CPCR Flashcards
Described the adminstration of chest compressions during CPR
High-quality chest compressions should be delivered in uninterrupted cycles of 2 minutes with most patients in lateral recumbency, at a compression rate of 100–120/min and a compression depth of 1/3–1/2 the width of the chest while allowing for full elastic recoil of the chest between individual compressions.
Source - RECOVER Ch 7
Decribes the administration of ventilation during CPR
Endotracheal intubation, 10 breaths per minute, 10ml/kg inspiratory time of 1 second. If intubation not available may be able to mouth to snout with 2 breaths every 30 compressions.
How often should the person doing chest compressions be swapped during CPR
Every cycle (2 mins) - with an attempt to avoid interruptions to compressions
What does basic life support include?
Recognition of CPA, chest compressions, airway management, provision of ventilation
Equipment and supply failure/inaccessibility has been implicated delayed CPR in up to what % of CPA
18%
How often is refresher training recommended
Every six months
Source - RECOVER Ch 7
From human literature is there a benefit of having a physician (vet) as the team leader?
No
Source - RECOVER Ch 7
Describe closed loop communication?
Closed loop communication
is accomplished by a clear, directed order being
given to one team member by another, after which the
receiving team member repeats the order back to the
requestor to verify the accuracy of the receiver’s perception.
This simple technique drastically reduces medical
errors, especially in an emergency situation, due to misunderstanding
of orders and prevents the possibility of
an order not being carried out because the receiver did
not hear the request
Source - RECOVER CH 7
During CPA what should theoretically be administered first?
Chest compressions
Source - RECOVER
What are the 2 main theories of how external compressions result in flow during CPR
Thoracic pump and cardiac pump
Source - RECOVER CH 7
Described the cardiac pump therory?
The cardiac pump theory
postulates that the cardiac ventricles are directly compressed
between the sternum and the spine in patients in dorsal recumbency or between the ribs in patients
in lateral recumbency.
Appropriate in keel chested large dogs or small dogs and cats
Source - RECOVER CH 7
Described thoracic pump therory?
The thoracic pump theory proposes
that chest compressions increase overall intrathoracic
pressure, secondarily compressing the aorta and
collapsing the vena cava leading to blood flow out of the
thorax.During elastic recoil of the chest, subatmospheric
intrathoracic pressure provides a pressure gradient that
favors the flow of blood from the periphery back into
the thorax and into the lungs where oxygen and carbon
dioxide exchange occurs.
Appropriate for barrel chested large dogs
Source - RECOVER CH 7
List chest compression style and recumbancy for the following: Golden retriever English Bulldog DSH Greyhound
Golden - lateral, thoracic pump Bulldog - dorsal cardiac pump DSH - lateral circumferntial cardiac pump Greyhound - lateral thoracic pump Source - RECOVER Ch 7
In what recumbency should intubation occur during CPR?
Lateral to allow compressions to continue
Source - RECOVER Ch 7
What percentage of normal cardiac output is roughly achieveable to during CPR?
25-30%
Source - RECOVER Ch 7
Why is 10 breaths per min at 10ml/kg tidal volume with a insp time of 1 sec recommended?
Higher respiratory rates, longer inspiratory
times, and higher tidal volumes can lead to impaired
venous return due to increased mean intrathoracic pressure
as well as decreased cerebral and coronary perfusion
due to vasoconstriction, and have been documented
to lead to poorer outcomes in people during
CPR
Source - RECOVER Ch 7
Describe mouth to snout ventilation
the rescuer holds the patient’s mouth
tightly closed, places his or her mouth over the patient’s
nares making a seal with the snout, and blows
into the nares.
There have been no studies investigating the optimal compression-to-ventilation (C:V) ratio during CPR in nonintubated dogs and cats and the results of studies in other species are somewhat conflicting. The preponderance of the evidence suggests C:V ratios of at least 30:2 should be maintained.
Source - RECOVER Ch 7
How long is the intial assessment phase recommended to be when determining if a patient is in CPA?
5-10 seconds to avoid delay in CPR. There is little evidence that patients experience serious harm from CPR. If there
is any doubt as to whether the patient has experienced
CPA, CPR should be initiated immediately while further
assessment to support the diagnosis of CPA is accomplished
simultaneously by other personnel or after an
initial cycle (2 min) of CPR.
Source - RECOVER Ch 7
What is advanced life support (ALS)
Encompasses the components of CPR performed after BLS - vasopressors, positive
inotropes, and anticholinergics, correction of electrolyte
and acid-base disturbances and volume deficits,
and prompt defibrillation.
Source - RECOVER Ch 7
What aspect of epinephrine be harmful in CPR?
B agonism may increase myocardial O2 demand and exacerbate ischemia if ROSC is achieved.
Source - RECOVER Ch 7
What dose and frequency of epi administration is recommended in CPR?
0.01mg/kg every 3-5 mins IV, (every other cycle)
0.1mg/kg may be administered after prolonged CPR
Source - RECOVER Ch 7
How may vasopressin be utilised in CPR?
peripheral V1 receptor located on vascular
smooth muscle. This mechanism of action is completely
independent of the a1 effects of epinephrine. Unlike 1
receptors, V1 receptors remain responsive in the face
of an acidic pH, and vasopressin has no inotropic or
chronotropic effects that could worsen myocardial ischemia.
Literature divided however may be of benefit??
0.8U/kg IV every other cycle as a substitute for or administered with epi
Source - RECOVER Ch 7
Discuss the use of atropine in CPR
May be considered, has not been associated with worse outcomes unless at very high doses. Most likely helpful in cases of asystole or PEA caused by high vagal tone.
Dose 0.04mg/kg IV
Source - RECOVER CH 7
What is the goal of defibrillation?
Used in VF or VT
to depolarize
as many of these cells as possible, driving them into
their refractory period, and stopping the random electrical
and uncoordinated mechanical activity, that is, to
stop the ventricles from fibrillating.
Source - RECOVER Ch 7
