Cardiac Arrest

Question 1

Common causes of cardiac arrest

Answer 1

Metabolic: hypovolaemia, hypothermia, hypoxia, hyper/hypokalaemia

Non-metabolic: tamponade, tension pneumothorax, thromboembolic/mechanical obstruction

Question 2

Common presentations which may precipitate cardiac arrest

Answer 2

IHD

Respiratory failure

Drug overdose

Drowning

Question 3

DANGER

Answer 3

Check for hazards to patient and yourself

Use gloves and protective eyewear

Remove patient from immediate danger if indicated

Question 4

RESPONSE

Question 5

AIRWAY

Answer 5

Put pt in supine position if only latered conscious state without cardiac arrest or if suspected injury; in non trauma pt, put in lateral position

Check airway

Clear airway

Open airway (not if suspected C spine injury)

Maintain airway

Question 6

BREATHING

Answer 6

Look: chest wall movements
Listen: inspiratory and expiratory sounds of breathing
Feel: for movement and currents of expired air over nose and mouth
Intervene if pt not breathing

Question 7

CIRCULATION

Answer 7

Palpate carotid pulse for 5-10 secs (may be bradycardic, have low BP and can only feel ectopics)

If pulse is present, continue with ventilation

If pulse absent, commence external cardiac compression at rate of 100 bpm; give 30 chest compressions then 2 ventilations

Question 8

Praecordial thump

Answer 8

Only appropriate if rhythm is VF or pulseless VT (so pt must be monitored at the time)

Not recommended for unwitnessed cardiac arrest

Has no evidence base

Question 9

Bag and mask ventilation

Answer 9

5 quick ventilations over ~10 secs

Question 11

If recurrent VT/VF not responding to defibrillation?

Answer 11

Consider amiodarone 300mg (5mg/kg), or lignocaine 100mg (1.5mg/kg) or magnesium 5mmol