Cardiopulmonary Resuscitation Flashcards
what is cardiopulmonary arrest (CPA)
sudden cessation of spontaneous and effective ventilation and circulation lack of systemic perfusion
what are some examples of CPA
hypovolemia, metabolic derrangemnt, electrolyte abnormalities, cardiac dx, brain injury, drug overdose, pulmonary dx, anemia
what is the goal of cardiopulmonary resuscitation
the return of spontaneous circulation
what things may you need in a resuscitation area
crash cart, venous access, airway management, drug therapy, doppler, oxygen, EKG, defibrillator
what drugs may in used for drug therapy with this
Epinephrine, atropine, diazepam, lidocaine, reversal agent
if airway is obscured what do we do
use a suction device
how can we verify airway intubation
proper chest movement, direct visualization, palpation, ETCO2
what patients cannot be intubated orotracheally
foreign bodies, pharyngeal swelling/mass, trauma, dental fixation
what we do use to ventilate a patient with
100% oxygen
what is the goal of cardiac compression
to pump blood to the lungs for as exchange -> systemic arterial blood flow, or to maximize blood flow to the coronary and cerebral vascular beds
what are the 2 theories of chest compression
thoracic pump, and cardiac pump
when do we use the thoracic pump
larger patients - over 10 kg
when do we use the cardiac pump
smaller patients, keel-chested dogs, flat chested dogs
what is the thoracic pump theory for circulation
overall increase in intrathoracic pressure
- promotes blood flow from the aorta into the systemic circulation
- blood is suctioned into the vena cava during recoil phase
what is the thoracic pump theory for chest compression
the heart acts a channel (blood flows passively through the heart)
-use the widest portion of the thorax
what is the cardiac pump theory for chest compression
direct compression of the heart, lateral recumbency, directly over the heart
what is interposed abdominal compression (3rd way/ 2ppl)
abdomen is compressed during relaxation phase of chest compression, increased effectiveness venous return and forward flow
when do we not use interposed abdominal compressison
known abdominal trauma, hemoperitoneum, recent abd sx
what are the current recommendations for chest compressions
lateral recumbency, 100-120 bpm, 1/3 to 1/2 chest diameter, 2 min cycle
what is internal compression direct internal cardiac compression
greater CO + BP, better perfusion, direct assess to ventricles, aortic inclusion
when might we do a direct interal cardiac compresion
very large dog, rib fractures, severe plerual effusion, pneumothorax, cardiac tamponade, when ROSC is not achieved in approx 5 min.
what should we do for BLS
ABC assessment (don't do if patient is apneic) -> CPR Chest compression, intubate and ventilate full 2 min cycle without interruptions. Connect EKG and Capnograph
what fluids do we use
crystal/colloid fluid therapy
what is a intracardiac injection not recommended
risk of lacerating lung tissues, coronary vasculature, arrhymias
what should we know about atropine
vagolytic, vagal arrests, V/D, urinating/ defecating, laryngeal manipulation
what should we know about epinephine
vasoconstriction ino/chronotropic low dose every other compression cycle high dose with prolonged CPR >10 min may become ineffective in an acidic environment
what should we know about Lidocaine and Amiodarone
antiarrhythmic, (Amiodarone - do not use to IT admin), indicated for prolonged CPR, reversal agents
what is electrical defibrillation
application of an electrical shock to terminate a cardiac arrhythmia, global depolarization of myocadium
what is monophasic defibrillation
current is delievered in one direction between paddles
what is biphasic defibrillation
positive currect followed by a negative currect, lower energy setting -> more efficient and les myocardial damage
what is the setting for monophasic defibrillator
4-6J/kg with monophasic defibrillator
what is the setting for biphasic defibrillator
2-4J/kg with biphasic defibrillator
what should we do after each attempt with electrical defibrillation
increase energy by 50% with each attempt, up to 10 J/kg
what is mechanical defibrillation
precordial thump, generate approx 5- 10 J of energy
