Cardiac Arrest

Question 1

CAB: No pulse/breathing –> call for help, begin CPR:

Answer 1

100-120 compressions/min (30x)–> 2 breaths, repeat

Question 2

How soon should you attach AED and potentially shock?

Answer 2

ASAP

Question 3

Which rhythms are shockable?

Answer 3

Vfib, pulseless Vtach

Question 4

Cardiac arrest meds

Answer 4

1 mg epi q 3-5 min (after 1st shock)

300 mg amiodarone (1st dose) –> 150 mg amiodarone (2nd dose)

Question 5

Reversible Causes: Hs and Ts

Answer 5

Hypovolemia, hypothermia, hypoxia, hydrogen ions (acidic pH), hypo/hyperkalemia
Tension pneumo, tamponade, toxins, Thrombus (cardiac, pulm)

Question 6

Vent rate if intubated:

Answer 6

1 breath q six sec (10/min)

Question 7

Cardiac arrest defibrillation

Answer 7

Biphasic: 120-200 J
Monophasic: 360 J

Question 8

ROSC achieved IF:

Answer 8

Pulse and BP
PETCO2 stays above 40mmHg
Spontaneous arterial pressure waves (if monitoring)

Question 9

ROSC –> now worry about?

Answer 9

Vent and O2 (SpO2 >94% and PETCO2 35-40)

Question 10

ROSC and O2 sat >94% w/o hypervent –> now worry about?

Answer 10

Blood pressure (SBP should be >90)

Question 11

ROSC: tx hypotension

Answer 11

1-2 L NS or LR
Vasopressors: 
Epi: .1-.5 mcg/kg/min
NE: .1-.5mgc/kg/min
DA: 5-10 mcg/kg/min

Question 12

ROSC: O2 and BP are fine; cause was STEMI or suspect AMI –>

Answer 12

REPERFUSION

Question 13

ROSC: Not concerned that pt needs reperfused, or pt has been reperfused –> Cannot follow commands –>

Answer 13

Targeted Temp Mgmt –> CCU