Medical Cardiac Arrest

Question 1

Primary Survey

Answer 1

• Stabilize head and neck if necessary
• Assess level of consciousness using AVPU (note apnea or agonal respirations)
• Assess carotid pulse for a max of 10 seconds
• If no pulse immediately start chest compressions
• Advise partner of known cardiac arrest and initiate CPR protocol attaching AED to analyze immediately
• Open airway and ventilate using BVM
• Apply high flow O2 at 15 lpm as soon as possible
• Insert airway adjunct as soon as practical (OPA or NPA)
• Conduct full RBS (visualize, palpate, and auscultate where appropriate) and complete Primary Survey
• Ensure compressor changes every 2 minutes(may switch at each ‘ANALYZE’)
• Attempt to locate DNR
• Attempt thorough history taking from bystanders to determine cause of cardiac arrest

Question 2

Decision Point

Answer 2

Findings in an unstable (RTC) patient include:
- Cardiac Arrest
- Post-Arrest

Question 3

Patient History

Answer 3

SAMPLE/OPQRRRST (if applicable/available from bystander or family)

Question 4

Critical History

Answer 4

• Time of collapse/last seen well?
• Bystander CPR/AED initiated?
• If yes, shocks/no-shocks prior to arrival
• How was the patient presenting prior to collapse?
• Are there any advanced directives in place?

Question 5

Load and Transport

Answer 5

• Refer to protocol on when to transport
• Request additional resources (FR’s, ACP, additional PCP, etc.)
• Handle the patient gently; communicate with partner/team prior to any movement of the patient
• Utilize lifting device to minimize movement of the patient (clamshell/backboard)
• Leave AED attached to the patient (With power on) until arrival at hospital
• Continue CPR as required during transport, minimize interruptions to CPR

Question 6

Protocol(s)

Answer 6

• Cardiac arrest protocols
• Discontinue resuscitation

Question 7

Post Arrest Care

Answer 7

• Continue assessment of ABC’s including and interventions that were introduced
• Anticipate re-arrest and preparation of resuscitation equipment
• Leave AED attached to patient until arrival at hospital
• Begin secondary survey and continue with critical history