Code Blue Flashcards
Prior to CPR there should be ___ breaths every ___ sec
1 breath 5-6 seconds
Once CPR is in place, how often and how many breaths do you give ?
after 30 compressions you give 2 breaths
How often are breaths given to an intubated patient that is receiving CPR?
1 breath every six seconds
What color should the ETCO2 detector be?
GOLD
Which rhythms are shockable?
Vfib and pulseless VT
Which rhythms are not shockable?
asystole and PEA
Shockable rhythm cycle
Shock –> CPR 2min: IV/IO access –> shock –> CPR 2 min: epinephrine 1mg IV/IO q 3-5 min –> shock –> CPR 2 min, treat reversible causes, amiodarone: first dose 300 mg bolus, 2nd dose 150mg
How deep should compressions be?
at least 2 inches
epinephrine dose
1 mg q 3-5 min
amiodarone 1st and 2nd dose
1st –> 300 mg bolus
2nd –> 150 mg
Reversible causes 5 H’s
hypovolemia hypoxia hyper/hypokalemia hypothermia h+ ions (acidosis)
reversible causes 5 T’s
tamponade cardiac tension pneumothorax thrombosis, pulmonary thrombosis, cardiac toxins
What is ROSC?
return of spontaneous circulation
how to know ROSC was achieved (3)
- pulse and BP present
- abrupt sustained increase in PETCO2 (typically greater than 40 mmhg)
- spontaneous arterial pressure waves with intraarterial monitoring
goals post resuscitation
- optimize cardiopulmonary function
- transport to critical care
- identify and treat cause of arrest
What is the most important question to ask post ROSC?
is the patient able to follow commands?
What is done if a patient is unresponsive post ROSC?
-therapeutic hypothermia
When should therapeutic hypothermia start?
ASAP (ideally 4-6 hours post arrest)
Nursing care during hypothermia: monitor core body temp (2)
- Bladder catheter with temperature probe
- NO axillary, tympanic, and oral probes
Nursing care during hypothermia: shivering (3)
- Increases oxygen consumption
- Increases body temperature
- Control with IV sedatives, analgesics, neuromuscular blockade medications
Nursing care during hypothermia (4)
- monitor core body temp
- shivering
- hyperglycemia management
- drugs can mask seizure activity: continuous EEG
Bradycardia algorithm –> what question do you ask yourself?
Are they symptomatic?
Bradycardia algorithm –> what do you do if the pt is symptomatic?
atropine 1mg q 3-5 min max 3mg
Bradycardia algorithm –> what do you do if pt is unresponsive to atropine? (3)
- transcutaneous pacing
- dopamine IV 5-20 mcg/kg/ min
- epinephrine 2-10mcg/min
Tachycardia with a pulse algorithm if pt is symptomatic what do you do?
cardio version
Tachycardia with a pulse algorithm –> if pt is not symptomatic, but has a wide QRS what do you do?
adenosine 6mg followed my 20 ml NS flush
tachycardia with a pulse algorithm –> what do you do if pt is not symptomatic and the QRS is normal?
vagal maneuvers
