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Small Animal Emergency Medicine > CPR/RECOVER > Flashcards

CPR/RECOVER Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

________ is cessation of normal circulation due to failure of the heart to contract effectively.

A

cardiopulmonary arrest (CPA)

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2
Q

________ is an emergency procedure performed in order to MANUALLY maintain perfusion until spontaneous circulation is restored.

A

cardiopulmonary resuscitation (CPR)

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3
Q

T/F: if CPA does not have a reversible caues, CPR is unlikely to be successful so you should not attempt.

A

true

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4
Q

T/F: CPR has a 25% success rate regardless of the inciting cause of the CPA

A

false 5%
if anesthetic-related, it is 25%

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5
Q

what are 3 key features to recognize CPA?

A
  1. loss of consciousness
  2. loss of normal, spontaneous breathing
  3. loss of palpable pulses
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6
Q

what are 4 common events that PRECEDE CPA?

A
  1. bradycardia
  2. worsening mentation
  3. sudden increase in vagal tone (vomiting, straining to defecate)
  4. sudden change in breathing pattern
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7
Q

what are a few common conditions that predispose a patient to CPA and therefore warrant intense monitoring and aggressive therapy?

A
  1. sepsis
  2. SIRS
  3. heart failure
  4. pulmonary disease
  5. trauma
  6. neoplasia
  7. general anesthesia
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8
Q

T/F: you should have 2 people at minimum for CPR

A

false – THREE

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9
Q

what are some roles that can be given to persons involved in CPR?

A
  1. leader (directs everyone, best for this person to be the one who knows the patient the best)
  2. ventilator
  3. compressor
  4. time keeper
  5. recorder
  6. drug administrator
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10
Q

what are some things to make handy on your crash cart?

A

ET tubes
ambu bag
laryngoscope
gauze squares
ET tube ties and cuff syringe
ECG and supplies
defibrillator
drugs – epi and atropine
drug chart
catheter supplies
suction supplies
end-tidal CO2 monitor

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11
Q

at what point should you discuss CPA with an owner?

A

BEFORE the patient is to possibly arrest.
Always discuss the likelihood of CPA occurring with the patients current condition or status and explain the success rates of CPA.
obtain their wishes.

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12
Q

what are the 3 components of BASIC life support?

A
  1. airway (SECOND)
  2. breathing (THIRD)
  3. circulation (FIRST)
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13
Q

T/F: you should establish an airway prior to starting compressions

A

false opposite

start manual compressions immediately, then place ET tube, and strt providing manual breaths.

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14
Q

once a patient is intubated and compressions are continuing, you should be giving manual breaths. what % oxygen should u put the patient on and how many breaths/min should you give the patient?

A

100% oxygen
8-12 breaths/min

if you give too many, this can decrease venous return to the heart

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15
Q

what is the difference between the thoracic pump theory and the cardiac pump theory in regard to manual chest compressions during CPR?

A

thoracic pump – for large breed dogs; we have to place our hands over the widest part of the chest in order to cause the greatest change in intrathoracic pressure to generate adequate blood flow. we cannot reach their heart

cardiac pump – for smaller animals; placing hands directly over heart space to push blood forward

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16
Q

how many compressions do you give a patient per minute during CPR and how hard should these compressions be?

A

100 compressions per minute

you should do them to depress the chest by 1/3 and allow COMPLETE recoil of the chest (this is when venous blood returns to the heart, which is required)

17
Q

what are indications for open-chest CPR?

A
  1. large and giant breed dogs
  2. thoracic trauma (rib fractures)
  3. pleural or pericardial space disease (pneumothorax, pleural/pericardial effusion, diaphragmatic hernia)
  4. intraoperative arrest
  5. ineffective chest compressions

you should ONLY perform if you have the facilities and are prepared for thoracotomy if you are successful.

18
Q

what are the 4 heart rhythms for CPA?

A
  1. asystole
  2. pulseless electrical activity
  3. pulseless VTACH
  4. ventricular fibrillation
19
Q

what are the shockable rhythms?

A
  1. ventricular fibrillation
  2. pulseless ventricular tachycardia
20
Q

how can you obtain emergency venous access in patients during CPA?

A

venous cut down
intraosseous catheter

21
Q

what is the most common drug used in CPA?

A

epinephrine

22
Q

what drug can be used BEFORE arrest for bradycardia?

A

atropine

23
Q

T/F: lidocaine is routinely used in CPA for correction of arrhythmias

A

false – not routinely used
it suppresses ventricular activity and may reduces likelihood of successful defibrillation

24
Q

when should you give fluid therapy during CPA?

A

not in ALL cases
only if the patient was hypovolemic
can reduce coronary perfusion.

25
Q

T/F: you should give patients in CPA steroids in order to suppress an inflammatory reaction associated with CPA

A

false – steroids are not routinely recommended. only in cases of anaphylactic shock.

26
Q

T/F: electrolytes are not routinely indicated during CPA

A

true
if hypoglycemic or hyperkalemic give calcium gluconate.

27
Q

what reversal agents should you have available on your crash cart?

A

atipamezole, naloxone, flumazenil, or just turn off anesthetic gasses.

28
Q

what are 2 monitoring parameters you need to do during CPR?

A
  1. electrocardiogram - rhythm diagnosis and evaluating therapy success
  2. end-tidal CO2 – confirm ET tube placement, identify ROSC, assess quality of CPR
29
Q

T/F: post-resuscitation care is just as vital as resuscitation care

A

true these patients frequently have cardiovascular instability and may require CRIs of norepi, dopamine, or dobutamine. and arrhythmias are common too.
neurologic dysfunction is very common (blindness, stupor, coma)

30
Q

what is involved in post-resuscitation care?

A
  1. pain management – use reversible drugs (opioids prefered)
  2. postpone procedures if you can.
  3. watch for additional complications (coagulopathies, organ dysfunction, contusions)

Small Animal Emergency Medicine (10 decks)

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