Cardiac Arrest

Question 1

The ALS guidelines divides patients into ‘shockable’ and ‘non-shockable’ rhythms.

What are the 2 ‘shockable’ rhythms?

Answer 1

1) Pulseless VT

2) VF

Question 2

What are the 2 ‘non-shockable’ rhythms?

Answer 2

1) Pulseless electrial activity (PEA)

2) Asystole

Question 3

What is the rate of chest compressions to ventilation in adults ALS?

Answer 3

30:2

Note - chest compressions are continued while a defibrillator is charged.

Question 4

Main point regarding defibrillation in VT/VF?

Answer 4

A single shock is given for VF/pulseless VT followed by 2 minutes of CPR.

Question 5

If the cardiac arrested is witnessed in a monitored patient (e.g. in a coronary care unit), what is recommended?

Answer 5

Give up to 3 quick successive shocks, rather than 1 shock followed by CPR.

Question 6

What is given as soon as possible for non-shockable rhythms?

Answer 6

IV Adrenaline 1mg

Question 7

When is IV adrenaline given in VF/VT cardiac arrest?

Answer 7

Given once chest compressions have restarted after the 3rd shock.

Question 8

How often should adrenaline be repeated in ALS?

Answer 8

Every 3-5 mins whilst ALS continues

Question 9

When is amiodarone given in VT/VF?

Answer 9

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

A further dose of amiodarone 150 mg should be given to patients who are in VF/pulseless VT after 5 shocks have been administered

Question 10

What dose of amiodarone is given in ALS?

Answer 10

300mg

Question 11

what dose of adrenaline is given in ALS?

Answer 11

1mg

Question 12

What can be used as an alternative to amiodarone in ALS?

Answer 12

Lidocaine

Question 13

What are the 8 causes of reversible cardiac arrest (4 H’s and 4 T’s)?

Answer 13

Hypoxia
Hypovolaemia
Hypothermia
Hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia and other metabolic disorders

Cardiac tamponade
Thrombosis
Tension pneumothorax
Toxins