CPR/RECOVER Flashcards
Define cardiopulmonary arrest
The cessation of normal circulation due to failure of the heart to contract effectively
- aka death
Define CPR
Cardiopulmonary resuscitation= an emergency procedure performed in order to manually maintain perfusion until spontaneous circulation can be restored
- aka bringing them back from the dead
What are 4 things that are very important to keep in mind about CPR?
- If CPA does not have a reversible cause, CPR is unlikely to be successful so you should not attempt it
- CPR is unlikely to be successful- success rates are generally around 5% (around 25% if anesthetic related)
- Owners think that CPR works
- Prevention will give you the best odds
What information does the owner need from the veterinarian in order to help with the decision about whether they want CPR to be performed if their patient arrests?
-chances of coming back? (can share data, but data does not apply to an individual)
-cost
In reality, owners cannot be fully informed, and often aren’t thinking rationally in these stressful situations
- can offer it to be up to veterinary discretion
Are you allowed to tell owners that you will not perform CPR on their animal?
Yes- CPR is a medical procedure
- you can say that you do not believe that it is medically appropriate
What are the 3 main features of cardiopulmonary arrest and what are the common preceding events?
Key features:
- loss of consciousness
- loss of normal, spontaneous breathing
- loss of palpable pulses
*dont need any special equipment- can have a heartbeat on auscultation, but if no pulses you still need to initiate CPR
Common preceding events:
- bradycardia
- worsening mentation
- sudden increase in vagal tone (vomiting, straining to defecate)
- sudden change in breathing pattern
Where should you feel for a pulse in a dog/cat?
Femoral
- if you cant feel this, start doing CPR
- don’t delay CPR to find a pulse
What are some common diseases or situations that predispose to cardiopulmonary arrest (and therefore warrant intense monitoring and aggressive therapy)?
- Sepsis
- SIRS
- heart failure
- pulmonary disease
- trauma
- neoplasia
- general anesthesia
What are the different roles during CPR?
Leader (directs traffic), ventilator, compressor, time keeper, recorder, drug administrator
- need a minimum of 3 people
What are some important things you should discuss with the owner if there is a risk of a patient undergoing arrest?
- Ideally talk to them before the arrest
- Discuss with owners the likelihood of an arrest happening
- Explain the likelihood of success should a CPA occur (likelihood of rearrest is high)
- Obtain their wishes in advance when possible
What is included in basic life support?
Airway, breathing and circulation
- aka securing airway, breathing for them, and performing chest compressions
Advanced life support includes everything else
T/F: after an arrest, you should immediately start chest compressions
True
- securing the airway can wait
Order should be circulation, then airway, then breathing
- often just one person available at first - can do immediately and on your own
What is the rate of manual breaths that you should do after you have intubated a patient?
8-12 breaths/min with 100% oxygen
- keep this low as it is a positive pressure breath- can reduce venous return to the heart
What is the difference between the thoracic pump and the cardiac pump theory?
Thoracic pump: hands over widest part of chest to provide greatest change in intrathoracic pressure (in patients >15 kg)
Cardiac pump: squeezing the heart itself to push blood forward (in patients <15 kg)
In both, should depress the chest by 1/3, allow complete chest recoil
- 100 compressions per min- use music!
What are the 4 recognized arrest rhythms? Which are shockable?
Asystole, pulseless electrical activity (looks like normal ecg with no pulse), ventricular fibrillation, pulseless vtach
Ventricular fibrillation and pulseless Vtach are the shockable rhythms
- trying to shut down the electrical activity of the heart to restart it
