In hospital resuscitation

Question 1

Describe proper chest compression technique

Answer 1

• 30 compressions to 2 ventilations
• hands over middle of lower half of sternum
• depth of 1/3 the AP diameter (5cm)
• rate of 100-120 compressions per minute

Question 2

What information can waveform capnography provide during CPR?

Answer 2

• confirm airway placement
• quality of CPR
• ROSC
• prognostication - low ETCO2 has worse outcomes

Question 3

Can you ventilate while compressions are happening?

Answer 3

• if an airway has been placed (LMA/ETT)

- rate of 10 bpm

Question 4

Describe the sequence of events after the defibrillator is attached

Answer 4

COACHED
Compressions continue
O2 away
All else clear
Charging 
Hands off (Im safe)
Evaluate Rhythm
Defibrillation/Dump

Question 5

When can you do a stacked shock?

Answer 5

If:
- Monitored or witnessed cardiac arrest
and
- immediately prior was well oxygenated and perfused
and
- a manual defib is rapidly available / shock can be delivered within 20s of arrest
Then:
-if initial rhythm is VF/pVT you can give 3 quick successive (stacked) shocks.
- check rhythm rapidly between shocks
- start CPR if 3 unsuccessful shocks
- these stacked shocks count as first defib in ALS algorhythm

Question 6

What is a precordial thump and when may it be done?

Answer 6

within 20s of monitored VF/pVT arrest while awaiting defib

using the ulnar edge of a tightly clenched fist delivering a sharp impact to the lower half of the sternum from a height of 20cm and retracting immediately to create an impulse

rarely works for pVT, no evidence fo VF