Cardiac Arrest

Question 1

What artery do you check in confirmation of ROSC?
How long do you need ROSC before any next step?
After that time frame of achieving ROSC, what do you do?

Answer 1

If you get ROSC check femoral for 30 seconds (do not lose femoral after the 30 seconds)
After confirming ROSC and finding femoral, begin post ROSC procedures prior to moving PT

Question 2

Considerations w/ a hypothermic patient in cardiac arrest

Answer 2

Give only one round of meds before contacting Base (asystole)
Limit defibrillation (Vfib or Vtac) to 6 times
Field determination is discouraged
Transport to hospital

Question 3

Define asystole

Answer 3

Flatline
No electrical activity
Heart has completely stopped

Question 4

Define V-fib

Answer 4

Lower chambers of heart quiver instead of beat
Life threatening and needs intervention

Question 5

Define V Tach

Answer 5

Lower chambers of the heart are pumping two fast and aren’t pumping blood proficiently

Question 6

What heart rate is considered V tach

Answer 6

150+

Question 7

What is the age we use to determine which ROSC policy to follow

Answer 7

48hrs old
Use post ROSC or neonatal resuscitation policy

Question 8

Metronome count during compressions

Answer 8

112 BPM

Question 9

O2 Liters for full arrest

Answer 9

15 Liters per minute

Question 10

How often do you give a breath during CAM?

Answer 10

Every 10th compression on the recoil

Question 11

EtCO2 level that would warrant a pulse check

Answer 11

> 20
Organized rhythm greater than 40
Huge spike in EtCO2

Question 12

What are the priorities during a cardiac arrest

Answer 12

High quality chest compressions
Delivery of O2
Early defibrillation
Switch compressors every 2 minutes

Question 13

What are priorities post ROSC?

Answer 13

Immediate recognition of re-arrest
Preventing re-arrest with C-A-B management
Thorough assessment/identification of correctable causes
Movement/Transport decisions that keep patient care the highest concern

Question 14

When do you check the femoral and how long would you check for?

What do you do if you use the femoral pulse?

Answer 14

Palpate the femoral for 10 minutes after ROSC and before moving the patient

Immediately begin chest compressions

Question 15

How does O2 administration change after ROSC

Answer 15

One ventilation every 6 seconds (no more than 10 breaths per minute)

Question 16

How long do you have to have ROSC before transporting the PT?

Answer 16

10 minutes

Question 17

Procedure if you get ROSC and then the person re-arrests?

Answer 17

Begin CAM again for another 20 minutes from losing ROSC or initial re-arrest

Question 18

If re-arrest occurs during movement of patient what do you do?

Answer 18

Resume CAM outside of ambulance
If already loaded remove outside and create workable space

Question 19

What do you do if your patient re-arrests during transport?

Answer 19

CAM in the rig, prioritizing good compressions and effective advanced airway

Question 20

When is base contacted during CAM?

Answer 20

Asystole/PEA for 20 minutes of CAM
Witnessed arrest 40 minutes of CAM
ROSC or one shock delivered 40 minutes of CAM
Re-arrest 20 minutes form initial re-arrest