Resuscitation

Question 1

reversible causes cardiac arrest

Answer 1

4Hs 4Ts
hypothermia
hypovolaemia
hypoxia
hypo/hyperkalaemia

tension pneumothorax
tamponade
thrombosis
toxins

Question 2

describe VF tracing

Answer 2

Chaotic irregular deflections of varying amplitude
No identifiable P waves, QRS complexes, or T waves
Rate 150 to 500 per minute
Amplitude decreases with duration (coarse VF –> fine VF)

Question 3

describe pulseless VT tracing

Answer 3

• Regular, broad complex tachycardia
• Uniform QRS complexes within each lead — each QRS is identical (except for fusion/capture beats)

Question 4

describe pulseless EA tracing

Answer 4

• no P waves

Question 5

describe asystole tracing

Answer 5

flat line

Question 6

shockable rhythms

Answer 6

VF and pVT

Question 7

non-shockable rhytms

Answer 7

PEA and asystole

Question 8

drugs in shcokable cardiac arrest

Answer 8

• adrenlaine 1mg IV/IO after shock 3 and repeat every 3-5mins
• amiodarone 300mg IV/IO shock 3
• amiodarone 150mg IV/IO shock 5

Question 9

drugs in non-shockable cardiac arrest

Answer 9

adrenaline 1mg IV/IO after 2 mins and then every 3-5mins

Question 10

post-resuscitation care

Answer 10

• check ABCDE, ECG. CXR, and EBG
• Aim for 94-98% sats and normal PaCO2
• targeted temperatuere management
• treat precipitating. ause
• ?ICU

Question 11

how to assess 4Hs and 4Ts in cardiac arrest

Answer 11

• hypoxia - sats and give 100% o2 via BVM
• hypovolaemia - haemorrhage or fluid loss
• hypothermia - use thermomter
• hypo/hyperkalaemia - ABG, calcium, K+ and glucose
• tension pneumothorax - bilateral air entry, chest movement and tracheal deviation
• toxins - drug chart
• tamponade - cardiac USS
• thrombosis - signs of DVT

Question 12

rx: bradycardia

Answer 12

• atropine 500microgram boluses to 3mg total
• if 2ary to B-blocker or CCB give glucagon
• if deteriorating and risk of asystole prepare pacing or no affect from atropine
• give adrenaline, isoprenaline or dopamine if pacing not available

Question 13

bardycardia risk of asytole signs

Answer 13

• recent asystole
• syncmobitz II AV block
• complete heart block with broad QRS
• ventricular pauses >3s

Question 14

doses of drugs in bradycardia if no pacing or no response to atropine

Answer 14

isoprenaline 5 micrograms per min
adrenaline 2-10 micrograms per min

Question 15

contraindication: adenosine

Answer 15

asthma