Medical Emergencies

Question 1

Chain of survival includes:

Answer 1

1) Early access to emergency medical services (EMS) and cardiac arrest prevention
2) Early high-quality CPR
3) Early defibrillation
4) Early advanced care and post-resuscitation care

Question 2

Shockable rhythms:

Answer 2

1) Ventricular fibrillation (VF)
2) Pulseless ventricular tachycardia (VT)

immediate defibrillation is essential for VF and pulseless VT

Question 3

Well performed CPR can help maintain…

Answer 3

• myocardial and cerebral viability and may improve the likelihood of success with subsequent shocks -

Question 4

Non-shockable rhythms:

Answer 4

1) PEA (pulseless electrical activity)
2) Asystole

• do not defibrillate- as this may be deleterious*
• prognosis for these conditions is much worse than for VT/ VF*

Question 5

Algorithm loops:

Answer 5

1) Minimize interruption to chest compressions during ALS interventions by planning and confirm their utility before attempting them
2) Administer 100% O2 when available
3) Attempt to secure an advanced airway/ ventilation technique but do not interrupt CPR for more than 20 seconds
4) Use waveform capnography to confirm airway placement and monitor the adequacy of CPR
5) Obtain vascular access
6) Administer adrenaline every second loop (i.e. every 4-5 minutes)
7) Administer other drugs or electrolytes as indicated for individual circumstances
8) Correct potential reversible conditions that may have precipitated the cardiac arrest/ and or reduced the chances of successful resuscitation

Question 6

The 4 H’s

Answer 6

1) Hypoxaemia
2) Hypovolaemia
3) Hyper-/ hypokalaemia/ other electrolyte or hydrogen ion disorders
4) Hypo-/ hyperthermia

Question 7

The 4 T’s

Answer 7

1) Tension pneumothorax
2) Tamponade (cardiac)
3) Toxins, poisons, drugs
4) Thrombosis: pulmonary or coronary