Resuscitation Flashcards
Reversible causes of medical cardiac arrest
Hypovolaemia Hypoxia Hypo/Hyper metabolic states Hypothermia Toxins Tension pneumothorax Cardiac tamponade Thromboembolic
Drug therapy in Hypothermic cardiac arrest
<30 oC - Withhold drugs
30 - 35 oC - Double intervals
Defibrillation in Hypothermic cardiac arrest
If VF/VT and persists for 3 shocks in total no more until >30 deg
Acceptable pre-ductal spo2
2 mins - 60%
5 mins - 85%
10mins - 90%
Paediatric cardiac arrest shock voltage
4 J /kg
Pre ductal spo2 probe location
Right hand
Paediatric cardiac arrest defibrillation energy
4J/Kg
Adult defib pads from what age
8+
Management of the preterm
<32 weeks
Place undried in plastic bag and radiant heat
Inflation breaths
Chain of Survival
1) Early recognition and call for help
2) Early CPR
3) Early defibrillation
4) Post-resuscitation care
Treatment for Narrow complex regular tachyarrhythmia
1) Vagal manoeuvres
2) Adenosine 6mg
3) Adenosine 12mg
4) Adenosine 18mg
5) Verapamil
6) DC cardioversion
Treatment for Narrow complex irregular tachyarrhythmia
1) Control rate with Beta Blocker
2) Consider amioderone
Treatment for Broad complex irregular tachyarrhythmia
Torsades - IV magnesium 2g
AF w/ BBB - treat as for irregular narrow complex (Beta blocker)
Treatment for Broad complex regular tachyarrhythmia
Amioderone 300mg IV over 10-60 mins
In unstable tachyarrhythmia patient where DC cardio version has failed what is the next step?
1) 300mg Amioderone over 10-20 mins
2) Repeat DC cardio version
Broad complex tachycardia DC cardioversion initial shock energy
120-150J
AF tachyarrhythmia initial DC cardioversion shock energy
Max available
Atrial flutter tachyarrhythmia initial cardioversion shock energy
70-120J
Treatment of Bradyarrhythmia with life threatening features
1) Atropine 500mcg
2) Transcutaneous pacing
3) Transvenous pacing
Treatment of Bradyarrhythmia without life threatening features
1) assess for risk of asystole
- recent systole,
- mobitz II AV block,
- complete heart block
- Ventricular pause >3s
If present - Pacing
If not present - Observe
Rate for percussion pacing
50-70 / min
For every minute that passes between collapse and defibrillation mortality increases by _______ %
7-10%
NLS Algorithm
1) Dry & rub baby
2) Clamp and Cut cord if concern after 60s
3) Assess Colour, Tone, Breathing rate, Heart rate
4) Give 5 inflation breaths (in air)
5) If no chest rise - change something
6) If no chest rise, insert SGA
7) Once chest rise - 30s ventilations
8) If not adequate HR, start 3:1 compressions/ventilations
Changes in Paediatric ALS
- 5 ventilations
- 15:2 compressions/ventilations
- Drugs dosages
