CPR Flashcards

1
Q

indications for CPR

A

cardiopulmonary arrest

respiratory arrest - if treated quickly may prevent cardiac arrest

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2
Q

how can respiratory arrest be treated

A

Intubate and ventilate

Acupuncture point GV26 – use a 25 g. needle

NO DOXAPRAM – increases cerebral O2 demand

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3
Q

underlying cause of cardiac arrest

A

inadequate cardiac oxygenation

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4
Q

what is the goal of CPR

A

maximize myocardial and cerebral oxygenation

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5
Q

T/F CPR success rates are poor overall in dogs and cats

A

True

35-45% have a return to spontaneous circulation (ROSC)

survival to discharge is only 2-10% → majority arrest again

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6
Q

CPA had a better/worse prognosis

A

better

50% survival at discharge

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7
Q

considerations for providing CPR

A

Owners will require counselling to aid in decision-making

Is this a rapidly correctable problem?

What is the longer-term prognosis?

What is the expected cost?

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8
Q

code status

A

DNR

CPR - open vs. closed

ask BEFORE patient is admitted

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9
Q

how can you indicate the crash cart is ready for use

A

put tape over the front - if broken, its been used and should be stocked

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10
Q

what is the most important part of basic life support

A

chest compressions

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11
Q

an apneic, unresponsive patient should be assessed for less than _______ before startin compressions

A

5-10 secs

interruptions should be minimized - can have significant impact on blood flow

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12
Q

chest compressions only achieve _________of normal cardiac output

A

less than/equal to 25-30%

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13
Q

how often should you trade off person doing compressions

A

every 2 min

trade off without interruption

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14
Q

2 theories of chest compressions

A

cardiac pump theory - direct compression of ventricles, smaller patients

thoracic pump theory - increase intrathoracic pressure, larger patients

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15
Q

what determines where to do chest compressions

A

size and shape of patient

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16
Q

where are compressions performed with thoracic pump theory

A

over the widest part of the chest

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17
Q

rate and deptht of chest compressions

A

100-120 per min

1/3 -1/2 width of thorax - allow full thoracic recoil

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18
Q

indications for inernal cardiac massage

A

Conditions which prevent effective external cardiac compressions - Pericardial effusion, Pleural space disease

Other - Intraoperative cardiac arrest if abdomen is already open (diaphragmatic approach)

19
Q

T/F intubation should be completed ASAP but without interruption of chest compressions

A

True

keep in lateral recombency

20
Q

ventilation parameters

A

10 breaths/min

tidal volume 10 ml/kg

inspiratory time 1 second

21
Q

what provides an indication of adequacy of cardiac compressions

A

EtCO2

should be >15-20 mmHg

22
Q

sudden increase in EtCO2 indicates

A

ROSC - return to spontaneous circulation

draumatic increase in cardiac output and pulmonary circulation

23
Q

what is an impedance threshold device (ITD)

A

fits between endo of ETT and ambubag/breathing circuit

created negative intrathroacic pressure→increases venous return (preload)

only useful in animals >10kgs

25
advanced life support systems
drugs and defibrillation tx depends on arrest rhythm - determined by ECG
26
3 main arrest ryhthms seen on ECG
asystole pulseless electrical activity ventricular fibrillation
27
Is dedibrilation indicated with asystole/PEA
**no -** requires drug tx vasopressor q EO cycle (3-5min) - epi or vasopressin atropine q EO cycle (3-5min) - esp with high vagal tone
28
what are the shockable rhythms
**Vfib /pulseless Vtach** should occur ASAP once Dx is made
29
MoA of defibrillation
Depolarizes ventricular myocardial cells all together, forcing refractory period → Allows pacemaker cells in SA node to take over Goal is to establish a sinus rhythm
30
welcome back to SAM - what rhythm is this
ventricular fibrillation
31
welcome back to SAM - what rhythm is this
ventricular tachycardia
32
how is a defibrillator used
dorsal recumbency → Paddles placed on opposite sides of thorax over costochrondral junction over heart Make sure no one is in contact with the patient or steel table! Make sure no alcohol is on patient fur – fire hazard Resume compressions for 2 minutes before rechecking ECG
33
what may be considered if defibrillation is not effective
amiodarone and lidocaine
34
what is used for torsades de pointes
magnesium
35
T/F all reversible anesthetic drugs that have been administered should be reversed during CPR
**True**
36
T/F calcium should not be routinely administered
**True** documented hypoglycemia may be treated
37
T/F documented hyperK should be treated and hypoK may be treated
**True**
38
are corticosteroids recommended
**NO!**
39
when is administration of bicarb considered
after prolonged (10-15 min) CPR
40
IV fluids should be given only to \_\_\_\_\_\_\_patients
hypovolemic
41
which drugs can be given intratracheal
epi, atropine, vasopressin only if cant get IV or IO access deliver via catheter at the level of the carina or distal dilute in sterile water/saline
42
injections should NEVER be made into \_\_\_\_\_\_\_\_\_
myocardium (intracardiac)
43
what are some post cardiac arrest (PCA) syndromes
multiorgan failure cardiogenic shock anoxic brain injury
44
T/F physiologic (low) doses of steroids may be indicated post cardiac arrest
**true** for stress - maintain GLU and vascular tone