CPR

Question 1

What is respiratory arrest?

Answer 1

Cessation of effective breathing

Question 2

What is Cardiorespiratory arrest (CPA)?

Answer 2

Cessation of effective cardiac activity (cardiac output) and respiration

Question 3

What is Return of spontaneous circulation (ROSC)?

Answer 3

Re-establishment of sustained cardiac output without assistance

Question 4

What is Basic life support (BLS)?

Answer 4

Chest compressions and assisted ventilation

Question 5

What is Advanced cardiac life support (ACLS)?

Answer 5

BLS plus medical and electrical interventions

Question 6

What is CPCR (cardiopulmonary cerebral resuscitation)?

Answer 6

Resuscitative efforts (BLS and/or ACLS) required to elicit ROSC and emphasizing the importance of neurological outcome

Question 7

Why is it sometimes difficult to recognised cardiopulmonary arrest?

Answer 7

Can be difficult in the critically ill, those with altered mental states and those under the effects of analgesics it can be hard to tell

Question 8

Which parameters is it important to assess to determine whether a patient is in cardiopulmonary arrest?

Answer 8

Remember ABC!

Is there spontaneous breathing effort? Auscultate the heart, feel the apex beat and pulses

Question 9

What are some impending signs on an ECG of a cardiopulmonary arrest?

Answer 9

Ventricular tachycardia, ventrial flutter, third degree AV block, atrial standstill, ST depression, R on T phenomenon

Question 10

How can high vagal tone lead to cardiopulmonary arrest? What can cause high vagal tone?

Answer 10

It can cause a life threatening bradycardia causing a vasovagal syncope and vagal arrest.
Vagal stimulation can be cause by vomiting, defecation, resp/abdominal disease.

Question 11

What should you do in the even of a vasovagal arrest?

Answer 11

Administer oxygen, and administer atropine (0.005-0.02mg/kg)

Question 12

What are some essential pieces equipment for successful CPR?

Answer 12

ET tubes, IV catheters, bandaging material, laryngoscope, syringes and needles, drugs. (Also helpful: defribrillator, scalpel blades, suture material, IV fluids, pressure bag, ETCO2 monitor)

Question 13

How many people is ideal for CPR?

Answer 13

Ideally 4 (minimum 3)

Question 14

What should be the first steps in CPR?

Answer 14

Secure AIRWAY, BREATHE for the patient, and get CIRCULATION going (compressions can start before breathing)

Question 15

How many breaths should you aim to provide an animal in cardiopulmonary arrest? What equipment is needed, how do you do this?

Answer 15

12-15 breaths per minute (anymore or less is detrimental). Use positive pressure ventilation with 100% oxygen using an Ambu bag.

Question 16

What types of closed CPR can be done? When are these appropriately used?

Answer 16

Cardiac pump - used for small dogs and cats

Thoracic pump - larger dogs (>7kg)

Question 17

What is the cardiac pump theory in cats and dogs?

Answer 17

Used in cats and smaller dogs. Compression encompass heart from both sides and essentially squeeze the heart to pump blood.

Question 18

What is the thoracic pump theory in cats and dogs?

Answer 18

For larger dogs (>7kg). Compression focused on widest part of the chest so that changes occur due to changes in intrathoracic pressure.

Question 19

What are some possible indications for open CPR?

Answer 19

Very large dogs >40kg, significant pleural space disease, pericardial effusion.

Question 20

Once basic life support is started, advanced life support is started. What monitoring device is used to determine which drugs should be administered?

Answer 20

ECG
Some electrical activity on ECG, but no pulses (pulseless electrical activity) or no electrical activity (asystole) should be given adrenaline. Sinus bradycardia give atropine, sinus tachycardia is given lidocaine.

Question 21

Once basic life support is started, what drug should be given when Some electrical activity on ECG, but no pulses (pulseless electrical activity) or no electrical activity (asystole)?

Answer 21

Adrenaline

Question 22

Once basic life support is started, what drug should be given for sinus bradycardia seen on an ECG?

Answer 22

Atropine

Question 23

Once basic life support is started, what drug should be given for sinus tachycardia seen on an ECG?

Answer 23

Lidocaine

Question 24

Should fluids be given during resusscitation? When are they contraindicated?

Answer 24

As circulation usually poor, usually fluids are given via pressure bags. Only contraindication is when fluid overload was original cause of arrest.