CPR - Basic Life Support Flashcards
What are some of the 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
What are the signs of cardiopulmonary arrest?
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 (can be normal!)
Dry cornea
General muscle flaccidity
ECG arrhythmias (VF, VT, Asystole, PEA/EMD)
What is the ultimate outcome of cardio-pulmonary arrest?
Acute failure of cardio-respiratory systems:
- Lack of oxygen delivery to tissues (DO2)
- Unconsciousness and systemic cellular death
- Cerebral hypoxia - brain death occurs within 4-6 mins
What are the different types of chest compressions?
Cardiac pump
Thoracic Pump
Describe the features of the cardiac pump
Used in cats, small dogs, rabbits
You are focusing on the ventricles of the heart, wrapping your hands around.
Ventral 1/3 thorax, ribs 3-6.
100-120 bpm for 2 minutes.
Less effective with obesity, pericardial effusion, pneumothorax.
Describe the thoracic pump
Used in medium to large dogs, foals, calves, sheep
Focus on the thorax, not the heart.
Works through changing intrathoracic pressures.
Lateral recumbency - widest part of the chest, compress to 1/3-1/2 the width.
In Dorsal recumbency e.g., bulldog – ¼ width.
100-120 bpm for 2 minutes.
Describe internal cardiac compressions
Trans-diaphragmatic or Lateral-thorax approach.
Better than external compressions
55% cardiac output vs 22%
Better survival in experimental studies (dogs)
Takes time unless already in surgery.
Training required.
Post arrest care more complex and intensive
Describe cardiac compressions in large animals e.g., horses
Two potential options:
- All compressors line up then -> throw whole body onto caudo-dorsal lung field and immediately switch with the next person.
- One person at a time for two minutes jumping up and down/kneeing the horse in the chest.
Horse needs to be in lateral recumbency on solid surface
Describe ventilation in CPR
First assess airway (remove obstructions manually or with suction)
Secure control:
- intubate
- emergency tracheostomy
Give PPV (positive pressure ventilation)
What are the methods of ventilation?
ET tube connected to AMBU Bag, Anaesthetic machine or a demand valve (Large Animal).
Mouth-to-snout/nose/mask ventilation (Be careful – possible zoonotic risk)
What is the most important thing to remember when providing ventilation?
Easy to pop lungs if exceed max inspiratory pressure
Consider tidal volume (~10ml/kg) and ventilation rate (10 bpm)
