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Anesthesiology > CPR > Flashcards

CPR Flashcards

1
Q

When should a crash cart be checked to make sure the emergency medications are up to date?

A

At least once a month and every time after it is used.

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2
Q

What are 4 essential supplies?

A
  • ET tube
  • Laryngoscope
  • IV catheter
  • Fluids
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3
Q

What has to be done before CPR is begun?

A

Make sure that is what the client wants.

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4
Q

Is CPA hospital survival rates high or low?

A

Very low

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5
Q

What does DNAR stand for?

A

Do not attempt resuscitation

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6
Q

What does CPCR stand for?

A

Cardio pulmonary cerebral resuscitation

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7
Q

What is the most successful CPCR?

A

The one avoided

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8
Q

Can anesthesia cause CPA?

A

Yes

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9
Q

What are the steps to follow with basic life support?

A
  • Chest compressions
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • ECG
  • Fluid therapy
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10
Q

If you can only do one thing, what should be done?

A

Chest compressions

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11
Q

What is the goal of chest compressions?

A

Maximize cerebral & myocardial perfusion

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12
Q

How long are pauses between external chest compressions?

A

Less than 10 seconds

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13
Q

The thoracic pump theory is used in what size dogs?

A

Medium to large

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14
Q

What is the thoracic pump theory?

A

Applying rhythmic pressure to chest wall creates blood flow by increasing intrathoracic pressure on the arteries and veins to create forward blood flow.

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15
Q

What is used in cats and dogs less than 15 kg?

A

Cardiac pump theory

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16
Q

Forward blood movement from external chest compressions directly on the ventricles is known as what?

A

Cardiac pump theory

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17
Q

What type of a surface should a patient be placed on?

A

Firm

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18
Q

Change who is giving chest compression how often?

A

Every 2 minutes

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19
Q

How many compressions are given per minute?

A

80-100

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20
Q

How much is the chest compressed?

A

30%

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21
Q

Should the chest be allowed to fully recoil?

A

Yes

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22
Q

Should chest compressions be paused for anything?

A

No

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23
Q

How are hands positioned for medium to large dogs?

A

1 hand on top of the other parallel

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24
Q

Where are hands placed on chest for medium to large dogs?

A

At widest part of chest

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25
Q

How is pressure applied for medium to large dogs?

A

Evenly using palm of hand.

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26
Q

For patients 7-10 kg, where are hands placed?

A

Over apex of heart between 4-6th intercostal space (right behind elbow/axilla

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27
Q

How are hands positioned for cats and dogs less than 7 kg?

A

Fingers of 1 hand on one side, thumb on the other side.

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28
Q

For penetrating chest wounds, thoracic trauma with rib fracture, pleural space disease, diaphragmatic hernia, pericardial effusion hemoperitoneum, intra-op cardiac arrest and inadequate circulation after 2-5 minutes of external, what can be used?

A

Internal cardiac massage

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29
Q

How can an airway be established?

A

Place an ET tube

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30
Q

What are 4 ways to confirm placement of an ET tube?

A
  • Visual
  • chest wall excursions
  • Palpation
  • ETCO2
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31
Q

A vertical incision through tracheal rings is called what?

A

Tracheostomy

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32
Q

Are masked recommended for use in animals?

A

No

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33
Q

How are breaths given during respiratory arrest?

A

2 breaths given 1-2 seconds in duration

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34
Q

Is Doxapram recommended?

Why?

A
  • No

- Increases oxygen requirements

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35
Q

What is the acupuncture site that might help stimulate breathing if jabbed multiple times?
Where is it located?

A
  • Jen Chung (GV26)

- On septum just below nose

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36
Q

Full CPA may be avoided if what resumes?

A

Breathing

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37
Q

What rate should ventilation proceed at if breathing does not resume?

A

10-12 bpm

38
Q

Airway pressures need to be maintained below what level?

In order to avoid what?

A
  • 20 cm H2O

- Barotrauma

39
Q

Where is an impedance threshold device placed?

A

Between ET tube and breathing circuit

40
Q

What device prevents air flow in ET tube creating more negative pressure in the chest generated during chest recoil?

A

Impedance threshold device

41
Q

IV access should be obtained where?

A

Cephalic: peripheral before jugular

42
Q

What size catheter should be used?

A

Largest diameter possible

43
Q

If unable to get IV access, can you administer directly to the heart?
What are 2 options?

A
  • No

- IO or down ET tube

44
Q

What needs to be done with drugs?

A

Reverse any drugs that may cause CV depression.

45
Q

What is the reversal agent for opioids?

A

Naloxone

46
Q

What is the reversal agent for alpha-2 agonists?

A

Atipamazole, Yohimbine

47
Q

What is the reversal agent for benzodiazepenes?

A

Flumazenil

48
Q

What is epinephrine?

A

Mixed adrenergic receptor

49
Q

What receptors does epinephrine work on?

Which does it work strongest on?

A
  • Alpha and beta

- Alpha

50
Q

Stimulation of which receptor type increases myocardial contractility and heart rate?

A

Beta-1

51
Q

Stimulation of which receptor type causes peripheral arteriolar vasoconstriction and increases pulmonary PP?

A

Alpha-2

52
Q

What size epinephrine does should be used first?

A

Low

53
Q

What kind of drug is atropine?

A

Anticholinergic parasympatholytic

54
Q

Where does atropine work?

A

Muscarinic receptors

55
Q

what is given if there is a suspected increase in vagal tone during arrest?

A

Atropine

56
Q

What is an indication for atropine?

A

Vagal-induced asystole

57
Q

What drug increases automaticity of SA node and conduction of AV node?

A

Atropine

58
Q

What is a drug that increases cerebral profusion through vasodilation?

A

Vasopressin

59
Q

What type of an environment does vasopressin work in?

A

Acidic

60
Q

Vasopressin can be used with or instead of what?

A

Epinephrine

61
Q

How does lidocaine work?

A

Stabilizes cell membrane by Na+ channel blockade.

62
Q

What are 2 negative effects lidocaine can have if defibrillation is planned?

A
  • Increases defibrillation threshold

- Decreases myocardial automaticity

63
Q

A pulseless cardiac arrest is known as what?

A

Ventricular asystole

64
Q

What is the most common arrest rhythm?

A

Ventricular asystole

65
Q

There are 2 types of what heart rhythm?

What are they?

A
  • Ventricular tachycardia

- Pulse and no pulse

66
Q

Is VT potentially life threatening?

A

Yes

67
Q

Which type of VT heart rhythm is shockable?

A

No pulse

68
Q

VT has a heart rate greater than what?

A

150 bpm

69
Q

Unorganized ventricular excitation is known as what?

A

Ventricular fibrillation

70
Q

What are 2 things seen with ventricular fibrillation?

A
  • Inadequate myocardial contractions

- Cardiac pump failure

71
Q

Is ventricular fibrillation a shockable rhythm?

A

Yes

72
Q

The termination of ventricular fibrillation 5 seconds or more is known as what?

A

Defibrillation

73
Q

How does defibrillation work?

A

Electrical shock depolarizes myocardial cells.

74
Q

What are 2 rhythms that defibrillation can be used for?

A
  • Ventricular fibrillation

- Ventricular tachycardia with no pulse

75
Q

Can alcohol be used with defibrillation?

A

No

76
Q

What is put on the paddles for defibrillation?

A

Conductive paste

77
Q

What position is the patient put in?

A

Dorsal recumbency

78
Q

What is done immediately after defibrillation is given?

A

Immediately resume chest compressions for 2 minutes.

79
Q

What type of dose is given if patient is hypovolemic?
What is the dose for a dog?
Cat?

A
  • Shock dose
  • Dog: 90 mL/kg
  • Cat: 45 mL/kg
80
Q

How much fluid is given if the patient is euvolemic for a dog?
Cat?

A
  • Dog: 20 mL/kg

- Cat: 10 mL/kg

81
Q

What is the daily maximum of Hetastarch a dog can have?

Vetstarch?

A
  • 20 mL/kg/day

- 40 mL/kg/day

82
Q

What is the daily maximum amount of colloid a cat can receive?

A

5-10 mL/kg/day

83
Q

A fast bolus of hypertonic saline is associated with what 2 side effects?

A
  • Vagal-induced bradycardia

- Hypotension

84
Q

What can decreased ETCO2 be due to?

A

Compression fatigue during CPR

85
Q

What can a sudden increase in ETCO2 be due to?

A

Probable return of spontaneous circulation during CPR.

86
Q

What is the prognosis of ROSC if a level of greater than 20 mmHg at 20 minutes of CPR is achieved?
If less than 10 mmHg at 20 minutes of CPR?

A
  • Increased likelihood of ROSC

- ROSC unlikely to occur

87
Q

Does pulse palpation give an indication of arterial perfusion?

A

No

88
Q

What gives an indication of perfusion?

A

ETCO2

89
Q

What is the most accurate blood gas?

A

Central venous

90
Q

What can be seen after resuscitation?

A

Permissive hypothermia

91
Q

What can be given to increase CO without excessive vasoconstriction?

A

Dobutamine CRI

Anesthesiology (19 decks)

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