Cardiopulmonary Resuscitation Flashcards
What is the underlying cause of cardiac arrest?
Inadequate cardiac oxygenation
What are some different mechanisms of cardiac arrest?
Arrhythmia, pulmonary/airway dysfuntion, anesthesia, electrolyte abnormalities, severe trauma, intracranial dz, sepsis, multiple organ dysfunction
What is the goal of CPR?
To maximize myocardial and cerebral oxygenation
Why do you have a better success rate of bringing a patient back with CPR when under anesthesia?
Because patient is actively hooked up to monitors, they are already intubated and they already have a catheter in.
What type of communication is important in successful CPR?
Closed loop communication
How long is one CPR cycle?
1 cycle=2 minutes
How many compressions/minute should be done and to what depth?
100-120/min at 1/3-1/2 chest width
How many breaths per minute is important in adequate ventilation?
10/min
If your patient is is Vfib-how would you respond?
Continue giving CPR, charge defibrillator, give 1 shock, resume CPR immediately for 1 cycle before checking ECG
If your patient was in asystole/PEA how would you respond?
Resume CPR for 1 cycle, low dose epi/vasopressin every 5 minutes, consider atropine if increased vagal tone
What is the most important part of BLS?
Chest compressions
What % of cardiac output will you achieve during CPR?
25-30%
What is the difference of the cardiac and thoracic pump theory?
Cardiac pump theory: direct compression of the ventricles (small patients)
Thoracic pump theory: Compressions cause increase in intrathoracic pressure (larger patients)
Why is it important that you make sure your hands come off the chest for a split second during CPR?
To allow for full thoracic recoil of the ventricles
T/F: Internal cardiac massage is indicated when there is pericardial effusion/pleural space disease present?
TRUE
What type of bag is used during ventilation of the patient during BLS?
Ambu bag
What should your end tidal CO2 be during CPR and what would it indicate if under the number?
15-20 mmHg- if it is lower, then you are not providing adequate cardiac compressions
What device is used in LA that creates negative intrathoracic pressure to increase venous return?
Impendance threshold device-prevents O2 from entering lungs during chest recoil
What are the three main arrest rhythms?
Asystole, pulseless electrical activity or V-fib/pulseless ventricular tachycardia
If asystole/PEA is present how would your respond?
Use epi/vasopressin. DO NOT use defibrillation-not a shockable rhythm.
What are examples of shockable rhythms?
Vfib/Pulseless Vtach
What does a defibrillator do?
Depolarizes the ventricular myocardial cells forcing refractory period.
What position should the patient be in for defibrillator?
The patient should be in dorsal recumbency with paddles placed in costochondral junction
When you have a patient with torsades de pointes, what drug should be administered?
Magnesium
What are the reversal agents for opioids, a-2 agonists and benzodiazepines?
Opioids: Naloxone
A-2 agonist: Atipamezole
Benzodiazepine: Flumazenil
What is a common electrolyte abnormality seen in blocked tom cats?
Hyperkalemia
What drug should be administered if you have a patient under prolonged CPR (over 10-15 minutes)?
Sodium Bicarbonate
What three drugs can be administered through intratracheal routes?
Epi, atropine and vasopressin
T/F: If your patient is under extreme stress and nothing else is working during CPR-you can inject drugs into the myocardium.
FALSE. Never inject drugs into the myocardium
