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YEAR 4 OSCE > ILS Training > Flashcards

ILS Training Flashcards

1
Q

How can the reversible causes of cardiac arrest be remembered?

A

5Hs
5Ts

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2
Q

What are the 5Hs?

reversible causes of cardiac arrest

A

Hypovolaemia
Hypoxia
Hypokalemia
Hypothermia
Hydrogen ion excess

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3
Q

What are the 5Ts?

reversible causes of cardiac arrest

A

Toxins
Tension pneumothorax
Tamponade
Thrombosis - pulmonary thrombosis
Thrombosis - coronary thrombosis

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4
Q

What are signs of hypovolaemia?

A
  • tachycardia - racing HR
  • narrow QRS on an ECG
  • blood loss
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5
Q

How is hypovolameia managed?

A
  • get IV access or IO access
  • give fluids and/or blood
  • fluid challenge
  • high flow oxygen (if sats are low) - 15L high flow oxygen through non-rebreathe max then titrate down
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6
Q

What are signs of hypoxia?

A
  • bradycardia
  • cyanosis - can be peripheral or central.
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7
Q

How is hypoxia managed?

A
  • check airway is patent
  • ventilation
  • oxygen supply - check it is adequate.
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8
Q

What are signs of hypokalaemia and hyperkalaemia on an ECG?

A
  • hypo = flattened T waves and U waves, long PR and long QT
  • hyper = tall tented T waves and widened QRS
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9
Q

How is hyperkalaemia managed?

A

Hyper
* ventilation
* sodium bicarbonate

Hypo
* saline with pot chloride (40mmol)
* ventilate
* continuous ECG

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10
Q

What are signs of hypothermia?

A

shivering, and Hx of exposure to cold temp

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11
Q

How is hypothermia managed?

A

active warming

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12
Q

what are signs of hydrogen in excess i.e. acidosis?

A

low amplitude QRS

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13
Q

How is hydrogen ion excess managed?

A

ABG
Ventilate
sodium bicarb

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14
Q

What are signs of tamponade?
How is it maanged?

A

Signs:
* tachycardia
* narrow QRS
* raised JVP
* no pulse
* muffled heart sounds

Managed:
* pericardiocentesis
* thoracotmoy

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15
Q

What are signs of toxin/overdose?
How is it managed?

A

signs = long QT, pinpoint pupils, resp depression
Management - based on drug, need supportive care. See table from Sas

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16
Q

What are signs of tension pneumothorax?
How do we manage tension pneumothorax?

A

Signs:
* slow HR/brady,
* narrow QRS,
* unequal rise and fall of chest,
* raised JVP,
* tracheal deviation

Managed:
* needle decompression
* insert chest tube

17
Q

What are signs of pulm thrombosis?
How is it managed?

A

Signs:
* tachycardia
* narrow QRS
* SOB
* low O2 sats
* pleuritic chest pain

Managed:
* emblectomy
* anticoag therapy
* fibrinolytic therapy

18
Q

What are signs of coronary thrombosis?
How is it managed?

A

signs = abnrmal ECG, cardiac chest pain
management = MONA, angioplasty, stent, coronoary bypass

19
Q

What are non-shockable rhythms?

A

aystole and PEA

20
Q

How is a non-shockable cardiac arrest managed?

taken from Sas

A
  • Continue CPR and recheck rhythm every 2 mins
  • Establish IV or IO
  • Administer 1mg 1:10,000 adrenaline IV
  • Repeat every 3-5 mins whilst patient remains in cardiac arrest
  • Consider reversible causes e.g. 5Hs and 5Ts
21
Q

what do 1, 2 and 3 show?

A

1 = asystole
2 and 3 = PEA

22
Q

How is asystole managed?

taken from sas

A
  • Recognise as asystole
  • Continue CPR and re assess rhythm every 2 minutes
  • Establish IV or IO access
  • immediately administer 1mg:10,000 adrenaline IV
  • Repeat every 3-5 minutes whilst patient remains in cardiac arrest
  • Consider reversible causes of cardiac arrest e.g. hypovolaemia give fluids
23
Q

What is PEA?

A

pulsless elec activity - they have a rhythm on ECG but no pulse when you check

24
Q

How is PEA managed?

taken from Sas

A
  • Recognise as PEA
  • Continue CPR and chassess rhythm every 2 minutes
  • Establish IV or IO access
  • Immediately administer 1mg:10,000 adrenaline IV
  • Repeat every 3-5 minutes whilst patient remains in cardiac arrest
  • Consider reversible causes of cardiac arrest e.g. hypovolaemia give fluids
25
Q

What rhythms in ILS are shockable?

A

VT (pulseless VT)
VF

26
Q

How to carry out managmenet for shockable rhythm?

A
  • once you know it is shockable = 1st shock 200J
  • go back to CPR straight after
  • reassess rhythm every 2 mins
  • 2nd shock 300J
  • 2 mins CPR
  • 3rd shock 360J –> after this shock = give 1mg 1:10,000 adrenaline and 300mg amiodarone with flush
  • all shocks from this point = 360J

Note: IV adrenaline can be given every 3-5 mins
Amiodarone is only given ONCE

27
Q

What is this?

A

VF

Note:
can be coarse (deep valleys and taller peaks) or fine (waves are short and shallow)
you cant see any identifiable P, QRS or T

28
Q

How is VF managed?

A

Needs shock - as it is NOT compatible with life
1. shock 200J
2. CPR
3. reassess 2 mins
4. if still in VF = shock 300J
5. CRP and assess 2 mins
6. if still in VF = shock 360J
7. give 1mg 1:10,000 adrenlaine and 300mg IV amiodarone, followed by flush of saline.
8. can give adrenaline every 3-5mins
9. continue cpr and shocks 360J

29
Q

What is this?
what do you need to check with this rhythm?

A
  • pulseless V tachycardia
  • need to check pt does NOT have pulse to confirm it as PULSELESS VT = so can shock
30
Q

How do you manage pulseless VT?

A

Needs shock
1. shock 200J
2. CPR
3. reassess 2 mins
4. if still in VF = shock 300J
5. CRP and assess 2 mins
6. if still in VF = shock 360J
7. give 1mg 1:10,000 adrenlaine and 300mg IV amiodarone, followed by flush of saline.
8. can give adrenaline every 3-5mins
9. continue cpr and shocks 360J

YEAR 4 OSCE (6 decks)

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