(!) Cardiac arrest Flashcards
Define cardiac arrest
Sudden cardiac arrest is a sudden state of circulatory failure because of loss of cardiac systolic function
result of 4 cardiac arrythmias
Pulseless Ventricular tachycardia, ventricular fibrillation, pulseless electrical activity and systole
torsade de point is a subgroup of VT
Aetiology and risk factors of Cardiac arrest
ischemic heart disease-62%, unspecified-25% and cardiomyopathy 15%
pea-heart continues having electricity but no systole
all of them resolve in no pulse-definition
pulselessVT and VF are most common
pVT and VF are the most common result from large cardiac ischemia
PEA can result of MI,/ishcemia, hypovalemia, hypoxia and PE
4T and 4H-reversible causes
Thrombosis, tension pneumo, tamponade, toxins
H-Hypoxia, hypovalemia, hypokalaemia/hyper, hypothermia
PEA and asytole are NON-shockable
risk factors:
Risk of MI-coronary artery disease, Left ventricular dysf,
Hypertrophic cardiomyopathy
Long QT syndrome (VT)
medication that prolong QT (VT)
valvular issues/rupture
smoking, eating disorders
Signs and Sx of Cardiac arrest
Unresponsive patient-ABCDE approach
absent breathing /agonal breaths
Absent circulation-puleselss in all
pulseless VT, PEA, Asytole
cardiac rythmic disturbances
identity causes-trauma-tamponade, tension pneumonia
4T and 4H-consider all and causes
murmurs-valvular issues
Pulm-pneumo, cardiac failure,
Investigations of Cardiac arrest
continuous monitoring-identify if shockable rhythm
FBC-low heamatocrit in heamorhage
Electrylytes-low/high K, any other
ABG-hypoxia, toxins, maybe resp aetiology
ECG
shockable-
pVT-Regular broad complex tachy, rabbit ear shaped (like RBB), but whole thing is fuck
VF-chaotic irregular deflections or varying amplitudes, no QRS anything
rates up to 500
Non-shock
PEA-any rhythm, even normal, but no pulse asssocaited-can have anything
asytole-flat line
Management of cardiac arrest
BLS-CAB approach
want to start CPR and give breaths as soon as possible
always give adrenaline-1mg 1in 1000
shockable-
defibrillator can help or team as fast as possible
1 shock, then 5min of CPR, reshock, adrenaline, CPR, repeat until gone
non-schock
CPR, adrenaline, repeat until gone/dead
in the meanwhile, consider the 4T and H and their treatment-
temperature management help reduce brain damage
Complications of cardiac arrest
death-very likely->85% even is hospital
Rib/sternal fracture
Anoxic brain injury-almost 50% of survivors
recurrent arrest
Liver shock
etc
