Cardiac Arrest Flashcards
What do you do if VF / VT identified [3]
Shock + CPR up to 3x
IV adrenaline after every shock
- 10ml 1:10000 IV
IV amiodarone
- After 3 shocks
- 300mg I V
What do you do if witnessed in CCU
3 shocks then CPR initiated
If astyole [5]
IV adrenaline ASAP
2 mins CPR
Recheck rhythm
Not able to defib
What are shockable rhythms
VT and VF
Non shockable [2]
Astyole
Pulseless electrical activity
What suggests unstable patient that is peri-arrest? [4]
Shock - low BP <90
Syncope
MI
HF
How do you treat? [4]
ABCDE
IV access + bloods
ECG
Decide if stable or not
If unstable [2]
DC shock
Treat as per rhythm detected on defib
If broad complex and regular [2]
Assume VT
IV amiadarone infusion
If broad complex and irregular [2]
AF with BBB = treat as SVT
Polymorphic VT = magnesium sulphate
If narrow and regular [3]
Valsalva/ carotid sinus massage
IV adenosine if fails
Consider atrial flutter if fails
If narrow and irregular [4]
AF
Anti-coagulate
DC cardioversion or chemical
BB for rate control
What dose of adrenaline in cardiac arrest
10ml of 1:10000
What dose in anaphylaxis
0.5ml IM 1 in 1000
If go into cardiac arrest what do you do [4]
Start chest compression
Get defibrillator on ASAP which will see if shockable rhythm
Someone will call 2222 and get resus trolley
Wide bore IV access
What is more likely to cause a shockable VT / VF
Metabolic disturbance
What are most arrests: shockable or non-shockable
Non-shockable
What are reversible causes of cardiac arrest? 4H’s and 4T’s
Hypovolaemia
Hypoxia
Hypo or hyperkalaemia
Hypothermia
Thrombus
Tamponade
Toxins
Tension pneumothorax
Management of bradycardia [4]
Atropine (500mcg IV) is the first line treatment in this situation.
If there is an unsatisfactory response the following interventions may be used:
1. atropine, up to maximum of 3mg
2. transcutaneous pacing
3. isoprenaline/adrenaline infusion titrated to response
Risk factors for Asystole [4]
complete heart block with broad complex QRS
recent asystole
Mobitz type II AV block
ventricular pause > 3 seconds
