Cardiac Arrest; CPR With AED

Question 1

Five main uses for capnography in cardiac arrest

Answer 1

Verify advanced airway placement, identify advanced airway displacement, evaluate CPR quality, identify return of spontaneous circulation, determine when ROSC is unlikely

Question 2

Use of capnography in cardiac arrest after 20 minutes of advanced cardiac life support (ACLS)

Answer 2

ETCO2 levels <10 mm Hg associated with futility
ETCO2 levels >25 mm Hg associated with survival

Question 3

Monitor CPR quality

Answer 3

Higher ETCO2: higher cardiac output 12-15 mmHg (good CPR)
ETCO2 increasing: CPR is likely effective and ventilation appropriate; substantial rise can indicate ROSC
Lower ETCO2: change compressors or improve CPR quality <10 mmHg
ETCO2 decreasing: observe for chest compressor fatigue, hyperventilation, pneumothorax, airway obstruction, or advanced airway displacement

Question 4

What is defibrillation?

Answer 4

Surge of electric energy delivered to the heart

Question 5

What does defibrillation do?

Answer 5

Stops the chaotic rhythm, needs to be carried out as soon as possible (every minute of delay results in 10% reduction of survival)

Question 6

What heart rhythms are shockable?

Answer 6

Ventricular fibrillation (Vfib), ventricular tachycardia (vtach)

Question 7

What heart rhythms are not shockable?

Answer 7

Asystole, pulseless electrical activity (PEA)

Question 8

Automated external defibrillator “3Ps”

Answer 8

Power, pads, plug in

Question 9

What to do if defibrillator indicates a shock advised?

Answer 9

Continue compressions while charging, clear the patient (I’m clear, you’re clear, were all clear) VISUAL CHECK, push the shock button to deliver shock, restart CPR immediately