Cardiac Arrest (Adult) Flashcards
How many ventilations do we aim to achieve in 60 seconds during CPR
6-10
Where should the pads be placed when in the Antero-lateral configuration
Anterior or sternal pad:
Right upper sternum below the clavicle
Apical or lateral pad:
left mid-axillary line / level with V6 ECG and clear of any breast tissue
How far away should a Pad be placed from a medically implanted device
8cm
Where should the pads be placed when in the Antero-posterior configuration
Anterior:
Over the patients left precordium
Posterior:
Posterior to heart but below left scapula
When should pad placement be changed
Refractory VF which persists after 3 shocks
What are the reversible causes for cardiac arrest
H:
Hypoxia
Hypovaloaemia
Hypokalaemia
Hyper/Hypothermia
T:
Tension Pneumo
Tamponade
Toxin
Thrombosis
Considerations in a hypothermic arrest
<30 degrees celcius:
Maximum of three shocks
Withhold all drugs
30-35 degrees celcius:
Double drug intervals
Considerations in an asthmatic arrest
Small tidal volumes and slow ventilations to allow for adequate chest deflation
Severe gas trapping may be relieved with a period of apnoea up to 30 seconds (disconnect BVM from advanced airway)
Consideration for ETT in an asthmatic arrest
mitigates risk of gastric inflation but increases risk of lung hyper-inflation
Considerations in a obstetric arrest
Displacement of the uterus to the left to minimise aorto-caval compression
OR
15-30 degree left tilt
At what point in a pregnancy should we alter our cardiac arrest protocol
After 20 weeks
In an obstetric arrest, where should we place the IO
Above the diaphgram
Two considerations for a bariatric arrest
Increased pressure during ventilation may be required
Leakage with an SGA so early ETT
ECC should not be paused any longer than _____?
10 seconds
Which patients will benefit most from transport under ECC
Premorbid independence
ECC within 10 mins
Initial rhythm of VT or VF
Intermittent but unsustained ROSC
At what point can a traumatic arrest be ceased?
10 minutes
At what point can a non-traumatic arrest be ceased?
10 minutes if persistent asystole
30 minutes for all other scenarios
What Joulage do we shock an adult?
200J
When is Adrenaline given in an adult arrest?
1mg
non-shockable - ASAP
Shockable - after second shock
When is Amiodarone given in an adult arrest?
300mg after 3rd shock
What is our CPRIC protocol in an adult?
IV/IO Midazolam
1-2mg
Repeat every 5 mins to 5mg max
What 5 interventions will occur simultaneously in an adult traumatic arrest?
Assess rhythm
Control Haemorrhage
Control Airway
Bi-lateral chest decompression
Fluid resuscitation
Fluid resuscitation in an Adult cardiac arrest
250mL aliquots up to 30mL/kg
