Medical Cardiac Arrest MD

Question 1

What are the indications?

Answer 1

non- traumatic cardiac arrest

Question 2

What are our 5 early transport primary clinical considerations in this directive?

Answer 2

1. pregnancy >=20wks
2. hypothermia
3. airway obstruction
4. non opioid drug OD/toxicity
5. other known reversible cause of arrest not adressed

Question 3

For patients in refractory VF or pulseless VT, when should we transport them?

Answer 3

after 3 consecutive shocks

Question 4

When should the initial rhythm interpretation be performed?

Answer 4

AS SOON AS POSSIBLE!!

Question 5

After first analysis, when should the rest of the interpretations be performed? (if you are running the full 20 mins)

Answer 5

every 2 mins with high quality chest compressions in between!!

Question 6

What are the conditions for CPR!

Answer 6

altered LOA

performed in 2 min intervals

Question 7

What are conditions for manual DEFIB??

Answer 7

> =24hours
alters LOA
VF or pulseless VT

Question 8

Do we as paramedics count PRE arrival interventions as part of our patient care???

Answer 8

NO. Care PTA of EMA can be considered and documented, however, in the setting of a cardiac arrest where a medical TOR may apply, the paramedics should do a complete 20 mins of resuscitation.

Question 9

When can we consider patching early for a TOR?

Answer 9

If there are extenuating circumstances and if the medic believes resuscitation is futile

Question 10

When using an SAED and performing rhythm analysis what should take place?

Answer 10

the truck MUST be stopped to minimize artifact and the risk of an inaccurate rhythm interpretation

Question 11

For witness arrests in the back of the truck, what should medics DO??

Answer 11

use clinical judgement to decide wether to stay and perform resuscitation or proceed to hospital.

paramedics should perform three full analysis and then proceed/patch or to provide ONE analysis and GO!!
- must perform minimum of ONE analysis!!!

Question 12

What are factor that are apart of the decision to run the arrest en en-route or STOP for the 20 mins on the road?

Answer 12

distance to ER

probable cause of arrest

ability to provide adequate CPR/ventilations

shockable / vs non shockable etc…

Question 13

Conditions for EPI in cardiac arrest?

Answer 13

> = 24hrs

anaphylaxis as suspected cause of arrest

Question 14

What are conditions for the MEDICAL TOR?

Answer 14

arrest NOT witnessed by paramedics

AND

no rosc in 20 mins

AND

no defibs delivered

Question 15

Contraindications for MEDICAL TOR??

Answer 15

all the early transport considerations
- hypothermia
- pregnant >= 20 wks
- airway obstruction
- non opioid drug overdose/toxicity
- other known reversible cause not addressed

Question 16

What are the manual defib settings for someone >=24hrs - <8yrs?

Answer 16

initial shock:
- 2J//kg
subsequent shocks:
- 4J/kg after that!

Question 17

What are manual defib settings on the ZOLL monitor for someone OVER 8 years???

Answer 17

120, 150, 200 joules!!!

Question 18

Should we administer naloxone in medical cardiac arrests?

Answer 18

NAAAAHHHHH
**oxygenation and compressions= the bigger priority!!

Question 19

What could we consider if the OPA/NPA and BVM isnt working well?

Answer 19

SGA!!! under the SGA medical directive.

Question 20

Once an SGA is placed, what happens to compressions vs ventilations?

Answer 20

they become asynchronous!!

Question 21

If a pt re arrests EN route after a ROSC, what are the four steps we need to follow?

Answer 21

1. pull over
2. perform ONE analysis
3. treat rhythm accordingly
4. continue with transportation to the receiving facility with no further stops!

Question 22

Do we need a blood sugar on a VSA patient??

Answer 22

NOPE, not indicated and no clinical value!!