CPR Flashcards
When should a crash cart be checked to make sure the emergency medications are up to date?
At least once a month and every time after it is used.
What are 4 essential supplies?
- ET tube
- Laryngoscope
- IV catheter
- Fluids
What has to be done before CPR is begun?
Make sure that is what the client wants.
Is CPA hospital survival rates high or low?
Very low
What does DNAR stand for?
Do not attempt resuscitation
What does CPCR stand for?
Cardio pulmonary cerebral resuscitation
What is the most successful CPCR?
The one avoided
Can anesthesia cause CPA?
Yes
What are the steps to follow with basic life support?
- Chest compressions
- Airway
- Breathing
- Circulation
- Drugs
- ECG
- Fluid therapy
If you can only do one thing, what should be done?
Chest compressions
What is the goal of chest compressions?
Maximize cerebral & myocardial perfusion
How long are pauses between external chest compressions?
Less than 10 seconds
The thoracic pump theory is used in what size dogs?
Medium to large
What is the thoracic pump theory?
Applying rhythmic pressure to chest wall creates blood flow by increasing intrathoracic pressure on the arteries and veins to create forward blood flow.
What is used in cats and dogs less than 15 kg?
Cardiac pump theory
Forward blood movement from external chest compressions directly on the ventricles is known as what?
Cardiac pump theory
What type of a surface should a patient be placed on?
Firm
Change who is giving chest compression how often?
Every 2 minutes
How many compressions are given per minute?
80-100
How much is the chest compressed?
30%
Should the chest be allowed to fully recoil?
Yes
Should chest compressions be paused for anything?
No
How are hands positioned for medium to large dogs?
1 hand on top of the other parallel
Where are hands placed on chest for medium to large dogs?
At widest part of chest
How is pressure applied for medium to large dogs?
Evenly using palm of hand.
For patients 7-10 kg, where are hands placed?
Over apex of heart between 4-6th intercostal space (right behind elbow/axilla
How are hands positioned for cats and dogs less than 7 kg?
Fingers of 1 hand on one side, thumb on the other side.
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?
Internal cardiac massage
How can an airway be established?
Place an ET tube
What are 4 ways to confirm placement of an ET tube?
- Visual
- chest wall excursions
- Palpation
- ETCO2
A vertical incision through tracheal rings is called what?
Tracheostomy
Are masked recommended for use in animals?
No
How are breaths given during respiratory arrest?
2 breaths given 1-2 seconds in duration
Is Doxapram recommended?
Why?
- No
- Increases oxygen requirements
What is the acupuncture site that might help stimulate breathing if jabbed multiple times?
Where is it located?
- Jen Chung (GV26)
- On septum just below nose
Full CPA may be avoided if what resumes?
Breathing
What rate should ventilation proceed at if breathing does not resume?
10-12 bpm
Airway pressures need to be maintained below what level?
In order to avoid what?
- 20 cm H2O
- Barotrauma
Where is an impedance threshold device placed?
Between ET tube and breathing circuit
What device prevents air flow in ET tube creating more negative pressure in the chest generated during chest recoil?
Impedance threshold device
IV access should be obtained where?
Cephalic: peripheral before jugular
What size catheter should be used?
Largest diameter possible
If unable to get IV access, can you administer directly to the heart?
What are 2 options?
- No
- IO or down ET tube
What needs to be done with drugs?
Reverse any drugs that may cause CV depression.
What is the reversal agent for opioids?
Naloxone
What is the reversal agent for alpha-2 agonists?
Atipamazole, Yohimbine
What is the reversal agent for benzodiazepenes?
Flumazenil
What is epinephrine?
Mixed adrenergic receptor
What receptors does epinephrine work on?
Which does it work strongest on?
- Alpha and beta
- Alpha
Stimulation of which receptor type increases myocardial contractility and heart rate?
Beta-1
Stimulation of which receptor type causes peripheral arteriolar vasoconstriction and increases pulmonary PP?
Alpha-2
What size epinephrine does should be used first?
Low
What kind of drug is atropine?
Anticholinergic parasympatholytic
Where does atropine work?
Muscarinic receptors
what is given if there is a suspected increase in vagal tone during arrest?
Atropine
What is an indication for atropine?
Vagal-induced asystole
What drug increases automaticity of SA node and conduction of AV node?
Atropine
What is a drug that increases cerebral profusion through vasodilation?
Vasopressin
What type of an environment does vasopressin work in?
Acidic
Vasopressin can be used with or instead of what?
Epinephrine
How does lidocaine work?
Stabilizes cell membrane by Na+ channel blockade.
What are 2 negative effects lidocaine can have if defibrillation is planned?
- Increases defibrillation threshold
- Decreases myocardial automaticity
A pulseless cardiac arrest is known as what?
Ventricular asystole
What is the most common arrest rhythm?
Ventricular asystole
There are 2 types of what heart rhythm?
What are they?
- Ventricular tachycardia
- Pulse and no pulse
Is VT potentially life threatening?
Yes
Which type of VT heart rhythm is shockable?
No pulse
VT has a heart rate greater than what?
150 bpm
Unorganized ventricular excitation is known as what?
Ventricular fibrillation
What are 2 things seen with ventricular fibrillation?
- Inadequate myocardial contractions
- Cardiac pump failure
Is ventricular fibrillation a shockable rhythm?
Yes
The termination of ventricular fibrillation 5 seconds or more is known as what?
Defibrillation
How does defibrillation work?
Electrical shock depolarizes myocardial cells.
What are 2 rhythms that defibrillation can be used for?
- Ventricular fibrillation
- Ventricular tachycardia with no pulse
Can alcohol be used with defibrillation?
No
What is put on the paddles for defibrillation?
Conductive paste
What position is the patient put in?
Dorsal recumbency
What is done immediately after defibrillation is given?
Immediately resume chest compressions for 2 minutes.
What type of dose is given if patient is hypovolemic?
What is the dose for a dog?
Cat?
- Shock dose
- Dog: 90 mL/kg
- Cat: 45 mL/kg
How much fluid is given if the patient is euvolemic for a dog?
Cat?
- Dog: 20 mL/kg
- Cat: 10 mL/kg
What is the daily maximum of Hetastarch a dog can have?
Vetstarch?
- 20 mL/kg/day
- 40 mL/kg/day
What is the daily maximum amount of colloid a cat can receive?
5-10 mL/kg/day
A fast bolus of hypertonic saline is associated with what 2 side effects?
- Vagal-induced bradycardia
- Hypotension
What can decreased ETCO2 be due to?
Compression fatigue during CPR
What can a sudden increase in ETCO2 be due to?
Probable return of spontaneous circulation during CPR.
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?
- Increased likelihood of ROSC
- ROSC unlikely to occur
Does pulse palpation give an indication of arterial perfusion?
No
What gives an indication of perfusion?
ETCO2
What is the most accurate blood gas?
Central venous
What can be seen after resuscitation?
Permissive hypothermia
What can be given to increase CO without excessive vasoconstriction?
Dobutamine CRI
