Principles of Recusitation Flashcards
What is resuscitation?
The process of correcting physiological disorders in an acutely unwell patient
What is the pathophysiology of cardiac arrest?
Adequate
-Airway
-Breathing
-Circulation
All are required for oxygen delivery to organs
Inadequate oxygen delivery leads to organ failure
Vital organ failure leads to cardio-respiratory arrest
Early detection and treatment of a developing problem may avoid cardio-respiratory arrest
What are some clinical indicators of deterioration?
Tachypnoea
Tachycardia
Hypotension
Reduced conscious level
What is the rapid assessment of Acute Illness?
General impression
ABCDE
What questions should you think about when a patient is unwell?
Are we in the best place/postition?
What equiptment do i need?
Do i have enough help?
Who am i gonna call? - GHOSTBUSTERS
What are important assessments of the Airway?
Open or closed Action required Adjucts Anaesthetic support Obstruction
What can help you support an airway?
Nasopharyngeal
Oropharyngeal
Chin lift
What are important assessments of Breathing?
Present or absent Adequate ventilation Oxygen source and means of delivering oxygen Monitor SATs Visible signs - Tripodding
Who gets High flow oxygen?
ALL PATIENTS (who are breathless)
What is Hypoxic Drive?
Longstanding pulmonary disease results in CO2 retention as chemoreceptors are downregulated
Swith from hypercapnic drive to hypoxic drive of ventilation
High O2 conc results in hypoventilation and CO2 retention
What is important in COPD patients?
Aim to avoid severa Hypoxia All breathless patients get oxygen Measure ABGs -If CO2 is ok observ closely -If CO2 is rising treat (O2 88% to 92%)
How can High CO2 in breathless patient and Pulmonary oedema be differentiated?
HCO3
What is the sepsis 6?
Oxygen Blood cultures IV antibiotics Fluid challenge Lactate Urine Output BUFALO chicken wings
What is important in the assessment of Circulation?
Present or absent Pulse assessment Blood pressure CRT ECG Adequate perfusion Colour Concious level
What can cause circulatory failure?
Internal/GI bleeding Haemorrhage Clots - PE, Cardiac Tamponade Hypovolaemic shock Trauma
What can cripple someone?
The vein that they keep on closing
What can be used immediately at the scene of an accident to reduce a pelvis fracture?
Reduce volume of the pelvis by using a special belt
Where can blood loss occur from/
Chest
Pelvis
Long bones
ETC
What is the treatment for a complete femoral fracture?
Thomas Splint
What must be considered when using a Thomas splint?
IV access
What should be considered with IV access?
If present, is it working? If not, what sort of cannula? Where to put it? What blood samples to take? Do you want to give fluids?
What should be considered with fluid?
What fluid?
How much?
How quickly?
What is transamic acid used for?
massive blood loss
DEFG?
Don't ever forget Glucose Hypoglycaemia cause of decreased conscious level Appear acutely unwell Give dextrose orally or IV IM Glucagon Rapid reversal
What is measured in the D section?
Glucose Neuro -AVPU -GCS -Pupils -Weakness
What should be looked for in the Exposure section?
Colour
Rashes
Blood loss
Drains
What important information should be gathered?
Who is the patient? What is the working diagnosis? Events preceding acute episode Get the notes Get the observation chart Should we be resuscitating?
What should be done after ABCDE?
Re-evaluate Continuous monitoring Further investigations Specialist involvement Inform /involve relatives
