Cardiac Arrest Flashcards
Reversible causes of Cardiac Arrest
Hypoxia
Hypovolaemia
Hypo / Hyperkalemia
Hypo / Hyperthermia
Thromboembolus
Tension Pneumothorax
Toxins - Opioids, Benzodiazepines, TCA
Tamponade
CPR
Chest compressions : breaths in a ratio of 30:2
Continuous chest compressions if supported airway
Depth of 5-6 cm
Rate of 100-120 bpm.
Shockable rhythms
VT and VF
Non-Shockable Rhythms
Asystole, Pulseless electrical activity.
Treatment of shockable rhythms
Adrenaline (1mg) and Amiodarone (300mg) after the third cycle of shock.
Repeat adrenaline every 3-5 minutes.
Preferable IV if not interosseous.
Treatment non-shockable rhythm
Adrenaline (1mg) as soon as non-shockable rhythm is confirmed.
Repeat adrenaline every 3-5 minutes.
Pregnancy CPR
Move uterus to the left to relieve pressure of the gravid uterus on caval vessels increasing venous return.
If still no response after 5 minutes emergency C-section must be considered.
Post Cardiac Arrest Treatment
O2 94-98%
Temperature <37.7 for at least 72 hours
MAP >65mmHg
Do not routinely give corticosteroids after arrest.
Treatment of hypoxia causing cardiac arrest
Guedel airway or intubation, with high flow oxygen.
Treatment of Hypovolaemia causing cardiac arrest
blood transfusion or fluid.
Treatment of Hypo/Hyperkalaemia causing cardiac arrest
if too low administer potassium.
If too high administer calcium chloride with insulin and glucose to drive K into cells.
Treatment of hypothermia causing cardiac arrest
Dry, cover, withdraw Defib and meds until temp >30.
Between 30-34 double intervals between medication doses.
Treatment of Thromboembolism causing cardiac arrest
Echo if suspected at cardiac arrest. CPR continue for up to 90 minutes post thrombolysis.
PCI and coronary angiography can occur during chest compressions by a specialist.
Treatment of toxins causing cardiac arrest
Use of counter medications - opioids = naloxone.
Treatment of Tension Pneumothorax causing cardiac arrest
Large bore cannula in 2nd intercostal space mid clavicular.
