CPCR - BLS & ALS Flashcards by Jasmine Lelliott

What does CPCR stand for?

Cardio Pulmonary Cerebral Resuscitation

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What are we aiming to perfuse when performing CPCR?

Heart, lungs, brain

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What does ROSC stand for?

Return Of Sponatneous Circulation

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What is respiratory arrest?

The patient is not breathing/apnoea

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What is cardiac arrest/cardio-pulmonary arrest?

The patient has no cardiac output
They will also not be breathing

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What patients are most at risk? (high risk)

Trauma
Systemically unwell
Paediactrics
Geriatrics
Iatrogenic (anaestheitic overdose)
Recently arrested

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What can happen if a patient becomes hypoxic?

They could go into cardiac arrest

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Iatrogenic patients are at even more risk than others

True

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Why could patients coming in for routine procedures be more at risk?

Potentially less monitoring

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When do we start CPCR?

As soon as we think the patient has crashed

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What can respiratory arrest lead to?

Cardiac arrest

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What could you do before starting compressions?

Feel for an apex beat if cannot feel pulse

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Who can help with performing CPCR?

Anyone, someone trained in CPCR is ideal

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Do you need guidance from a vet to perform BLS?

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What does BLS stand for?

Basic Life Support

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What is included in BLS?

CPCR cycle
Oxygen therapy

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What is involved in ALS?

Drug therapy
Fluid therapy
Cardioversion

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What is cardioversion?

Defibrilation

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What postion should the patient be in for cardiac compressions?

Right lateral recumbency

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What side of the patient should the compressor be on?

Dorsal side

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What rate should compressions be performed at?

100-120 compressions per minute

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At what depth should you compress the chest?

50% - 2/3 the width/depth of the thorax

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What chambers allow blood to pump around the body?

Left ventricle (this is slightly to the left)

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What is cardiac pump?

Compression of the thorax directly over the heart

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How would you place your hands for a cardiac pump in a cat/small dog?

Both hands, thumbs over thorax directly over heart

How do you perform thoracic pump?

In lateral recumbency, over the widest point of the thorax The dorsal, caudal thorax or ocer the xiphisternum

Can nurses perform direct internal cardiac compressions?

Yes however they cannot open the chest

How much should you squeeze the ventricles when performing direct internal cardiac compressions?

50%

At what rate should you peform IPPV?

10-12 breaths per minute 1 breath every 6 seconds

What are the benefits of using an ambu bag over a circuit for ventilation?

Generally easier to use Come in different sizes 250ml would ventilalte any patient Don't have to leak test circuit

What can you use to oxygenate?

Room air or 100% oxygen

What should be in the airway access drawer of the crash trolley?

ET tubes, cuffed and whole sizes Laryngoscope ET tube tie Cuff inflator Guide wire Plain gauze swabs Intubeaze Dog urinary catheter (8fg) with size 3 ET tube connector

What is included in the IV access drawer?

Various sizes IV/IO connectors, aspecitally primed Tape Scissors Cut down kit Scalpel blade size 11

What does the phrase 'cut down' mean?

Where the vein is exposed surgically and a catheter is inserted into the vein under direct vision

What length catheter is ideal for quick IV access?

Short for quick infusion of fluids

What is a stab incision when placing an IV catheter?

What should be inside the ventilation drawer?

paediactric ambu bag with capnograph connector and flow regulator adult ambu bag with capnograph and flow regulator in-line capnograph

What is a low dose of adrenaline?

1:10.000 (0.1mg/ml)

What is a high dose of adrenaline?

1:10000 (1mg/ml)

What else can be found in the drug drawer?

Atropine 0.9NaCl pre-drawn up in 10ml syringes pre-prepared syringes (needles attached to syringes) ECG pads

Why would you use adrenaline?

If patient is in asytole Positive inotrope Positive chronotrope Potent vasopressor Profound vasocontriction Increases systemic vasicar resistance Increases mean arterial pressure

How can adrenaline be given?

IV through central catheter, IO or intra-tracheal DO NOT GIVE INTRA-CARDIAC

What does inotrope mean?

Increases contractility

What does chronotrope mean?

Affects rate of contractility

When would you give atropine?

When they arrest When they are profoundly bradycardiac when in asystole

What is atropine?

Positive chronotrope Increases rate the heat contracts

How do you give atropine?

IV, IO or intra-tracheal DO NOT GIVE INTRA-CARDIAC

What is Amiodardone?

Anti-dysrhthmic second line for prolong ventricular tachycardia and fibrilation

What can amiodarone cause?

Anaphylaxis!

What does glucose treat?

hypo-glucaemia

How is glucose given?

IV (through central line), IO or trans-mucosally DO NOT GIVE INTRA-CARDIAC

When would you give propofol?

When patient is in respiratory distress

What is propofol?

phenol as lipid IV anaesthetic agent

What equipment would you need for a thoractomy?

- long sleeved surgical gown - surgical gloves sizes 6.5 and 7.5 - surgical drape 150x180cm - chloroprep 10.5m and 26ml - thorocotomy kit - scalpel blade no.1 - small swabs (radiopaque) pack of 10 - laparotomy swabs pack of 4 - finochietto rub retractors small and large - internal defibrilator paddles -100ml bag of 0.9% NaCl

What important additional equipment may be inside a crash cart?

- capnography - suction unit - crash record chart - ECG - defibirlator and conduction gel - IO access

What other equipment may be useful but not a neccessity?

- pulse ox - non-invasive blood pressure - invasive blood pressure

What is capnography?

Visual graph of ventilation

Why is capnography important for CPCR?

Shows us perfusion, gaseous exchange and metabolism

What are capnography reading are we aiming for when performing CPCR?

12 ETCO2

What are the benefits of a suction unit?

- most are portable - removes airwaysecretions - improves larynx visualisation - reduces aspiration risk

What does an ECG tell us?

- Electrical impulse/conduction - ECG complex formation - ECG rate - Doesn't give information about perfusion - Very advanced life support

When would you use a defibrilator?

When the patient is in ventricular fibrilation and pulseless ventricular tachycardia -if patients heart rate is above 180 (dogs)

When should you NOT use defibrilation?

- when the patient is covered in spirit - if the patient is wet

How do you use the defibrilator?

- increase voltage by 50% each time used prime the defibrilator - conduction gel - apply to chest - stand clear (at least 1 metre)

What intraosseus route would you go for in cat?

gretaer tubercle, humerus

What intraosseus route would you go for in a large breed dog?

wing of the ileum

What is the main disadvantage of providing fluids?

they act as a wall which makes it harder to achieve cardiac output

Patients are likely to arrest again after arresting for the first time true or flase?

true