CPR - Basic Life Support Flashcards
Causes of Cardio-Pulmonary Arrest (CPA)
- Anaesthetic complications
- Severe trauma
- Severe electrolyte disturbances
- Hypovolemia
- Vagal stimulation
- Cardiac arrhythmias
- Cardiorespiratory disorders
- Debilitating or end-stage diseases
- Myocardial hypoxia
- Drugs and toxins
- pH abnormalities
- Electrolyte disturbances
- Temperature problems
Signs of Cardio-Pulmonary Arrest (CPA)
- Loss of consciousness
- Apnoea or agonal gasping
- No corneal reflex or palpebral reflex
No heart sounds
No palpable pulse
Central eye position
Pupils fixed and dilated
Bleeding stops at surgical site
Mucous membrane grey/blue/white
CRT altered
Dry cornea
General muscle flaccidity
ECG arrhythmias (VF, VT, Asystole, PEA/EMD)
Consequences of acute failure of cardio-respiratory systems
Lack of oxygen delivery to tissues
Can no longer metabolise properly
Unconsciousness
Systemic Cellular Death
Cerebral hypoxia
Brain dead within 4-6 minutes
Wy do we have an algorithm for CPR?
CPR is used in stressful emergency situations
Algorithm provides quick and easy to follow instructions
Save Time
Prevent missing important steps
What is the first step of CPR algorithm?
Assess patient - what do they look like?
If unresponsive and apnoeic start CPR
What is the basic life support steps?
Initiate CPR immediately:
Chest compressions
Ventilation
Could argue to establish an airway first but if you can’t, start compressions
Chest compressions in Small Animals <10kg
Cardiac pump
Wrap hands around heart or place directly over heart
Patient in lateral recumbency on hard surface
Imagine you are squeezing the heart itself
Ventral 1/3 of thorax
Ribs 3-6
100-120 BPM for 2 minutes (same as humans)
Chest compressions in Small Animals/foals >10kg
Thoracic pump
Compressing thorax - changes in pressure create a pump
Patent in lateral recumbency on a hard surface
(If brachycephalic in dorsal recumbency)
Think about compressing thorax not heart
On widest part of chest
Compress to 1/3-1/2 width of chest
60-120 BPM for 2 minutes
(High change in pressure more important than high rate)
Broken rib is an acceptable side effect
What are internal cardiac compressions?
Trans-diaphradmatic
Often done during surgery
Cut though diaphragm and reach through from abdomen
OR lateral-thorax approach - Hand between ribs
Better than external compressions
Problems with large animal CPR
Need lots of people
Extremely tiring
Need to swap every 2 minutes
Limited success
Large animal CPR
Throw body onto caudo-dorsal lung field
Horse must be on solid surface
Aim for highest compression rate possible
How can you establish an airway
Airway may need to be cleared manually or with suction
Orotracheally with ET tube - lateral intubation due to chest compressions
Emergency tracheostomy
Emergency tracheostomy
If airway is obstructed
Simple/diry surgery
3-5cm midline incision and blunt dissection
trachea entered 2-4cm caudal to larynx
Place ET tube between rings
Takes time
What is PPV?
Positive Pressure Ventilation
Type of mechanical ventilation
Forces oxygen into lungs
In full control of lungs - careful
PPV method
ET tube connected to an AMBU bag (if you can’t get an ET tube can use mask ventilation)
Anaesthetic machine
Demand valve in large animals
