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Sudden Death > Principles of Resuscitation > Flashcards

Principles of Resuscitation Flashcards

1
Q

What is the most common natural cause of sudden death?

A

Ischaemic heart disease

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2
Q

Why is it important that compression reach an adequate depth?

A

If they are too shallow then they won’t eject blood out of the heart

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3
Q

What is the most common reason that there is no chest recoil during CPR?

A

Leaning on the patient in between compressions

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4
Q

How can CPR be monitored?

A

CPR meters = real time feedback on CPR parameters

Waveform canography = efficiency of CPR

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5
Q

What are the shockable rhythms?

A

Ventricular fibrillation and pulseless ventricular tachycardia

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6
Q

What are some features of ventricular fibrillation?

A

Bizarre irregular waveform
Random frequency and amplitude
No recognisable QRS complexes
Uncoordinated electrical activity

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7
Q

What are the two kinds of pulseless ventricular tachycardia?

A

Monomorphic VT = broad complex rhythm, rapid rate, constant QRS morphology
Polymorphic VT = torsades de pointes

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8
Q

When should drugs be given to treat shockable rhythms?

A

If persisting after three shocks = adrenaline 1mg and amiodarone 300mg given IV

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9
Q

What are the non-shockable rhythms?

A

Asystole and pulseless electrical activity

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10
Q

What are some features of asystole?

A

Absent QRS activity
May have P waves
Rarely straight line trace

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11
Q

How should non-shockable rhythms be treated?

A

Restart CPR then adrenaline 1mg IV every 3-5 minutes

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12
Q

What are some features of pulseless electrical activity?

A

Clinical features of cardiac arrest

ECG normally associated with an output

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13
Q

How is hypoxia treated?

A

By ensuring adequate ventilation and give oxygen if needed

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14
Q

What does the return of spontaneous circulation signal?

A

The beginning of post resuscitation care

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15
Q

What are some aspects of post resuscitation care?

A

Aim for normal PaCO2 and SpO2 of 94-98%

12 lead ECG and targeted temperature management

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16
Q

What is clinical death?

A

Period of respiratory, circulatory and brain arrest during which initiation of resuscitation can lead to recovery with pre-arrest CNS function

17
Q

Is clinical death a reversible state?

A

Yes

18
Q

What does the length of clinical death depend on?

A

Length of time the cerebral cortex survives in absence of circulation and respiration

19
Q

What is the normal period of time between clinical death and biologic death under normal temperatures?

A

Doesn’t exceed 3-6 minutes

20
Q

What is sudden cardiac death?

A

Death arising from abrupt loss of heart function = reversible condition

21
Q

Why is prompt treatment of sudden cardiac death important?

A

If treated with defibrillation within a few minutes the heart may be restored to an organised rhythm

22
Q

What is biologic death?

A

Sets in after clinical death = irreversible state of cellular destruction

23
Q

What should be done to confirm cardiac arrest?

A

Check patient response and open airway
Check for normal breathing and signs of life
Pulse check

24
Q

How long should assessment for cardiac arrest take?

A

Less than 10 seconds

25
Q

What should be done once cardiac arrest is confirmed?

A

Call resus team

Start CPR and attach defibrillator

26
Q

What are some features of high quality compressions?

A

Ratio of 30:2 with minimal interruptions
5-6cm depth at pace of 100-120 per minute
Allow chest recoil and switch provider every 2 mins
Continuous compressions once airway secured

27
Q

In what time frame should the two breaths be given?

A

Within 10 seconds

28
Q

What does transthoracic impedance depend on?

A

Energy selected, electrode size, distance between electrodes, size of chest, hairy chest, air trapping

29
Q

What is transthoracic impedance?

A

The body’s resistance to current flow = varies from 25-180 ohms-

30
Q

What is the determining factor of successful defibrillation?

A

Energy in respect to impedance

31
Q

What are some reasons for the difference in transthoracic impedance from person to person?

A

Body mass, age, disease, skin resistance, tissue type and amount

32
Q

How can vascular access be achieved?

A

Peripheral vs central veins

Intraosseous

33
Q

What are some features of securing the airway?

A

Use supraglottic airway device or tracheal tube
Only attempt intubation if trained
Don’t interrupt compressions for ventilation
Avoid hyperventilation

34
Q

When is adrenaline given?

A

Every 3-5 mins via IV access

35
Q

When is amiodarone given?

A

After three shocks have been given = use IV access

Sudden Death (10 decks)

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