Cardiac Arrest, Diabetes, Shock, ACS/STEMI, Stroke Flashcards
Why such emphasis on cardiac arrest
System stress test
Foundation for creation of EMS
Rate of OHCA
0.5-1 events for every 1,000 people per year
Most important factors determining outcome from OCHA
Systems of community care
What did the PAD trial show
Survival in OHCA doubles at sites with AEDs
Decrease in survival for vfib every minute without shock
7-10% for each minute that passes
Who runs cardiac arrest in pit crew model?
Compressor, group works around compressor to optimize flow time
Shock first or compressions first?
No clinical significant difference between the two
If VF short duration, i.e witnessed, shock first preferred
AIRWAYS trial said
No difference in survival b/w Igel vs ETT
PART Trial
King LT vs ETI - favored King airway overall but very low intubation success rate
ALPS trial
No difference between all 3 all comers
5% improvement in witnessed arrests
PARAMEDIC 2 Trial
Eli higher rate of ROSC and 30 day survival but no favorable neurologic outcome
IM glutton time to correct sugar
8-21 minutes
vs 8 minutes for IV sugar
BP formula
CO x PVR
CO formula
SV x HR
Marker of perfusion in a fixed ventilatory rate
Waveform capnography
Challenges to prehospital vasopressor use
Lack of reliable weight based dosing
Pumps vs drips
Pediatric shock differences
Low cardiac output and high SVR (cold shock)
Higher fluid volumes (60 cc/kg)
Epi first line to counter low CO
Up to 40% of CO in beds due to work of breathing
Maximum ASA survival benefit
Within 4 hours of MI
Who is less likely to get ASA
Women (2.8 fewer women than men)
(45% of eligible patients get ASA)
LAPSS
Cincy +
Age greater than 45
No hx of seizures
Symptoms less than 24 hours
Baseline function not bedridden or wheelchair
Blood glucose 60-400
Order in seizure mgmt
- Immediate supportive care
- Give bentos (even if sugar low)
- Treat easily reversible causes
- Evaluate for suspected underlying causes
Order of hyper K changes in EKGs
- Peaked T waves
- QR interval lengthening
- Widening QRS
