hydrogen idons (acidosis)
Hypokalemia
Hypothermia

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14
Q

List the reversible T’s of cardiac arrest

A

Tension pneumo
Tamponade
Toxins
Throbosis (pulmonary or coronary)

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15
Q

Uses of waveform capnography in CPR

A

Evaluate effectiveness of chest compressions

Indentification of ROSC

Verify and monitor ETT placement

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16
Q

CPR Quality: depth and rate of compression. Frequency of compressor rotation. Compression-ventilation ratio if no advanced airway. How to monitor quality of CPR. PETC02 target

A

2 inchest at 100 - 120 bpm
Minimize interruptions in compressions
Rotate compressor every 2 minutes
with complete recoil

30-2 compression-ventilation ratio if no advanced airway
Avoid excessive ventilation

Insert advanced airway
Quantitative waveform capnography
PETC02 target > 10 mm Hg

17
Q

Advanced Airway: List 2 forms of advanced airway. How to confirm and monitor ET tube placement.

A

Endotracheal intubation
Supraglottic airway
Waveform capnography or capnometry

18
Q

Ventilation rate if advanced airway

A

1 breath every 6 seconds

19
Q

Ventilation rate with an advanced airway

A

1 breath every 6 seconds

20
Q

3 signs of Return of Spontaneous Circulation (ROSC)

A

Pulse and Blood Pressure

Abrupt sustained increase in PETC02 (typically >40 mmHg)

Spontaneous arterial pressure waves in intra-arterial monitoring

21
Q

Hypovolemia Intervention

A

Expose patient and look for signs of blood loss
Obtain IV access
Use fluid challenge to determine if arrest is related to hypovolemia

22
Q

Hypoxia Intervention

A

Ensure that the airway
is open.
Ensure adequate
ventilation and bilateral
breath sounds.
Ensure oxygen supply is
connected properly.

23
Q

Hydrogen Ion (acidosis) Intervention

A

VBG

Provide Adequate Ventilations

Use sodium bicarbonate 1 mEq / kg IV to prevent metabolic acidosis if necessary

24
Q

Sodium Bicarbonate dosing

A

1 mEq / kg IV
1 amp = 50 mEq = 50 ml

25
Q

Hyper / Hypokalemia intervention

A

Obtain ECG
Give diluted potassium
OR
Give Calcium gluconate

26
Q

IV potassium dosing: peripheral vs central line

A

Peripheral line: KCl 10mEq over 1 hour
Central line: KCl 20mEq over 1 hour

27
Q

Calcium Gluconate dosing

A

1 amp = 1 g

28
Q

Tension Pneumothorax ECG signs, Physical Signs, intervention

A

ECG signs: Narrow QRS complexes and slow or fast heart rate.

Physical signs: JVD, tracheal deviation, unequal breath
sounds, difficulty with ventilation, and no pulse felt
with CPR.

Treatment: Needle decompression.

29
Q

Etiology of cardiac arrest with toxins

A

Cardiac Toxicity
Respiratory Depression or circulatory side effects

30
Q

Naloxone dosing

A

0.4 - 2 mg IV
4 mg IN

31
Q

Examples of drugs causing respiratory depression

A

opioids
benzodiazepines
ETOH

32
Q

Examples of drugs causing torsades

A

amiodarone
sotalol
tricyclic antidepressants
calcium channel blockers.

33
Q

Toxicity associated with bradyarrhythmias.

A

calcium channel blockers
Beta-adrenergic blockers
digoxin
opioids
clonidine
cholinesterase inhibitors
succinylcholine.

34
Q

DDx Cardiac Arrest

A

Cardiac:
MI -> VF / VT
Arrythmia
Bradycardia
Aortic Dissection
Tamponade
PE

Pulmonary:
Upper Airway Obstruction
Respiratory Arrest - COPD / Asthma / Narcotics
PTX

Tox / Metabolic:
Overdose
Hypoglycemia
Hyper / Hypokalemia
Hypomagnesemia

Other:
Anaphlaxis
Septic Shock
IC Hemorrhage
Hemorrhage
Hypothermia

resuscitation / procedures (21 decks)

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