cardiac arrest management Flashcards

1
Q

how do you recognise a cardiac arrest?

A
  • unresponsive patient
  • not breathing properly
  • no pulse
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2
Q

what is the in-hospital management of collapsed/sick patient?

A

collapsed/sick patient
shout for help and assess patient
signs of life
NO = call resuss team, CPR 30:2, defib if appropriate, adv life support from team
YES = asses ABCDE, oxygen, monitoring, IV access, call ressus team if app, hand over to team

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3
Q

what are shockable rhythms?

A
  • VF

- pulseless VT

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4
Q

what is the immediate post cardiac arrest treatment?

A
  • ABCDE
  • aim for O2 of 94-98
  • aim for normal CO2
  • 12 lead ECG
  • treat cause
  • targeted temperature
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5
Q

what drug is given for bradycardia?

A
  • atropine or B-stimulant eg ephedrine
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6
Q

what drug do you use for excess afterload?

A
  • vasodilators

eg HBP

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7
Q

what drug do you use to reduce afterload?

A
  • vasoconstrictor

eg septic shock

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8
Q

how is airway obstruction treated?

A
  • airway opening eg head tilt chin lift
  • simple adjuncts
  • advanced techniques eg LMA, tracheal tube
  • oxygen (increase FiO2)
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9
Q

what are the 4 categories that patients can be in?

A
  1. responsive/unresponsive = conscious/uncoscious
  2. breathing = unconscious = recovery position/help
  3. not breathing = respiratory arrest = help/ventilation
  4. no pulse = cardiac arrest = help/CPR
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10
Q

what is the diagnosis of a cardiac arrest?

A
  • unresponsive

- not breathing normally

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11
Q

how to carry out adult basic life support?

A
  • shake and shout
  • head tilt chin lift
  • assess breathing eg look for movement
  • 30 chest compressions - 5-6cm, 100-120 per minute
  • 2x rescue breath - hold nose
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12
Q

what do you do if someone is chocking?

A
  • severe?
    unconscious = start CPR
    conscious = 5 back blows, 5 abdominal thrusts
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13
Q

what is ventricular fibrillation?

A
  • a shockable rhythm
  • no recognisable QRS complexes
  • random frequency and amplitude
  • unco-ordinated electrical activity
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14
Q

what is ventricular tachycardia? VT

A
  • monomorphic VT
  • broad complex rhythm
  • rapid rate
  • constant QRS morphology
  • polymorphic VT
  • torsade de pointes
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15
Q

what is defibrillation?

A
  • use of electrical current to reset heart electrical rhythm with hope that regular rhythm will recur
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16
Q

after delivery of shock, what should you do?

A
  • CPR for 2 mins
  • deliver second shock
  • CPR for 2 mins
  • deliver 3rd shock
  • given amiodarone
  • CPR, if VF/VT persists give 1mg adrenaline IV
17
Q

what is an example of a non shockable rhythm?

A
  • asystole

- PEA

18
Q

what is asystole?

A
  • absent ventricular (QRS) activity (check electrodes)
  • P waves may persist
  • rarely a straight line trace
  • adrenaline 1mg IV as soon as possible
  • every 3-5 mins thereafter
19
Q

what is pulseless electrical activity?

A
  • clinical features of cardiac arrest
  • ECG normally associated with an output
  • exclude / treat reversible causes
  • adrenlaine 1mg IV asap
  • every 3-5 mine thereafter
20
Q

what are the potentially reversible causes of MI?

A
  • hypoxia
  • hypovolaemia
  • hypo/hyperkalaemia/metabolic
  • hypothermia
  • thrombosis - coronary pulmonary
  • tension pneumothroax
  • tamponade - cardiac
  • toxins