CPR - Advanced Life Support Flashcards
What are the next steps in the CPR algorithm after basic life support?
- Monitoring
- Obtaining vascular access
- Administer reversals
When do you start advanced life support?
After the first 2 minutes of basic life support
What is involved in monitoring?
Electrocardiography gram - ECG
Capnography
Clinical changes
What does capnography tell you?
End tidal CO2 (ETCO2)
Most useful tool for monitoring
Measure perfusion
○ Movement of carbon dioxide from the tissues to the lungs
○ i.e. measures movement of blood
>15-20mmHg = Good compressions
What does ECG tell you?
Heart rate/rhythm
Does NOT tell you about perfusion/cardiac output
Can assess if it is shockable rhythm or not (use defibrillator?)
* Ventricular Fibrillation
* Pulseless Ventricular Tachycardia
What clinical changes can you assess?
- Pulses – difficult to palpate
- Mucous membrane colour
- Eye position changes
○ central -> ventromedial - Pupil changes size
- Palpebral, corneal, gag reflex may be noticed
- Breathing or chest movements (twitches) resume
- Lacrimation
- Animal regains consciousness
How can you establish vascular access?
Intravascular (IV)
Intraosseous (IO)
Intratracheal (IT)
What are the options for IV route?
Cephalic
Saphenous
Jugular
Central so doesn’t need flushing
Dirty procedure - risk of infection
Pros and Cons of using IV route
Ideal route of choice for drugs and fluids
Tricky during CPR because of movement
Jugular venous cannula is ideal for administration but risk of thrombophlebitis
Other veins not as effective but can ‘flush’ drug centrally
Pros and cons of intraosseous route
As rapid as using peripheral veins
Would need to use drill in adult patients
Not common in first opinion practice
Useful in small animals and birds
Methods of intraosseous route
Greater tubercle of humerus
Tibial crest or trochanteric fossa of femur
Pros and cons of intratracheal route
Chest inflations will distribute drugs
Higher doses needed
Dilute and use urinary catheter inserted beyond carina
Reversals/Antagonists examples
Atipamezole
Naloxone
Flumazenil
Atipamezole use
Reverses Alpha-2 agonists (medetomidine)
Naloxone use
Reverses opioids (methadone)