Cardiac Arrest

Question 1

Which arrhythmias are shockable (able to be defibrillated)?

Answer 1

VF (irregular, no QRS)
Pulseless VT (monomorphic or polymorphic TDP)

Question 2

How quick should defibrillation be done once cardiac arrest is identified?

Answer 2

Within 3 minutes

Question 3

How can SaO2 be measured?

Answer 3

Pulse oximetry

ABGs

Question 4

Describe unconsciousness

Answer 4

Not responsive, is breathing

Question 5

Describe respiratory arrest

Answer 5

Not responsive, not breathing, has a pulse

Question 6

Describe cardiac arrest

Answer 6

Not responsive, not breathing, no pulse

Question 7

What is the algorithm for advanced life support, once a shockable rhythm has been found?

Answer 7

Shock 1
CPR for 2 mins (30:2)
Reassess rhythm
Shock 2
CPR for 2 mins
Reassess rhythm
Shock 3
CPR for 2 mins
Reassess rhythm
Adrenaline 1mg + after every alternate shock

Question 8

Which rhythms are non-shockable?

Answer 8

Asystole (irregular, unrecognisable)

Pulseless electrical activity

Question 9

What is given in asystole/ PEA?

Answer 9

Adrenaline 1mg IV every 3-5 mins following CPR

Question 10

What is the alternative if defibrillation is not available?

Answer 10

Pre-cordial thump

Question 11

What are the main causes of cardiac arrest and how should they be managed?

Answer 11

4Hs:
Hypovolaemia (IV fluids)
Hypo/hyperkalaemia (U+Es, ABGs)
Hypothermia (rewarming)

4Ts:
Thrombosis (thrombolysis)
Tension pneumothorax (needle thoracentesis)
Tamponade (needle cardiocentesis)
Toxins (antidote)

Question 12

How is temperature managed in cardiac arrest recovery?

Answer 12

Therapeutic hypothermia - body cooled down to help neurological recovery