Cardiac arrest

Question 1

Causes of cardiac arrest

Answer 1

“Hs and Ts”

• Hypovolaemia
• Hypoxia
• Hypo/hyperkalaemia
• Hypo/hyperglycaemia
• Hypothermia
• Hydrogen ions (acidosis)
• Toxins/tablets
• Cardiac Tamponade
• Trauma
• Thrombosis (AMI)
• Thromboembolism (PE)
• Tension pneumothorax

+ arrhythmias and anaphylaxis

Question 2

Clinical presentation of cardiac arrest

Answer 2

1. Lack of carotid pulse (palpate for 10 seconds)
2. Loss of consciousness
3. Cessation of breathing

May be preceded by fatigue, weakness, dizziness, vomiting, syncope, chest pain and/or SOB

Question 3

Four types of rhythms in cardiac arrest and how they are classifcied

Answer 3

Shockable rhythms

1. Ventricular fibrillation
2. Pulseless ventricular tachycardia

Non-shockable rhythms

3. Asystole
4. Pulseless electrical activity

Question 4

Management of cardiac arrest

Answer 4

1. Defibrillation or amiodarone (shockable rhythms)
2. CPR (non-shockable rhythms)
3. Epinephrine (promotes ROSC)
4. Targeted temperature management (after ROSC but no return of consciousness)

Other

• Vasopressin early for patients in asystole
• Extracorporeal membrane oxygenation
• Cardiac cathetersiation
• Praecordial thump (first aid for VT)

Question 5

Percentage survival rate

• With initial emergency care by ambulance
• With defibrillation within 3-5 minutes

Answer 5

• 2%

- 30%