Cardiac Arrest

Question 1

Which pulse should be checked in adults during suspected cardiac arrest?

Answer 1

Carotid

In infants, the brachial pulse should be checked.

Question 2

What should be done if there is no pulse and the patient is unresponsive?

Answer 2

Call for help, ask for an AED, and start chest compressions

Immediate action is critical in cardiac arrest situations.

Question 3

What is the chest compression to ventilation ratio during CPR?

Answer 3

30:2

This ratio is used for adult and child CPR.

Question 4

What are the shockable rhythms in cardiac arrest?

Answer 4

Ventricular Fibriliation

Pulseless Ventricular Tachycardia

These rhythms can be treated with defibrillation.

Question 5

What are the non-shockable rhythms in cardiac arrest?

Answer 5

Asystole: complete absence of electrical activity in the heart

Pulseless Electrical Activity (PEA): heart has electrical activity but it’s not strong enough to produce a pulse or pump blood effectively

These rhythms do not respond to defibrillation.

Question 6

How many shocks should be administered for VF or pulseless VT before checking for ROSC?

Answer 6

1 single shock

Followed by 2 minutes of CPR before reassessing.

Question 7

Drugs for Shockable Rythym?
- Dose
- After which shock?

Answer 7

Shockable (VF, pulseless ventricular tachycardia):
* Adrenaline 1 mg after 2nd shock (1:10,000) - Repeat adrenaline 1 mg every 3-5 minutes
* Amiodarone 300 mg after the 3rd shock. Further dose of amiodarone 150 mg after 5 shocks.

Question 8

What should be done after administering amiodarone?

Answer 8

Flush with dextrose

Amiodarone may crystallize if not flushed properly.

Question 9

What should be done for non-shockable rhythms in terms of medication?

Answer 9

Give 1 mg adrenaline ASAP

Repeat every 3-5 minutes while ALS continues.

Question 10

What are the H’s that can cause cardiac arrest?

Answer 10

• Hypoxia
• Hypovolaemia
• Hypoglycaemia
• Electrolyte imbalances (hyperkalaemia, hypokalaemia, hypocalcemia, acidaemia)
• Hypothermia

These factors need to be considered in the management of cardiac arrest.

Question 11

What are the T’s that can cause cardiac arrest?

Answer 11

• Thrombosis (ACS or PE)
• Tension pneumothorax
• Tamponade
• Trauma
• Toxins

Identifying these causes is essential for treatment.