Cardiac arrest

Question 1

How should cardiac arrest be divided

Answer 1

‘shockable ‘ rhythms - ventricular fibrillation
pulseless ventricular tachycardia

‘non-shockable’ rhythms - asystole
pulseless electrical activity

Question 2

What are the reversible causes of cardiac arrest - The ‘Hs’

Answer 2

hypoxia
hypovolaemia
hyperkalaemia
hypokalaemia, hypoglycaemia,hypocalcamia ,acidaemia
hypothermia

Question 3

What are reversible causes of cardiac arrest - The ‘Ts’

Answer 3

Thrombosis - coronary / pulmonary

Tension pneumothorax
Tamponade- cardiac
Toxins

Question 4

How may someone with cardiac arrest present

Answer 4

unresponsive
absence of normal breathing
absence of circulation
cardiac rhythm distribution

Question 5

What investigations are required

Answer 5

continuous cardiac monitoring
FBC
U&Es
ABG
Cardiac biomarkers

Question 6

What management is rewuired

Answer 6

Chest compressions

Defibrillation -
single shock for VF/pulseless VT

Drug delivery
IV Adrenaline
IV amiodarone
IV thrombolytic drugs

Question 7

When should adrenaline be given

Answer 7

1mg ASAP for non-shockable rhythms

repeat 1mg every 3-5 minutes whilst ALS continues

Question 8

When should amiodarone be given

Answer 8

amiodarone 300mg should be given to patients who are in VF/pulseless VT after 3 shocks have been administered

Lidocaine can be used as alternative

Question 9

When should thrombolytic drugs be given

Answer 9

if PE suspected
if given CPR should eb continued for extended period of 60-90 minutes