CPR

Question 1

signs of impeding CPA

Question 2

basic life support: airway

Answer 2

lateral

direct visualization

palpation

chest wall motions

chest auscultation

end tidal capnography

Question 3

end tidal capnography (ETCO₂)

Answer 3

CO₂ production and elimination-ventilation, perfusion status, metabolism

trachea will have measurable CO₂

eosphagus will not have any measurable CO₂

D on capnogram

Question 4

bacis life support: breathing

Answer 4

ventilate at a rate of 10 breaths/min

this will maintain normocapnia and normoxia, hyperventilation causes cerebral vasoconstriction

be careful because positive pressure can decrease cardiac output!

deliver breath over 1 sec

tidal volume of 10 ml/kg

simultaneous compressions

Question 5

how long can you do just chest compressions?

Answer 5

4 minutes

…..

Question 6

cardiac pump theory of compressions

Answer 6

direct ventricular compression

enhances forward blood flow

patients that are < 15 kg

Question 7

thoracic pump theory of compressions

Answer 7

increase in intrathoracic pressure increased negative pressure

more negative pressure causes for increase flow back to the heart

medium and large dogs

Question 8

patient position for chest compressions

Answer 8

lateral recumbency

dorsal recumbency if barrel chested

Question 9

hand position for chest compressions

Answer 9

large dog-hands over widest part of chest

small dog or cat-hands over apex of heart, circumferential

Question 10

compressions

Answer 10

depth of 1/3 to 1/2 with width of chest

allow full chest wall recoil between compressions

continuous, uninterrupted compressions

switch compressors frequently to avoid fatigue

compression of 100 to 120 beats/min

Question 11

advanced life support includes?

Answer 11

Drugs

ECG, Evaluation

Fluids, fibrillation

Question 12

common arrhythmias patients die from

Answer 12

asystole

pulseless electrical activity

ventricular fibrillation

ventricular tachycardia

sinus bradycardia

Question 13

Asystole

Answer 13

….

Question 14

pulseless electrical activity (PEA)

Answer 14

ECG can appear normal

no detectable pulse (palpation, arterial waveform)

no heart sounds

with time converts to ventricular fibrillation

Question 15

ventricular fibrillation

Answer 15

ventricular myocardial cell moving in a chaotic asynchronous waves of motion

Question 16

epinephrine

Answer 16

mixed adrenergic agonist-alpha receptors (vasoconstriction), beta receptors (myocardial contraction)

use low dose (0.01 mg/kg) q 3-5 min early in CPR

high dose (0.1 mg/kg) may be considered after prolonged CPR

Question 17

vasopressin

Answer 17

non-adrenergic endogenous pressor agent

peripheral>coronary, renal vasoconstriction

preferential shunting of blood to cerebrum and myocardium

works in the face of acidosis

Question 18

atropine

Answer 18

reverses cholinergic-mediated responses

most effective in vagal induced asystole ie vomiting, anesthetics, chocking

Question 19

when to give drugs

Answer 19

intratracheal with epinephrine, atropine, vasopression

dilute with saline

double the dose

administered via catheter longer than ET tube

Question 20

evaluation

Answer 20

don’t use pulse

use ETCO₂

in death, there is an abrupt fall in ETCO₂ value due to decreased CO and pulmonary perfusion

Question 21

fluid administration

Answer 21

do not use unless hemorrhage or severe hypovolemia

prevents coronary perfusion

Question 22

defibrillation

Answer 22

goal is to put myocardial cells into a refractory period and allow the pacemarker cells to take over

if don’t have a defib, do precordial thump

biphasic defibrillator is better