Cardiovascular Anaesthetic Emergencies

Question 1

What is asystoli?

Answer 1

Cardiac arrest associated with the absence of cardiac electrical activity.

Question 2

How is the diagnosis confirmed?

Answer 2

No electrical activity on the ECG
No palpable central pulses (carotid or femoral).
Occasionally, atrial electrical activity continues in the absence of ventricular electrical activity. This ‘P-wave asystole’ may respond to electrical pacing.

Question 3

Step 1 management of asystole

Answer 3

Perform high-quality CPR
Establish an airway and provide oxygen to keep oxygen saturation > 94%
Monitor the victim’s heart rhythm and blood pressure

Question 4

Step 2

Answer 4

If the patient is in asystole or PEA, this is NOT a shockable rhythm

Question 5

Step 3

Answer 5

Continue high-quality CPR for 2 minutes (while others are attempting to establish IV or IO access)

Question 6

Step 3

Answer 6

Give epinephrine 1 mg as soon as possible and every 3-5 minutes

Question 7

Step 5

Answer 7

After 2 minutes of CPR, check rhythm

Answer 8

If the monitor and assessment show VTach or VFib, move to VTach/VFib algorithm

Answer 9

Evaluate and treat

Answer 10

If the patient attains Return of Spontaneous Circulation (ROSC), provide