Cardiac Arrest Flashcards
Define cardiac arrest?
Acute cessation of cardiac function
How can the reversible causes of cardiac arrest be summariesed?
As the 4 Hs and 4 Ts
What are the 4 Hs?
Hypothermia
Hypoxia
Hypovolaemia
Hypokalaemia/Hyperkalaemia
What are the four Ts?
Toxins (and other metabolic disorders (drugs, therapeutic agents, sepsis))
Thromboembolic
Tamponade
Tension Pneumothorax
What are the presenting symptoms of cardiac arrest?
Management precedes or is concurrent to history
Cardiac Arrest is usually sudden but some symptoms that may be preceded by fatigue, fainting, blackouts, dizziness
What are the signs of cardiac arrest on physical examination?
Unconscious
Not breathing
Absent Carotid Pulses
What would we use a cardiac monitor for in cardiac arrest?
Allows classifcation of the rhythm
What bloods would you do for cardiac arrest?
ABG U&E FBC X-match Clotting Toxicology Screen Blood Glucose
What is the most important thing to remember when managing a cardiac arrest?
Safety is important
Approach any arrest scene with caution
The cause of the arrest may pose a threat
Defibrillators and oxygen are hazards
What is the Basic Life Support you give in a cardiac arrest situation?
If the arrest is witnessed and monitored, consider giving a precordial thump
Clear ans maintain the airway with head tilt, jaw thrust and chin lift
Assess breathing by look, listen and feel
If they are not breathing, give two rescue breaths
Assess circulation at carotid pulse for 10 seconds
If absent - give 30 chest compressions at around 100/min
Continue cycle of 30 chest compressions for every 2 resuce breaths
Proceed to advanced life support as soon as possible
What is a precordial thump?
Thump the sternum of the patient with the ulnar aspect of your fist
What are the advanced life support for cardiac arrest?
Attach cardiac monitor and defibrillator
Assess rhythm
What do you do if the rhythm is pulseless ventricular tachycardia or ventricular fibrillation (shockable rhythms)?
Defibrillate once whilst making sure no one is touching the patient or the bed
Resume CPR immediately for 2 minutes and then reassess rhythm and shock again if still in pulseless VT or VF
Adminster adrenaline (1 mg IV) after second defibrillation and again ever 3-5 mins
If shockable rhythm persists after 3rd shock - adminster amiodarone 300 mg IV bolus (or lidocaine)
What do you do if the rhythm is pulseless electrical activity (PEA) or asytole (non-shockable rhythms)?
CPR for 2, and then reassess rhythm
Adminster adrenaline (1 mg IV) every 3-5 mins
Atropine (3 mg IV, once only) if asystole or PEA with rate < 60 bpm
What should you remember during CPR?
Check electrodes, paddle positions and contacts
Secure airway, once secure, give continous compressions and breaths
Consider magnesium, bicarbonate and external pacing
Stop CPR and check pulse only if change in rhythm or signs of life
