Cardiac arrest

Question 1

Define:

Answer 1

acute cessation of cardiac function

Question 2

Aetiology/risk factors:

Answer 2

4 Hs and 4 Ts:

Hypothermia
Hypoxia
Hypo/hyperkalaemia
Hypovolemia

Toxins (and other metabolic causes (drugs, therapeutic agents and sepsis)
Tampomade
Tension pneumothorax
Thromboembolism

Question 3

Epidemiology:

Answer 3

none available

Question 4

Symptoms:

Answer 4

happen very suddenly but may be preceded by:

• fatigue
• fainting
• dizziness
• blackouts

Question 5

Signs:

Answer 5

Unconscious

Not breathing

Absent carotid pulses

Question 6

Investigations:

Answer 6

Cardiac monitor - to classify the rhythm

Bloods:

• FBC
• U + E’s
• toxicology screen
• X match
• Glucose
• ABG

Question 7

management:

Answer 7

BLS - DRS ABC

–> CPR (30 Chest compressions to 2 rescue breaths)

Apply defib –> V FIb and V tach are shockable rhythms.

Shock and then continue CPR.

Then reassess the rhythm and apply second shock. After the second shock Img of IV adrenaline every 3-5 minutes

Then reassess rhythm again and give 300 mg IV of amiodrone or lidocane

If it is not a shockable rhythm:

• 2 CPR then reassess rhythm
• 1mg Iv adrenaline every 3-5 mins
• atropine (3mg Iv once)

Question 8

Management post cardiac arrest:

Answer 8

ABCDE approach

Oxygen/ventilation

ECG

Treat cause e.g. tamponade = pericardiocentesis

temp control

Question 9

Complications:

Answer 9

Irreversible hypoxic damage to the brain

Death

Question 10

prognosis:

Answer 10

resuscitation is less successful outside the hospital

The longer without CPR or CO the worst the prognosis