Overview

Question 1

Cardiac Arrest w/ potential Treatable Cause

Answer 1

In cases of cardiac arrest likely caused by hemorrhage or anaphylaxis, a rapid transport with en-route management is the expectation; call CliniCall if you require assistance but in these cases transport is key

For cardiac arrest situations where you suspect another treatable cause such as PE, sepsis, overdose, hypothermia etc. call CliniCall early - do NOT wait 15 mins

Question 2

Cardiac Arrest from unknown or Cardiac causes

Answer 2

Initiate call to CliniCall after 15mins of high quality of CPR

Question 3

5 Principles of High Quality CPR

Answer 3

• Optimum compression rate (100-120/min)
• Optimum depth (2” or 5cm)
• Complete chest recoil
• Optimum ventilation rate (1 breath/ 6 seconds)
• Infrequent compression pauses (no pause >10s)

Question 4

Compression Rate

Answer 4

100-120 per minute

Question 5

Compression Depth

Answer 5

2-2.5 inches in a normal adult

Question 6

Complete Chest Recoil

Answer 6

very important

• between each compression a negative pressure develops which draws blood in ready for the next compression
• also when coronary arteries are perfused

Question 7

Ventilation Rate

Answer 7

• must be kept down to 9-10 per minute
• hyperventilation maintains positive pressure in the chest and reduces CPR blood flow
• extremely important to ventilate w/ volumes 500-600ccs (approx 1/3 of bag)

Question 8

Compression Pauses

Answer 8

• minimize interruptions to 10s or less
• after initial absense of a pulse is established and CPR started, subsequent pulse checks are done only during the analyze time or if signs of ROSC (coughing, movement, normal breathing) are observed

Question 9

Guiding Principles - when to start CPR

Answer 9

CPR should be started when the rescuer finds the victim unresponsive and not breathing or not breathing normally. The 2015 AHA Guidelines have reorganized the traditional “A-B-C” to “C-A-B” in order to emphasize the importance of chest compressions.

Question 10

Guiding Principles - determining the history of the collapse

Answer 10

depending on hx of the collapse you will need to make a decision about early transport or on-scene cardiac arrest management

Question 11

When in doubt, start CPR.

Answer 11

• if the pt is not in cardiac arrest they will begin rapidly to show signs of life and CPR can be stopped

Question 12

Guiding Principles - time on chest makes a difference

Answer 12

2010 AHA guidelines now recommend a CAB approach underscoring the need to get on the chest early

**also important to maintain continuous chest compressions as much as possibe

Question 13

Guiding Principles - switching defibrillators

Answer 13

an appropriate time to switch AEDs is during one of the two minute periods of CPR

Question 14

Guiding Principles - pediatric arrest

Answer 14

most cardiac arrests in children are not due to sudden rhythm disturbances and focus should be on high quality CPR, oxygenation and rapid transport

paramedics need to consider the cause early and if there is a history of blunt trauma to the chest, electrocution, or the pt has a cardiac history