Cardiac Arrest Flashcards
The paramedic may determine that the patient is dead/non-salvageable and decide not to resuscitate if
- Lividity
- Rigor mortis
- Tissue decomposition
- Blunt or penetrating trauma without signs of life
- A valid DNRO is presented or discovered
The paramedic may determine that the patient is dead/non-salvageable and decide not to resuscitate if ALL
- Known down time > 30 minutes
- Asystole
- Pupils fixed and dilated
- Apneic
- Without hypothermic mechanism for arrest
Primary Arrest
- AMI
- Cardiac arrhythmias
- Cocaine overdose
- Electrocution (alternating current)
- unknown origin
Secondary Arrest
- ALL PEDIATRICS
- Hypoxia (e.g., Narcotic OD, FBAO, hanging)
- Drowning
- CHF
- Lightning strike (direct current)
- Trauma
- Cyanide exposure
- 3rd trimester pregnancy
ResQPOD Contradications
- Patient is < 1 year old
- Traumatic arrest
- Patient has a pulse
- During passive oxygenation
TERMINATION OF EFFORTS (ADULT ONLY)
- “Persistent Asystole” for 15 minutes
- EtCO2 of < 10 mm Hg
- Patient is normothermic
- NORMAL SALINE:
500 mL has been administered - 1 DEFIBRILLATION
200 joules (can be performed at any time during the arrest) - All reversible causes have been addressed
- All ALS interventions have been completed
- Social support group is in place for the family if needed
H’s (6)
- Hydrogen ion (acidosis): Ventilation
- Hyperkalemia (renal failure): Calcium chloride, sodium bicarb, albuterol
- Hypoglycemia: Glucose
- Hypoxia: Oxygen & ventilate
- Hypovolemia: Fluid bolus
- Hypothermia: Warming
T’s (4 )
- Toxins or tablets (OD): Opiates (Narcan)
- Tricyclic antidepressants (sodium bicarb)
- Calcium channel blocker (calcium chloride)
- Tension pneumothorax: Bilateral pleural decompression
DO NOT RESUSCITATE ORDERS
- The orders are presented on a valid pre-hospital DNRO. A Florida DNRO bracelet (worn by the patient, must contain the patient’s name, Social Security number, attending physician’s name and phone number, and effective date of the order); OR
- Is presented a DNRO document from a facility licensed pursuant
TO BE CONSIDERED VALID, THE DNR MUST MEET THE FOLLOWING CRITERIA
- The form states that it is a DNRO and specifies that the patient is not to be resuscitated.
- The original is signed and dated by the patient’s physician. Photocopies are acceptable.
- The form has been signed and dated by the patient or the patient’s surrogate or proxy, if applicable.
- The DNR order is not withdrawn by the patient, the patient’s attending physician, or the patient’s healthcare surrogate or proxy.
- The patient identity is verified by the driver license, other photo identification, or from a witness in the presence of the patient. If a witness is used, this shall be documented in the run report to include: Full name of the witness, address, telephone number, and relationship to the patient.
What does a ResQPOD do
Enhances circulation during CPR. This simple, non-invasive device regulates pressure in the chest and improves blood flow to the heart and brain.
Intubation should only be performed if
Unable to use an I-gel
Once working an arrest no further pulse check should be performed until
Spike of ETCO2 or signs of life
FBAO
1- Use Laryngoscope and Magill forceps
2- Surgical Cricothyrotomy
Primary arrest airway
- Apply ETCO2 filter line to I-gel
- Supply passive oxygenation with the I-gel port 8LPM
- After 6 mins apply resQpod
- Ventilate 1 breath every 10 mins
