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CRS2 > CPCR > Flashcards

CPCR Flashcards

1
Q

Warning signs of cardiopulmonary arrest?

A
  • Changes in the respiratory rate, depth, or pattern
  • Weak or irregular pulse
  • Bradycardia
  • Hypotension
  • Unexplained changes in the depth of anaesthesia
    • Can appear lighter especially nystagmus
  • Cyanosis
  • Hypothermia
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2
Q

Diagnosis of cardiopulmonary arrest?

A
  1. Absence of ventilation and/or cyanosis
  2. Absence of a palpable pulse
  3. Absence of heart sounds
  4. Dilatation of the pupils
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3
Q

When will pulse disappear?

A

Pulse will disappear when systolic pressure < 60 mm Hg

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4
Q

When will heart sounds disappear?

A

Heart sounds will disappear when systolic pressure < 50 mm Hg

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5
Q

Reasons for cardiac arrest in sick animals?

A
  • Cardiovascular collapse due to hypovolaemia
    • GDV
    • Colic
    • Pancreatitis
    • Pyometra
  • Severe electrolyte derangements (esp potassium)
    • GDV – dogs
    • Urethral obstruction
    • Ruptured bladder – foals, cats
  • Small animals with severe underlying cardiac disease
  • Trauma
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6
Q

Reasons for cardiac or respiratory arrest in healthy animals?

A
  • Neonates at term due to dystocia/no drive to breathe
    • RESPIRATORY ARREST
  • During or after anaesthesia
    • VAGAL STIMULATION
    • PROBLEMS WITH BREATHING CIRCUIT
    • DRUG OVERDOSE
    • AT EXTUBATION
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7
Q

What should your focus be with respiratory arrest?

A
  • A, B, C, D (drugs) Or D, A, B, C
  • If not intubated just start chest compressions
  • But try intubate if you can
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8
Q

Which cardiac arrest cases should you NOT attempt resuscitation on?

A
  • Adult horses with colic – esp if in dorsal recumbency under anaesthesia (We cannot do compressions on these)
  • Small animals with severe underlying cardiac disease
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9
Q

Recommendations for compressions?

A
  • Uninterrupted cycles of 2 minutes with patients in lateral recumbency
  • Compression rate of 100–120/min
  • Compression depth of 1/3–1/2 the width of the chest
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10
Q

What type of compression should be carried out in animals over 10kg?

A

Thoracic pump

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11
Q

What type of compression should be carried out in animals under 10kg?

A

Cardiac pump

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12
Q

How is CPCR carried out in an adult horse?

A
  • Lateral recumbency
  • Stay on dorsal side for safety
  • Need LOTS of people
  • Throw entire weight onto dorsal side of the thorax
  • Need to swop in every 2 minutes
  • AIM highest compression rate you can
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13
Q

Recommended ventilation rate for CPCR?

A

ventilation rate of approximately 10 breaths/min

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14
Q

Recommended rate of compressions to breaths if doing both together?

A

Repeated rounds of 30 chest compressions followed by 2 rapid breaths in cycles of 2 minutes

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15
Q

Best route for administration of drugs during CPR?

A

Intravenous (IV)-Preferred route.

(Follow each drug with a bolus of saline or water for injection to encourage transport towards the heart)

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16
Q

Possible routes of administration of drugs during CPR?

A
  1. Intravenous (IV)
  2. Intratracheal (IT)
  3. Intraosseous (IO) or Intramedullary
  4. Intracardiac (IC)
17
Q

Advantages of Intratracheal administration of drugs during CPR?

A

accessibility, close proximity to the left heart via PVs, and large surface area for drug absorption

18
Q

Disadvantages of Intratracheal administration of drugs during CPR?

A

Increased dose required for many drugs (10 times that given IV), decreased efficacy in the presence of pulmonary disease, and some drugs cannot be given IT as irritant (ie, sodium bicarbonate).

19
Q

What does electrical defibrillation do?

A
  • Convert chaotic electrical activity of the fibrillating heart to sinus rhythm
  • Discharge of an electrical current through the myocardium aims to allow SA node to resume its normal rhythm
  • Perform as soon as ventricular fibrillation diagnosed
20
Q

What could you try in ventricular fibrillation if there is no electrical defibrillator available?

A
    • precordial thump may be effective
      • Sharp blow with a clenched fist over the precordium
21
Q

What follow-up measures should be implemented following successful resuscitation?

A
  • Continue IPPV until patient breathing spontaneously
  • Correct Acidosis
  • Cardiac Support
  • Fluid Therapy
  • Minimise cerebral oedema
  • Assess neurological function
  • Monitor and maintain urinary output at 1-2ml/kg/hr.
  • Maintain body temperature

CRS2 (64 decks)

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