CPR/Recover Flashcards

1
Q

____ is cessation of normal circulation due to failure of the heart to contract effecively?

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 resorted?

A

Cardiopulmonary resuscitation (CPR)

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3
Q

T/F if CPA does not have a reversible cause, 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 cuase 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

sepsis
SIRS
heart failure
pulmonary disease
trauma
neoplasia
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

Leader (directs everyone, best for this person to be the one who knows the patient the best)
Ventilator
Compressor
Time keeper
Recorder
Drug administrator

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10
Q

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

A

ET tubes
Ambu bags
laryngoscope
gauze squares
ET tubes 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 O?

A

BEFORE the patient has arrested/ 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) circulation
2) airway
3) Breathing

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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 start 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 you 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.

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

17
Q

What are indications for open chest CPR?

A

large and giant breed dogs
thoracic trauma
pleural or pericardial space disease
intraoperative arrest
ineffective chest compressions

18
Q

What are the 4 heart rhythms of CPA?

A

asystole
pulseless electrical activity
pulseless VTACH
ventricular fibrillation

19
Q

What are the shockable rhythms?

A

Ventricular fibrillation
pulseless ventricular tachycardia

20
Q

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

A

Venous cut down
intraossesous 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 its not routinely used
it suppresses ventricular activity and many reduces likelihood of successful defibrillaiton

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) end tidal CO2 to confirm ET tube placement, identify ROSC, assess quality of CPR
2) Electrocardiogram- rhythm diagnosis and evaluating therapy success

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. Arrhythmias are common too. Neurologic dysfunction is very common

30
Q

What is involved in post-resuscitation care?

A

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