MDSO - Medical Cardiac Arrest And Post Arrest Care Flashcards
Automatic Joules Delivered, Shock #1, #2, #3
120 J, 150 J, 200 J
Hs and Ts - 6+ H; 4+ T
Hypovolemia, Hypoxia, H+ (acidosis), Hypo/Hyper K+, HypoMg++, Hypo/Hyper Temp
Thrombosis (coronary/pulmonary), Tension Pneumo, Tamponade (Cardiac), Toxins (incl Anaphylaxis)
Once ETT: Ventilation Rate: ?
10 per min ( 1 q 6 sec)
When do you give AMIO ? And How Much ?
Refractory VF/VT (shockable rhythm), after at least 1 EPI.
(Min Shockable Rythym at 2 successive analysis, after at least 1 EPI)
1st AMIO - 300 mg; 2nd AMIO if still refractory - 150 mg
When do you consider Chest Needle in VSA ?
Trauma Cardiac Arrest - double needles is standard
Otherwise, risk factors - COPD / Asthma - - - PEA with decreased AE/no AE on one side
Hypothermic Cardiac Arrest. What are the differences.
Only 1 shock on scene, CPR / work to rewarm, and transport ASAP
Not shockable, with CPR work to rewarm, transport ASAP
Handle with Care
No TOR unless can confirm internal temp is > 30 C
Consider Warm Fluids
ORNGE ROSC Guidelines:
12 lead post ROSC —— > PCI ?
Target MAP > 65
Targeted Temp Management (low normal - 32-36 - core- Monitor Temp
Sedation and NBM if shivering
Target SP02 of 94-98 or Pa02 of 100 mmHg
Target ETCO2 35-40 (low side of normal) or PaCO2 40-45
ROSC MDSO: Flowchart - 5 main considerations:
A: Optimize Ventilation & Oxygenation : target ETCO2 35-40 and Sats 94-98 - consider intubation if not already done
B: Manage Hypotension : target MAP > 65 - as per SHOCK Medical Directives (start with NE), do 12 Lead (consider PCI and other STEMI /ACS management)
C: NEURO - assess GCS, get sugar, manage sedation/pain for intubation as per MDSO, if sending is cooling patch to maintain
D: Comatose: if no response to Verbal on ROSC - then Targeted Temp Management (34-36)
E: If TTM - Esophageal Temp, TTM with +/- NMB
