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Cardiac Arrest Flashcards

1
Q

what is cardiac arrest

A

effective cessation of heart, no circulation and oxygen delivery

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2
Q

how do you recognise cardiac arrest

A

unresponsive patient, not breathing normally, no pulse

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3
Q

what is SaO2 or its indirect measurement SpO2

A

concentration of oxygen bound to haemoglobin in arterial blood

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4
Q

what is the formula for oxygen delivery

A

DO2= SaO2 x [Hb] x O2cc (carrying capacity of Hb) x Co (HR x SV)

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5
Q

what rhythms are shock able

A

ventricular fibrillation and pulse-less ventricular tachycardia

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6
Q

what does cardiac arrest often preceed

A

hypoxia and hypotension

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7
Q

what are the core standards for cardiac arrest

A
  • recognise deterioration EARLY and prevent if possible
  • arrest recognised early and CPR started immediately
  • help summon as soon as arrest recognised
  • defibrillation if appropriate, within 3 mins
  • appropriate post arrest care
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8
Q

how do you increase SaO2 (SpO2)

A

increase FiO2, clear airway, maintain adequate breathing

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9
Q

how do you increase [Hb]

A

transfusion trigger, treat anaemia

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10
Q

how do you treat low HR

A

atropine or B-stimulant (ephedrine)

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11
Q

how do you treat decreased pre load

A

IV fluid, raise lags

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12
Q

how do you treat low contractility

A

treat cause e.g. PCI for MI

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13
Q

how do you treat excess afterload

A

vasodilators (get this in e.g. high BP)

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14
Q

how do you treat reduced after load

A

vasoconstrictors (get this in e.g. septic shock)

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15
Q

how do you asses SaO2

A

pulse oximetry, ABG

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16
Q

how do you assess [Hb]

A

FBC

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17
Q

how do you assess HR

A

pulse, pulse oximeter, ECG monitor, arterial BP monitor

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18
Q

what are the two main component affecting BP

A

cardiac output and total peripheral resistance

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19
Q

what can cause airway obstruction

A

CNS depression- tongue

lumen blocked- blood, vomit, forgein body

swelling- trauma, infection, inflammation

muscle- laryngospasm, bronchospasm

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20
Q

how can you recognise airway obstruction

A

talking, difficulty breathing, distressed, choking, shortness of breath, stridor, wheeze, gurgling, see-saw respiratory pattern, accessory muscles

21
Q

how is an airway obstruction treated

A

airway opening (head tilt chin lift, jaw thrust, suction)
simple adjuncts/ advanced techniques (tracheal tube)
oxygen

22
Q

what can cause breathing problems

A

airway problems,
decreased resp drive (CNS depression),
decreased resp effort (muscle weakness, nerve damage, restrictive chest defect, pain from fractured ribs)
lung disorders (pneumothorax, haemothorax, infection, COPD exacerbation, asthma, PE, ARDS)

23
Q

what are the clinical signs of breathing problems

A

resp distress, accessory muscles, cyanosis, resp rate, chest deformity, conscious level, noisy breathing, expansion, percussion, tracheal position

24
Q

what are the primary causes of circulation problems

A 
Acute coronary syndromes
Dysrhythmias
Hypertensive heart disease
Valve disease
Drugs
Hereditary cardiac diseases
Electrolyte / acid base  abnormalities
Electrocution
25
what are the secondary causes of circulation problems
``` Asphyxia Hypoxaemia Blood loss Hypothermia Septic shock ```
26
what are the clinical signs of circulatory problems
distress, pallor, organ perfusion (chest pain, mental state, urine output), BP, HR, cap refill, bleeding, fluid losses, JVP, CVP
27
how is disability in ABCDE treated
ABC then treat underlying cause -e.g. blood glucose consider recovery position check drug chart
28
what happens in exposure in ABCDE
Remove clothes to enable thorough examination (to avoid missing causes of problems) avoid heat loss and maintain dignity
29
whats haematoma
solid swelling of clotted blood within the tissues
30
what is respiratory arrest
unresponsive, not breathing but have pulse
31
how is a-systole and PEA treated
adrenaline 1mg IV ASAP, every 3-5 mins after and CPR
32
what heart rhythms are not shockable
a systole, pulseless electrical activity
33
describe VF on an ECG
irregular, no recognisable QRS complex, random frequency and amplitude
34
is ventricular fibrillation shockable
yes
35
describe ventricular tachycardia on an ECG
two types monomorphic VT- broad complex rhythm, rapid rate, constant QRS morphology Polymorphic VT- torsade de pointes
36
when is VT shockable
when it is pulseless
37
what is a precordial thump
rarely effective, used only if defibrillator not immediately available and in witnessed and monitored VF/VT cardiac arrest
38
what is defibrillation
use of electrical current to reset heart electrical rhythm with hope that regular rhythm will recur
39
when should amidarone be given and what does it do
during CPR after 3 shocks- anti arrhythmic drug
40
what effect does adrenaline have
alpha vasoconstriction | beta inotropic
41
what are the potentially reversible causes of cardiac arrest
four H's and four T's - hypoxia - hypovolaemia - hypo/hyper-kalaemia/ metabolic - thrombosis- coronary or pulmonary - tension pneumothorax - tamponade - toxins
42
what is avoiding hyperventillation
ensuring that large volumes and high rates are not used as these will increase intrathoracic pressure, decreasing venous return and coronary perfusion
43
how can an airway be secured
tracheal tube, supraglottic airway device
44
what is a risk of mask to mouth and self inflating bag ventilation
gastric inflation, risk of inadequate ventilation
45
what extra advantage does a self inflating bag have
allows oxygen supplementation (up to 85%)
46
what is ROSC
return of spontaneous circulation
47
what is post cardiac arrest syndrome
brain injury, myocardial dysfunction, systemic ischaemia/ re-perfusion response, persistent precipitating pathology
48
when can therapeutic hypothermia be used
unconscious adults with ROSC should be cooled to 32-37 degrees

Cardiovascular (34 decks)

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