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QLD Ambulance Critical Care > Critical Care Concepts > Flashcards

Critical Care Concepts Flashcards

1
Q

During resuscitation, what circumstances (9) mandate contact with clinical advice line within 15min of starting CPR?

A
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2
Q

What is the general discontinuation criteria?

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3
Q

What is the rapid discontinuation criteria?

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4
Q

Verification of death exam parts?

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5
Q

When deciding to commence or withhold resuscitation, what legal factors need to be considered?

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6
Q

Describe the “Bundles of Care” for cardiac arrest management

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7
Q

What are the expected pre-ductal SpO2 in the neonate?

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8
Q

Describe the neonatal resuscitation algorithm

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9
Q

Describe the paediatric cardiac arrest algorithm

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10
Q

Describe post-ROSC management

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11
Q

Describe the traumatic arrest management algorithm

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12
Q

Describe strategies for managing cardiac arrest with suspected asthmatic/lung disease aetiology

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13
Q

Discuss management of CPR-induced consciousness

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14
Q

Describe management of hypothermic cardiac arrest

A

Consider prolonging resuscitation until warmed
# Consider transfer to ECMO-available hospital
# If < 30 deg and in PEA, assess for pulse over 1 minute and consider EtCO2 or USS if available to confirm cardiac output. CPR may precipitate VF in this cohort
# WITHHOLD drugs until warmed to > 30 deg
# >30 and <35 deg, double drug intervals ie adrenaline Q8min
# >35 deg revert to normal drug intervals
# If <30 deg & in VT/VF, give 3x DCCS then withhold until >30deg

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15
Q

Discuss issues with ventilation in obese patients

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16
Q

How should an arrest with a PPM/ICD in situ be managed?

A

Place defibrillator pads >8cm from device
# AP and AL positions both acceptable

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17
Q

What accommodations should be made for a pregnant patient in cardiac arrest?

A

Tilt to L) lateral to avoid aortocaval compression
# Intubation to facilitate higher Paw and/or PIP
# Downsize tracheal tube by 0.5-1mm due to airway oedema
# Place compressions superiorly due to gravid uterus

18
Q

Describe approach to tracheostomy/laryngectomy management

A
19
Q

What are the (7) contraindications of CPAP?

A
20
Q

What is the FiO2 of each CPAP Paw?

A
21
Q

What does a this waveform represent?

A
22
Q

What does a Curare-cleft represent?

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23
Q

What does a prominent phase IV represent?

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24
Q

What does a dimorphic phase II represent?

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25
Q

What does this waveform represent?

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26
Q

What does this waveform represent?

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27
Q

Discuss EtCO2 values in cardiac arrest

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28
Q

Describe asthma pathophysiology

A

Bronchospasm

29
Q

Describe COPD pathophysiology

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30
Q

Describe obstructive lung ventilation strategies

A

General Strategy
# Aim for largest ETT that can be passed
#Optimise IV & NEB bronchodilators (B2, steroids, Mg2+)
# Smaller tV 6-8mL/kg
# Lower frequency (~6-8/minute)
–> Higher levels of sedation may be required
–> Sustained paralysis may be required for desynchrony
# ZEEP (or PEEP <3-5cmH2O if you absolutely insist)
# Prolonged I:E ratios (1:4-6)
# Short inspiratory times (to prolong I:E ratio)
# Tolerate hypercapnoea
# Monitor for tension pneumonthorax

If on MV
# Tolerate high PIP
# Greater PIP - Pplat difference reflects degree of bronchospasm
#Paw not necessarily indicative of alveolar pressure

31
Q

Describe restrictive ventilation strategies

A

General strategy
# Smaller tV
# Higher frequency (14 - 20)
# Higher PEEP to maximise recruitment (>5cmH2O)

32
Q

What is a normal V/Q ratio?

A

0.8 (4L ventilation/5L cardiac output)

33
Q

Describe the concept of dead space

A

Adequately ventilated spaces of lung that have nil or poor perfusion

34
Q

Describe the VQ ratios in relationship to areas of lung

A
35
Q

Describe the differences between the right and left ventricle, especially in terms of pressure and volume relationships

A

“The right ventricle is volume-tolerant (preload) and pressure-intolerant (afterload)”

36
Q

Describe ECG changes in RV hypertrophy/strain

A
37
Q

Describe community management of pulmonary hypertension. What pressure is defined as pulmonary hypertension?

A

> 20-25mmHg MPAP

38
Q

What are the Well’s criteria (7) for pulmonary embolism?

A
39
Q

Explain the pathophysiology of obesity hypoventilation syndrome?

A
40
Q

What does lung compliance refer to?

A
41
Q

What is base excess?

A

QLD Ambulance Critical Care (4 decks)

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