Cardiac Arrest

Question 1

Asphyxia

Answer 1

Lack of O2 to the brain

Question 2

2 Pathways to CA in children

Answer 2

1. Hypoxia/Asphyxia

2. Suden Cardiac Arrest

Question 3

Why is hypoxia/asphyxia #1?

Answer 3

End result of progressive tissue hypoxia/acidosis due to RF or hypotensive shock

Question 4

Channelopathy

Answer 4

Disorder of the ion channels in myocardial cells that predisposes the heart to arrythmias

Question 5

H’s

Answer 5

Hypoxia
Hypothermia
Hydrogen Ions (Acidosis)
Hyper/Hypo kalemia
Hypovolemia

Question 6

T’s

Answer 6

Toxins
Tension Pneumo
Thrombosis - pulmonary
Thrombosis - cardiac
Tamponade - cardiac

Question 7

pVT Monomporphic

Answer 7

Ventricular complexes appear uniform

Question 8

pVT Polymorphic

Answer 8

Ventricular complexes do no look alike

Question 9

Torsades de pointes meaning

Answer 9

TORNADO IN HEART
“Twisting of points”
Polymorphic V-Tach

Question 10

Backup pacemaker

Answer 10

AV node

Question 11

What’s in control during Vtach/Vfib

Answer 11

Purkinje fibers/ventricle pacemaker cells

Question 12

Things to remember in Torsades de pointes of the P wave

Answer 12

She ain’t doing a thing son

No P, No P-R

Question 13

Low oxygen mnumonic

Answer 13

COLLAPSED

Question 14

COLLAPSED

Answer 14

Chest pain
O2 low
Low BP
Lethargy
Anxiety
Palpitations
Shortness of breath
Elevated HR
Dizziness

Question 15

PETCO2 you want during compressions to be

Answer 15

greater than 10-15mm HG

Question 16

Recommended ET dose of EPI

Answer 16

10x higher than the IV/IO dose

Question 17

Other ET dose of drugs

Answer 17

3-3x the IV/IO

Question 18

Technique for administering medication ET route

Answer 18

1. Briefly pause compressions while instillation
2. 5ml NS flush
3. 5 Rapid positive-pressure breaths after the drug is instilled

Question 19

If shock eliminates VF continue…

Answer 19

CPR bc most victims have PEA or asystole immediately after

Question 20

Medications used for tx of shock-refractory VF or pVT

Answer 20

Lidocaine or Amiodarone

Question 21

Asystole/PEA care

Answer 21

CPR
Epi 0.01mg/kg q3-5 mins. ET 0.1mg/kg
Consider advanced airway

Question 22

VF/pVT care

Answer 22

CPR

1. Shock
2. CPR - IV/IO access
3. Shock
4. CPR - Epi 0.01mg/kg q 3-5 mins / Consider advanced Airway
5. Shock
6. CPR - Amidarone or Lidocaine

Question 23

VF/pVT Medication dosages

Answer 23

Epi 0.01mg/kg — ET Epi 0.1mg/kg

Amidarone – 5mg/kg bolus, may repeat 2 more times refractory VT/pVT

Lidocaine – 1mg/kg loading dose, maintenance 20-50 mcg/kg per minute, >15 from initial bolus repeat bolus prior to starting maintenance

Question 24

Defib shock

Answer 24

First 2 J/kg
Second 4 J/kg
Subsequent 4 J/kg
Max: 10 J/kg

Question 25

Paddle Sizes

Answer 25

> 10kg adult

<10kg infant

Question 26

Prostacyclin

Answer 26

Inhibits PLT

Vasodilator

Question 27

2 Good vasodilators

Answer 27

1. Nitric Oxide
2. Prostacyclin
   Reduce pulmonary, vascular resistance