Principles of resuscitation

Question 1

Define resuscitation

Answer 1

•The process of correcting physiological disorders in an acutely unwell patient.

Question 2

What happens if their is inadequate O2 delivery ?

Answer 2

• Leads to organ failure.
• Vital organ failure can then lead to cardiorespiratory arrest

Question 3

What are some of the signs of patients at risk?

Answer 3

• Tachypnoea
• Tachycardia
• Hypotension
• Reduced conscious level

Question 4

What format is used to assess an acutely unwell patient ?

Answer 4

• General impression
• Airway assessment
• Breathing Assessment
• Circulatory Assessment
• Disability (Neuro)
• Exposure

ABCDE

Question 5

When assessing airway what do you need to check?

Answer 5

• Is the airway open or closed?
• Is their action required ?
• Do I need anaesthetic support?

Question 6

When assessing breathing what do you need to check?

Answer 6

• Is breathing present or absent ?
• Is their adequate ventilation?
• Do you need to give O2 to help with breathing

Question 7

What do all patients get?

Answer 7

High flow O2

Question 8

Briefly what happens in the hypoxic drive if given high flow O2?

Answer 8

• Longstanding pulmonary disease results in CO2 retention..Chemoreceptors ‘down regulated’
• Patient relies on hypoxia to drive ventilation
• High concentration of inhaled oxygen results in hypo-ventilation and further CO2 retention

Question 9

In tauma/ resuscitation situation do we give high flow O2 to COPD patients?

Answer 9

Yes to avoid severe hypoxia.

Unless carrying CO2 retainer card.

Then measure/ moitor ABG’s

Aim for 88-92%

Question 10

What is the sepsis six which is done for all patients with sepsis in the first hour?

Answer 10

1. Given high flow O2 - care if have COPD
2. Blood cultures taken
3. IV antibiotics given
4. Given fluids
5. Measure serum lactate
6. Monitor urine output

Question 11

What should be done when assessing circulation?

Answer 11

Is it present or absent ?

Then if present:

• Pulse assessment - e.g. fast, strong weak etc
• Take BP
• Cap refil time (CRT)
• ECG

Are they adequately perfused ?

• Look at their colour
• Conscious level

Question 12

You want to get IV access why?

Answer 12

So you can give fluids, antibiotics and taken blood samples

Question 13

What are you assessing when checking for disability ?

Answer 13

• AVPU
• Glasgow coma scale (GCS)
• Pupils

Question 14

If their is risk of a head injury what investigation would you want to do ?

Answer 14

Head CT scan

Question 15

When exposing the patient what signs are you looking at?

Answer 15

• colour
• rashes
• blood loss
• drains

Question 16

During assessing D and E what should you not forget to check ?

Answer 16

Don’t forget glucose!

• Hypoglycaemia cause of decreased conscious level
• Appear acutely unwell

Question 17

What should be given to a patient with hypoglycaemia ?

Answer 17

• Dextrose orally or IV
• IM glucagon

Question 18

After carrying out ABCDE what should you do?

Answer 18

• Re-evaluate
• Monitor
• Further investigations required?
• Specialist involvement?
• Involve relatives