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CPR Flashcards

1
Q

What is cardiopulmonary arrest?

A

Cessation of both the respiratory and circulatory systems

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2
Q

Is apnea the same as respiratory arrest?

A

No, apnea usually is a temporary cessation but it can least to complete respiratory arrest

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3
Q

What is respiratory arrest typically due to?

A

A pathologic process where the patient cannot initiate a breath (medullary ischemia)

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4
Q

What are the survival to discharge rates following CPR?

A

Dogs- 3-6%

Cats- 2-10%

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5
Q

How long does it take for cerebral death due to ischemia take?

A

> 4-7min

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6
Q

What kind of pathology has the least likelihood of survival even with CPR?

A

Cardiopulmonary arrest due to progressive illness

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7
Q

What is the most important aspect of resuscitating a CPA patient?

A

Early recognition and response

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8
Q

What conditions are classified as a respiratory emergency?

A

Tension pneumothorax, pulmonary or airway disease

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9
Q

What is a crash cart?

A

A box/cart that is stocked with all drugs and equipment necessary to resuscitate a patient

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10
Q

How many people are required for proper CPR?

A

At lease 4

Compressions, prepare drugs/monitors, provide ventilation, keep records

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11
Q

What drug is used to sedate animals in respiratory distress?

A

Acepromazine

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12
Q

What are the CS of upper airway obstruction and what breeds are predisposed?

A

Brachycephalics are predisposed

Inspiratory stridor, cynosis

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13
Q

What is the immediate step necessary for upper airway obstruction?

A

Induction and intubation

May need immediate surgery

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14
Q

What procedure can be done until definitive correction of an upper airway obstruction can be performed?

A

Tracheostomy

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15
Q

What are the CS due to an airway obstruction from a foreign body or tumor?

A

Inspiratory effort with abdominal effort and cynosis

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16
Q

Can a tracheostomy be performed with an airway obstruction?

A

Yes- go below the obstruction

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17
Q

What procedure is performed to visualize the obstruction?

A

Bronchostomy

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18
Q

What are the CS of a collapsed trachea and what breeds are predisposed?

A

Small and toy breed dogs

Marked inspiratory and exspiratory effort with a goose-honking noise

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19
Q

Should tracheal collapse patients be intubated?

A

Yes

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20
Q

What are the clinical signs of a pneumothorax?

A

Dyspnea, rapidly decreased SpO2, collapse

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21
Q

What are some causes of pneumothorax?

A

Thoracic trauma, spontaneous, barotrauma (closed pop-off!)

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22
Q

Can a pneumothroax lead to respiratory arrest?

A

Yes

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23
Q

What is done to treat a pneumothorax?

A

Oxygenation and evacuation of air from the chest (needle of chest tube)

Fluids recommended to improve circulation

Atropine if HR is decreased

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24
Q

If an anesthetized patient on a ventilator stops breathing, does this count as respiratory arrest?

A

Nope!

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25
What value will suddenly decrease in an anesthetized patient in respiratory arrest?
EtCO2 (
26
How with the MMs look in animals in CPA?
Blue/gray May still be pale pink if early
27
What is the procedure for CPA during anesthesia?
1. Turn off anesthesia and flush circuit 2. Start compression 3. Ventilate 10bpm
28
What is the procedure for CPA walking through the door?
Compressions and "mouth to snout" ventilation until you can intubate
29
What should be restarted first in CPR? Circulation, breathing or airway?
Circulation- start compressions
30
What percentage of CO is generated in closed CPR?
25-40%
31
What should you use for your compression rate?
100-120 bpm
32
How far should you compress the chest?
1/3-1/2 the width of the chest
33
Where should compressions be performed on the chest with thoracic pump theory?
With hands over the highest point of the thorax
34
Is the thoracic pump theory more effective in larger or smaller animals?
Larger Dogs especially
35
Where are compressions performed in cardiac pump theory?
Over the heart and compress with thumb and fingers Similar to open chest CPR
36
Cardiac pump theory is more effective in what kind of animals?
Smaller
37
What is the inspiratory/expiratory times for ventilation?
1 sec for inspiration | 5-6 sec for expiration
38
If only one person is performing CPR, what is the protocol?
Continuous compression with 1-2 breaths every 2-3min
39
Why is an ECG necessary in cardiac arrest?
Determine the rhythm of arrest
40
What is the most common arrest ECG in small animals?
Asystole
41
What is the most common arrest ECG in humans?
Ventricular fibrillation
42
What drug can induce ventricular fibrillation?
Epiephrine
43
What does pulseless electrical activity look like on ECG?
Wide QRS, no perception of heart function Looks almost normal
44
PEA is often observed in animals after what procedure?
Euthanasia
45
Is a slower PEA or faster PEA a better prognosis?
Faster has a better prognosis
46
What is the concern with PEA arrhythmias?
Depletion of global myocardial energy substrates
47
What three drugs are administered in advanced support?
Vasopressors (vasopressin/epi) Atropine
48
How long can compressions be halted to check ECG?
No longer than 10 seconds
49
Is there any advantages between the vasopressor drugs during CPR?
Nope
50
Which vessels are preferred to gain IV access in an arrested patient?
Jugular > cephalic > saphenous
51
Can drugs be administered intratracheally?
Yes!
52
What drug cannot be given intratracheally?
NaHCO3
53
Can intraossesous catheters be used in an arresting patient?
Yes, may be the only option if very small
54
What are interposed abdominal compressions?
Compressions timed in between chest compressions to enhance venous return to the heart
55
What are three complications of abdominal compressions?
1. Diaphramatic hernia 2. Hemoabdomen 3. Hepatobilliary sx All are rare but possible
56
Where is open chest CPR performed?
On the left lateral at the 6th rib space or Via the diaphragm in abdominal sx "Hack and slash" thorocotomy
57
What are some indications for open chest CPR?
- Cardiac tamponade - Large volume pericardial effusions - Chest trauma/fractures - Diaphragmatic hernia - If closed chest is not effective after ~5-10min - If EtCO2
58
Is palpating a pulse useful to assess compression quality?
No
59
What should be done to assess quality of compression?
Doppler probe over the cornea or over an artery
60
What is the EtCO2 expected to be if compressions are working?
>15 mmHg
61
Is SpO2 useful for assessing compressions?
No
62
What fluids should be given in cases of hypovolemia?
Colloids or crystalloids
63
When is giving NaHCO3 appropriate?
Arrest due to metabolic acidosis
64
When is giving Ca gluconate appropriate?
Arrest due to hypocalcemia, hyperkalemia, or Ca channel blocker toxicosis
65
When should CPR be discontinued?
If EtCO2
66
When is a defibrillator appropriate?
In ventricular fibrillation cases
67
Can alcohol be used with defibrillator paddles?
NO
68
If defibrillation is unsuccessful the first time, how long should compressions be continued before trying again?
At least 2min
69
Should the energy of the shock be increased for successive shocks?
Yes, 50%
70
What does ROSC stand for?
Return of spontaneous circulation
71
Should ventilation be maintained after ROSC?
Yes
72
What is the prognosis of a patient after ROSC depend on?
1. Cause of arrest 2. Duration of arrest 3. Other physiologic/pathologic processes after reperfusion
73
Medullary ischemia is likely unless circulation is restored in how many minutes?
74
What is a beneficial treatment to prevent hypoxic injury to neural tissues?
Therapeutic hypothermia Use either cold packs or cooled fluids
75
When should CPR patients be extubated?
When they can ventilate adequately to maintain PaCO2 on their own and is actively objecting to the tube
76
If spontaneous breathing has not returned withing in how many hours, the prognosis is poor.
6-12

Anesthesiology (27 decks)

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