Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emergency Medicine Review > Cardiopulmonary Arrest > Flashcards

Cardiopulmonary Arrest Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Pediatric Cardiac Arrest Algorithm

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which medication is sometimes mixed with nonmedically used narcotics, with overdose cases presenting as opiate ingestion unresponsive to naloxone?

A

Xylazine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rapid Review: Pediatric Advanced Life Support: Pulseless Arrest

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Appropriate Ventilation Rate in Pediatric Patient’s when providing ventilations

A

When an advanced airway is necessary and in place, the appropriate respiratory rate should be relatively close to the patient’s normal respiratory rate to provide adequate oxygenation and ventilation. A respiratory rate of 30–60 breaths/min is best for children < 6 months, 24–30 breaths/min for children 6 months to 1 year, 20–30 breaths/min for 1–5 years, and 12–20 breaths/min for > 5 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Neonatal Resuscitation Algorithm

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the appropriate FiO2 when providing positive pressure ventilation in a newborn resuscitation

A

Caution is advised to avoid hyperoxia by starting with an FiO2 of 21% for term infants and 30% for preterm infants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The first step to take in newborns who are gasping, apneic, or have a heart rate < 100 beats per minute is

A

positive pressure ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the complications of hypothermia in extremely premature infants?

A

Intraventricular hemorrhage, pulmonary hemorrhage, metabolic acidosis, and hypoglycemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rapid Review: Neonatal Resuscitation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What action is most critical to the initial minutes of the resuscitation?

A

the performance of chest compressions and ventilation through a bag-mask device.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What medications can be administered through an endotracheal tube?

A

Naloxone, atropine, vasopressin, epinephrine, and lidocaine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rapid Review: Pediatric Cardiopulmonary Resuscitation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is most important in positively affecting the chance of survival in cardiac arrest in the pre-hospital setting?

A

Adequate compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The most important aspect contributing to improved survival in out-of-hospital cardiac arrest is high-quality cardiopulmonary resuscitation, particularly compressions.

A

The most important aspect contributing to improved survival in out-of-hospital cardiac arrest is high-quality cardiopulmonary resuscitation, particularly compressions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Five Critical Components of High Quality CPR

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What rate of compressions is recommended in adult patients?

A

100-120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rapid Review: Adult Cardiopulmonary Resuscitation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the 11 Common Reversible Causes of PEA (the 11 H’s and T’s)

A
  1. Hypovolemia
  2. Hypoxia
  3. Hypercarbia
  4. Hypothermia
  5. Hyperkalemia
  6. Hydrogen ion (Acidosis)
  7. Tension Pneumothorax
  8. pericardial Tamponade
  9. Thrombosis (Ex: PE or MI)
  10. Trauma
  11. Toxic Overdose (Ex: BB or TCA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hyperkalemia is a metabolic derangement that can lead to malignant dysrhythmias such as ventricular tachycardia. This may be heralded by changes such as

A

peaked T waves, QRS widening, loss of P wave, and ultimately a sinusoidal waveform morphology on ECG or the cardiac monitor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be given if hyperkalemia is the suspected cause of PEA

A

calcium gluconate or calcium chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is calcium given in hyperkalemia

A

cardiac membrane stabilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What medical therapies are used for hyperkalemia

A

Medical therapies used for hyperkalemia include nebulized albuterol, sodium bicarbonate, insulin with dextrose, diuretics (e.g., furosemide), Lokelma, calcium and hemodialysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Rapid Review: Hyperkalemia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

An epsilon wave (small positive deflection at the QRS terminus) on ECG is pathognomonic for what cardiac condition?

A

Arrhythmogenic right ventricular dysplasia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Causes of PEA Chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Targeted Temperature management Chart

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What ECG finding can be found in patients with severe hypothermia?

A

Osborn waves or J waves, a deflection at the J point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Please Interpret the EKG

A

The EKG is consistent with an anterior wall myocardial infarction with ST elevations in leads V1–V5, I, aVL, and reciprocal changes in II, III, and aVF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Rapid Review: Targeted Temperature Management

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Please Interpret the EKG

A

Asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pediatric Epinephrine Dose in Cardiac Arrest

A

Epinephrine can be given via IV or IO at 0.01 mg/kg ( 0.1 mL/kg of 1:10,000 concentration)

32
Q

Pediatric defibrillation dose in cardiac arrest

A

The initial defibrillation dose is 2 J/kg, followed by 4 J/kg, up to a maximum dose of 10 J/kg.

33
Q

Asystole Chart

A
34
Q

Pediatric Epinephrine Dosing Chart

A
35
Q

What is the difference in treatment between asystole and pulseless electrical activity?

A

None

36
Q

What is the most common cause of sudden cardiac arrest

A

Both inside and outside the hospital, sudden cardiac arrest in an adult is attributable to primary cardiac disease in the majority of cases. Among the cardiac causes of arrest, acute coronary syndromes are the most common. Cardiac arrest due to acute coronary syndromes is most commonly present in those with ventricular tachycardia or ventricular fibrillation due to the direct ischemic effects on the myocardium.

37
Q

Rapid Review: Epinephrine in Pediatric Advanced Life Support

A
38
Q

What increases the likelihood of ventricular tachycardia

A
39
Q

Please Interpret the EKG

A

Ventricular Tachycardia

40
Q

What is the most common cause of cardiac arrest in pediatric patients?

A

Hypoxia

41
Q

Rapid Review: Ventricular Tachycardia

A
42
Q

Hyperkalemia causing pulseless electrical activity is treated with

A

calcium chloride, which will stabilize the cardiac membrane.

43
Q

What is the treatment for this in cardiac arrest

A

Pericardiocentesis

44
Q

What is the treatment for torsades de pointes?

A

Magnesium 1–2 g intravenous.

45
Q

Rapid Review: Adult Pulseless Electrical Activity (PEA) Arrest

A
46
Q

What is this

A

Cardiac Tamponade

47
Q

Please Interpret the EKG

A

Ventricular Tachycardia

48
Q

Narrow complex PEA is considered to be secondary to

A

Narrow complex PEA is considered to be secondary to mechanical pathology, including cardiac tamponade, tension pneumothorax, pulmonary embolism, or hypovolemia. As in the case noted above, ultrasound can help delineate the patient’s pathology. Some cases may require the emergency clinician to perform invasive procedures to reverse the underlying pathology

49
Q

Wide complex PEA is considered to be secondary to

A

Wide complex PEA is considered to be the result of a metabolic abnormality with a differential diagnosis of hyperkalemia, severe acidosis, myocardial infarction, and sodium channel blocker overdose.

50
Q

What percentage of cardiac arrests have an initial rhythm of pulseless electrical activity?

A

About one-third of cardiac arrests.

51
Q

Targeted temperature management facts

A

Therapeutic hypothermia should only be undertaken in patients with ROSC who are comatose (i.e., lacking meaningful response to verbal commands). The goal is to cool the patient to 32–36°C as rapidly as possible and maintain therapeutic hypothermia for at least 24 hours. Another option is to institute targeted normothermia at 36–37.5°C. There are a number of commercially available devices for cooling patients, but none have been proven to be superior to ice and cold intravenous fluids. It is vital to place a bladder or esophageal temperature probe for continuous temperature monitoring. While cooling is initiated, an investigation should take place to determine the cause of the arrest. This includes a 12-lead ECG looking for myocardial infarction, which is both a common cause of arrest and one that is amenable to intervention (thrombolytics or percutaneous coronary intervention).

52
Q

What are some relative contraindications to implementation of therapeutic hypothermia after ventricular fibrillation arrest and return of spontaneous circulation?

A

Relative contraindications include severe cardiogenic shock, life-threatening dysrhythmias, and uncontrolled bleeding.

53
Q

Propranolol overdoses in children can present with

A

profound hypoglycemia, seizures, coma, and dysrhythmia

54
Q

Propranolol overdose

A

Propranolol overdoses in children can present with profound hypoglycemia, seizures, coma, and dysrhythmia, as seen in this patient. Not all children with a propranolol overdose become symptomatic, and those who do typically develop symptoms within 4–6 hours. The profound bradycardia and hypotension are due to impaired atrioventricular conduction, which can manifest on ECG as a long PR interval and a widened QRS complex. This patient’s QRS complex is beginning to widen

55
Q

Pediatric Bradycardia

A

The American Heart Association recommends that for children with bradycardia and a pulse, the initial treatment is to assist breathing and identify the rhythm. Children with hypotension, shock, or abnormal mental status caused by profound bradycardia who do not respond when adequate oxygenation is provided should be treated with chest compressions when their heart rate is < 60 bpm. Additional treatment for bradycardia resulting in shock or hypotension consists of epinephrine, atropine, and then transthoracic pacing.

56
Q

Seizures in children with a beta-adrenergic antagonist overdose are best treated by

A

Seizures in children with a beta-adrenergic antagonist overdose are best treated by working to restore circulation, not with anticonvulsant medications.

57
Q

Treatment of beta adrenergic antagonist overdose

A

For those with mild symptoms of beta-adrenergic antagonist overdose, treatment is stepwise with IV fluids, atropine, glucagon, calcium, high-dose insulin with dextrose, vasopressors, and finally lipid emulsion therapy. A stepwise approach is not possible in critically ill patients like this one. These measures should be initiated but performed simultaneously when possible, and if they fail to produce the desired result, extracorporeal membrane oxygenation should be considered.

58
Q

Pediatric Bradycardia Algorithm

A
59
Q

Which underlying previously unknown ECG pattern may be revealed in a patient with a propranolol overdose?

A

Brugada pattern.

60
Q

Rapid Review: Pediatric Advanced Life Support: Bradycardia

A
61
Q

Asystole is usually a secondary event resulting from

A

Asystole is usually a secondary event resulting from prolonged ventricular fibrillation, pulseless electrical activity, hypoxia, and acidosis.

62
Q

What initial medication should be given if you recognize a patient to be in torsades de pointes?

A

Magnesium sulfate.

63
Q

Rapid Review: Asystole

A
64
Q

Narrow Complex PEA Rapid Review

A

Narrow-complex rhythms are usually secondary to mechanical causes and usually result in pseudo-PEA, a severe shock state in which the heart continues to pump but does not create a palpable pulse. Narrow-complex PEA is most often associated with mechanical problems causing right ventricular inflow or outflow obstruction, including cardiac tamponade, tension pneumothorax, and pulmonary embolism. These etiologies are often identifiable on ultrasonography and are managed with aggressive fluid resuscitation as well as cause-specific treatments including pericardiocentesis, needle decompression, and thrombolysis, respectively.

65
Q

Wide Complex PEA Rapid Review

A

Wide-complex PEA tends to be true electromechanical dissociation (i.e., true PEA) secondary to metabolic problems like hyperkalemia and sodium channel blocker toxicity, in addition to acute myocardial infarction with pump failure. Treatment for wide-complex PEA should include IV calcium chloride as well as sodium bicarbonate

66
Q

Littman Algorithm for PEA

A
67
Q

What bedside echocardiographic finding is classically seen with pseudo-PEA (i.e., narrow-complex PEA)?

A

Hyperdynamic left ventricle.

68
Q

Contraindications to therapeutic hypothermia

A

The only absolute contraindication is an advance directive precluding treatment. Hypothermia impairs coagulation, and active, noncompressible bleeding is a relative contraindication for targeted temperature management in the range of 32–34°C. However, maintaining a target temperature of 36°C in those with coagulopathy or active noncompressible bleeding is acceptable. Other complications of hypothermia include dysrhythmia, hyperglycemia, and an increased risk of infection.

69
Q

What are the targeted temperature management guidelines for pediatric patients?

A

Target the temperature to 32–34°C for 2 days followed by 3 days of normothermia 36–37.5°C or target the temperature to 36–37.5°C for 5 days.

70
Q

What is the most common rhythm identified in pediatric cardiac arrest

A

Asystole is the most common rhythm identified in pediatric cardiac arrest, with respiratory etiologies (e.g., respiratory failure, drowning, asphyxiation) representing the most common antecedents.

71
Q

How might a child’s weight be estimated?

A

Parental estimates, a Broselow-Luten tape measure, or upper extremity circumference (i.e., using a Mercy TAPE).

72
Q

Adult Cardiac Arrest Algorithm

A
73
Q

What coronary artery anomaly is most associated with sudden cardiac death?

A

Anomalous left coronary artery from pulmonary artery syndrome.

74
Q

For which etiology of cardiac arrest does induced hypothermia carry the best improvement in survival with good neurologic outcome?

A

Shockable rhythms such as ventricular fibrillation or ventricular tachycardia

75
Q

What are the two shockable rhythms?

A

Ventricular fibrillation and pulseless ventricular tachycardia.

Emergency Medicine Review (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions