Cardiorespiratory Arrest Flashcards
What is the definition of a cardiorespiratory arrest
- unresponsive and not breathing
What basic life support do you do in a cardiorespiratory arrest
- Airway - head tilt and chin lift
- Breathing - look, listen and feel for breathing for no more than 10 seconds, if there is any doubt whether breathing is normal proceed to chest compressions
- Chest compressions
Describe how chest compressions should be
- rate of 100-120bpm
- compress sternum 5-6cm
- after 30 compressions give 2 rescue breaths
- continue until a defibrillator is available
What happens in advanced life support
- continue chest compressions while preparing for defibrillation/moniotring
- stop chest compressions <5s to assess rhythm
- shockable - VF/pulselessness VT
- non-shockable - systole/pulseless electrical activity (PEA)
What happens if the defibrillator detects a shockable rhythm
- 1 shock
- CPR resumed immediately
- reassess pulse/rhythm after 2 minutes of CPR
- repeat if shockable rhythm remains
- give drugs after 3 shocks
What happens if there is a non shockable rhythm
- Continue CPR 30:2
- Obtain IV access and secure airway
- Once airway secure switch to continuous compressions and ventilation
- Give adrenaline 1mg IV
- Check rhythm every 2min
- Consider reversible causes (4Hs and 4Ts):
What are the reversible causes of cardiorespiratory arrest
4Hs, and 4Ts
- hypoxia
- hypovolaemia
- hyper/hypokalaemia
- hypothermia
- Thrombosis
- Tension pneumothorax
- Tamponade
- Toxins
What drugs should you give in a cardiorespiratory arrest
- Give adrenaline 1mg IV every 3-5mins for both shockable (after 3rd shock) and non-shockable rhythms
- In shockable rhythms give amiodarone 300mg IV after 3 shocks + consider further 150mg IV after 5 shocks; lidocaine is an alternative
What does adrenaline do
- increase heart rate
What does amiodarone do
treat arrhythmias (VT and VF)
What does lidocaine do
- treat arrhythmias (VT and VF) by decreasing electrical activity and heart rate
What does magnesium do
- low levels can lead to arrhythmia
- magnesium sulphate can correct it
What are the complications of cardiorespiratory arrest
- ventricular fibrillation
- ventricular tachycardia
what are predictors for poor outcome of cardiorespiratory arrest
- older age
- cardiac arrest occurring at home
- initial rhythm other than ventricular fibrillation/tachycardia
- longer duration of no flow
- longer duration of low flow
- administration of adrenaline
- Glasgow Coma Scale moor response 1
- lower pH
- low partial pressure of carbon dioxide
Who can give a DNAR decision
Only a doctor
- you cannot make a DNAR decision yourself but you can request that your doctor issues one
- it is not legally binding
