Cardiac Arrest

Question 1

Define Cardiac Arrest

Answer 1

effective cessation of heart so no circulation and therefore no oxygen delivered

Question 2

What are the clinical signs of cardiac arrest?

Answer 2

Unresponsive patient
Not breathing normally
No pulse

Question 3

When is a cardiac arrest shockable?

Answer 3

Ventricular Fibrillation

Ventricular Tachycardia - pulseless

Question 4

When is cardiac arrest non shockable?

Answer 4

Asystole

Pulseless Electrical Activity

Question 5

What is the management and drugs for non shockable Cardiac Arrest?

Answer 5

Exclude / treat reversible causes
Adrenaline 1 mg IV as soon as possible and every 3-5 min thereafter (every 2 cycles)
Amiodarone 300mg

Question 6

What are the 4 Hs of reversible causes of Cardiac Arrest? And how does one treat them?

Answer 6

Hypoxia - ventilation
Hypovolaemia - IV fluids (0.9% saline or Hartmann’s solution +/- blood)
Hypo-/hyperkalaemia/metabolic - Correct according to U&Es / blood gases or likely abnormality from history
Hypothermia - Consider rewarming

Question 7

What are the 4 Ts of reversible causes of Cardiac Arrest? And how does one treat them?

Answer 7

Thrombosis - coronary or pulmonary - Consider thrombolysis
Tension pneumothorax - Needle thoracentesis
Tamponade – cardiac - Needle cardiocentesis (very rare)
Toxins - Specific treatment/antidote if possible

Question 8

Outline the 4 possible outcomes of post-cardiac arrest syndrome?

Answer 8

1. post-cardiac arrest brain injury
2. post-cardiac arrest myocardial dysfunction
3. systemic ischaemia / reperfusion response
4. persistent precipitating pathology