New/important

Question 1

Describe high quality chest compressions? (Adult)

Answer 1

Depth of at least 5cm
At least 100/minute
Full chest recoil
Minimise interruptions - continue whilst charging
30:2

Question 2

What is the maximum interruption in chest compressions?

Answer 2

5 seconds

Question 3

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)

Answer 3

Three-stacked shocks

Question 4

How long should you do CPR before defibrillation in an unwitnessed OOHCA?

Answer 4

No specific time - defibrillate early

Question 5

What delivery method if IV access not working?

Answer 5

IO (No longer in ET tube)

Question 6

Describe the pharmacological adjuncts in treating VF/VT cardiac arrest?

Answer 6

Adrenaline 1mg after the third shock, then every 3-5 minutes.
Amiodarone (?300mg after third shock)

Question 7

Use of atropine in PEA/asystole?

Answer 7

No

Question 8

What O2 sats when ROSC?

Answer 8

94-98%

Question 9

What are the aims for blood glucose post ROSC?

Answer 9

Treat if over 10mmol/l

Avoid hypoglycaemia as well (<4)

Question 10

Why have NSTEMI/unstable angina been combined into NSTEMI-ACS?

Answer 10

DDx dependent on biochemical markers that do not show up for several hours, but treatment must be given on presentation of clinical signs.

Question 11

What information can be used for safe early discharge? (Of history, examination, biomarkers, ECG and risk scores)

Answer 11

None

Question 12

Should you use nitrates for diagnostic purposes?

Answer 12

No

Question 13

How to stop a broken ICD from continually shocking?

Answer 13

Magnet

Question 14

Can bystanders give acetyl salicylic acid without EMS dispatcher assistance?

Answer 14

Yes - aspirin tick tick

Question 15

Can you give abciximab before PCI?

Answer 15

No

Question 16

When are beta-blockers useful in MI?

Answer 16

Only if tachyarrythmias.
Only start (low and slow - titrate) once pt stable.

Question 17

What pulses can be used as part of assessing signs of life in paediatrics?

Answer 17

Carotid - children
Brachial - infants
Femoral - children and infants

Question 18

We know 15:2 for children, but what about if lay-rescuers?

Answer 18

Can use 30:2

Question 19

Chest compressions in paeds - signs of high quality

Answer 19

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.

Question 20

What output of defib for ages 1-8?

Answer 20

50-75J

Question 21

Can you use an adult AED for under 1 year old?

Answer 21

If shockable rhythm, and no attenuator yes - but preferably with lower output.

Question 22

What dose for adults and paeds when shocking?

Answer 22

single-shock: non-escalating dose of 4 j/kg.

Preferably biphasic

Question 23

When should cricoid pressure be modified/discontinued?

Answer 23

If impeding ventilation or the speed/ease of intubation.

Question 24

Should you use cuffed or uncured tubes in children?

Answer 24

Cuffed - use formula

Question 25

How long should you leave an uncompromised baby’s cord unclamped for?

Answer 25

At least one minute post complete delivery

Question 26

What % of inspired oxygen do you use for term infants?

Answer 26

21% - AIR.

Only increase if with effective ventilation

Question 27

What room temperature should a preterm baby of less than 28 weeks be delivered in?

Answer 27

At least 26 degrees.

Question 28

CPR ratio for neonates?

Answer 28

3:1

Question 29

Meconium aspirate tx?

Answer 29

Inspect oropharynx
Suction
Intubation - if unsuccessful: mask ventilation, esp if bradycardic.

Question 30

Neonatal adrenaline dose?

Answer 30

10-30 ug/kg

Question 31

Tx for moderate-severe hypoxic-ischaemic encephalopathy?

Answer 31

Therapeutic hypothermia

Question 32

How quickly do CPR skills deteriorate?

Answer 32

3-6 months