Cardiorespiratory Arrest (2*)

Question 1

What are the reversible causes of it?

Answer 1

4Hs and Ts:
• Hypoxia
• Hypovolaemia
• Hyper/hypokalaemia
• Hypothermia
• Thrombosis
• Tension pneumothorax
• Tamponade
• Toxins

Question 2

What is involved in Basic Life Support/BLS?

Answer 2

• Call 911 or Arrest team
• Start ABC assessment
‣ Airway - Head tilt and chin lift to open up airways
‣ Breathing - Ear to chest, looking towards their face. Look, listen and feel for breathing for 10 seconds. If any doubt whether they’re breathing, start chest compressions.
‣ Chest compressions - 30:2 ratio until defibrillator is available

Question 3

What is involved in Advanced Life Support/ALS?

What are the 2 shockable rhythms?
→ How is this managed?
→ What is done if rhythm still persistent after 3 shocks?

What are the 2 non-shockable rhythms?
→ How is this managed?

Answer 3

➊ ● Continue chest compressions until defibrillator is ready
● Once ready, stop chest compressions and quickly assess whether the rhythm is shockable (VT/pulseless VT) or non-shockable (asystole/pulseless electrical activity)

➋ ● Ventricular Tachycardia w/o a pulse
● Ventricular Fibrillation
→ CPR 30:2 + Unsynchronised shock
→ Give Amiodarone 300mg IV + Adrenaline 1mg IV (1:10,000) at the same time. Adrenaline can then be repeated after every other cycle following a shock (i.e. cycles 3, 5, 7 etc.).

N.B. Unsynchronised shock = Defibrillation.

➌ ● Pulseless electrical activity (normal ECG w/o a pulse)
● Asystole (no QRS complexes)
→ CPR 30:2 + IV Adrenaline 1mg