New/important Flashcards
Describe high quality chest compressions? (Adult)
Depth of at least 5cm At least 100/minute Full chest recoil Minimise interruptions - continue whilst charging 30:2
What is the maximum interruption in chest compressions?
5 seconds
What might be considered if VF/VT occurs during cardiac catheterisation or early post-op (cardiac)? (Also initial VF/VT if already attached to a manual debrifillator)
Three-stacked shocks
How long should you do CPR before defibrillation in an unwitnessed OOHCA?
No specific time - defibrillate early
What delivery method if IV access not working?
IO (No longer in ET tube)
Describe the pharmacological adjuncts in treating VF/VT cardiac arrest?
Adrenaline 1mg after the third shock, then every 3-5 minutes.
Amiodarone (?300mg after third shock)
Use of atropine in PEA/asystole?
No
What O2 sats when ROSC?
94-98%
What are the aims for blood glucose post ROSC?
Treat if over 10mmol/l
Avoid hypoglycaemia as well (<4)
Why have NSTEMI/unstable angina been combined into NSTEMI-ACS?
DDx dependent on biochemical markers that do not show up for several hours, but treatment must be given on presentation of clinical signs.
What information can be used for safe early discharge? (Of history, examination, biomarkers, ECG and risk scores)
None
Should you use nitrates for diagnostic purposes?
No
How to stop a broken ICD from continually shocking?
Magnet
Can bystanders give acetyl salicylic acid without EMS dispatcher assistance?
Yes - aspirin tick tick
Can you give abciximab before PCI?
No
When are beta-blockers useful in MI?
Only if tachyarrythmias. Only start (low and slow - titrate) once pt stable.
What pulses can be used as part of assessing signs of life in paediatrics?
Carotid - children
Brachial - infants
Femoral - children and infants
We know 15:2 for children, but what about if lay-rescuers?
Can use 30:2
Chest compressions in paeds - signs of high quality
Compress to at least 1/3 of anterior/posterior diameter.
(4 cm infants, 5cm children)
Complete release
Not greater than 120, but more than 100/min.
Infants - 2 finger if alone, two thumb encircling if 2 or more rescuers.
What output of defib for ages 1-8?
50-75J
Can you use an adult AED for under 1 year old?
If shockable rhythm, and no attenuator yes - but preferably with lower output.
What dose for adults and paeds when shocking?
single-shock: non-escalating dose of 4 j/kg.
Preferably biphasic
When should cricoid pressure be modified/discontinued?
If impeding ventilation or the speed/ease of intubation.
Should you use cuffed or uncured tubes in children?
Cuffed - use formula
How long should you leave an uncompromised baby’s cord unclamped for?
At least one minute post complete delivery
What % of inspired oxygen do you use for term infants?
21% - AIR.
Only increase if with effective ventilation
What room temperature should a preterm baby of less than 28 weeks be delivered in?
At least 26 degrees.
CPR ratio for neonates?
3:1
Meconium aspirate tx?
Inspect oropharynx
Suction
Intubation - if unsuccessful: mask ventilation, esp if bradycardic.
Neonatal adrenaline dose?
10-30 ug/kg
Tx for moderate-severe hypoxic-ischaemic encephalopathy?
Therapeutic hypothermia
How quickly do CPR skills deteriorate?
3-6 months
