Resuscitation Flashcards
clinical death is a reversible state, true or false
true
biologic death is a reversible state, true or false
false, it is irreversible
what is sudden cardiac death
abrupt loss of heart function
what number do you call if there is a cardiac arrest in the hospital
2222
how do you confirm cardiac arrest
open airway
check breathing
check pulse for 10 seconds and signs of life
what is the first thing to do when someone is in cardiac arrest
call for help
what is the ratio of compressions:breaths in CPR
30:2
where are compressions done
centre of the chest
how deep should compressions be
5-6 cm
how fast should compressions be
120/min
interruptions and pauses in CPR are good/bad
BAD!!!
what should be done to avoid leaning in CPR
release all pressure on the chest without losing contact to ensure recoil is achieved
ventilations always have to be done, true or false
false
if you are untrained or unable, you do not have to do them, compressions only is ok
why should you not squeeze the ventilation bag too hard in CPR
gastric inflation and contents may come up
what is an AED
automated external defibrillator
what is waveform capnography
continuous non-invasive measurement of end tidal CO2 from the body
helps to assess ventilation of the lungs
who performs waveform capnography
aneasthetists
What are the shockable rhythms
Ventricular fibrillation VF
Pulseless Ventricular tachycardia VT
what are the non-shockable rhythms
Pulseless electrical activity PEA
Asystole
what is transthoracic impedance
body’s resistance to current flow (ohms)
“interruptions”
transthoracic imedance should be increased/decreased to allow better outcome
decreased
what can alter transthoracic impedance
BMI age disease skin resistance tissue type and amount
what is manual defibrillation and who can perform it
manually set up defibrillator
FY2 and above
you can continue to do chest compressions whilst a manual defibrillator is charging, true or false
true
what happens if VF/pVT persists after the 1st shock
deliver a 2nd shock CPR 2 min 3rd shock CPR 2 min drugs
what drugs can be given in cardiac arrest
IV adrenaline 1mg
IV amiodarone 300mg
how and when is adrenaline given
every 3-5 min
IV
when is amiodarone given
after 3 shocks
how do you manage asystole + PEA
CPR 2min
IV adrenaline 1mg every 3-5min
what are the reversible causes of cardiac arrest
Hypoxia Hypovolaemia Hypothermia Hypo/Hyperkalaemia Tension pneumothorax Tamponade Toxins Thrombosis
management of hypoxia
patent airway
high flow oxygen 15L/min 100%
avoid hyperventilation
management of hypovolaemia
control haemorrhage
IV fluids
management of hypokalaemia
Hartmann’s infusion
management of hyperkalaemia
calcium gluconate - cardioprotective
insulin
fluids/dextrose
salbutamol
how can you get K levels checked rapidly
ABG machine
management of hypothermia
active rewarming techniques
consider cardio-pulmonary bypass
management of tension pneumothorax
check ET tube position
check for hyper-resonancy, tracheal deviation etc
needle decompression/thoracostomy
how do you diagnose a cardiac tamponade
ECHO
management of cardiac tamponade
needle pericardiocentesis or resuscitative thoracotomy
management of toxic cardiac arrest
review drug chart
reverse with antidote
management of thrombosis - PE
fibrinolytic therapy
continue CPR for 60-90 min after
what additional imaging technique can help to find reversible causes of cardiac arrest
ultrasound
what are different ways of gaining vascular access
peripheral veins
central veins
intraosseous
what kinds of ECG are there
adhesive pads
3 lead
12 lead
what are the 6 steps to reading an ECG
- is there electrical activity
- what is the ventricular rate
- regular or irregular rhythm
- wide or narrow QRS complexes
- atrial activity present
- atrial activity in association with ventricular activity
which medication is given in bradycardia
atropine - antimuscarinic
what is the difference between defibrillation and DC cardioversion
defibrillation = immediate treatment of life threatening arrhythmias in patient with no pulse, non-synchronised
cardioversion = any process that aims to turn an arrhythmia into sinus rhythm, synchronised with QRS complexes
what types of cardioversion are there
electrical
chemical
indications for DC cardioversion
decompensated AF
SVT
VT with a pulse
management of a supraventricular tachycardia SVT
vagal manoeuvres eg valsalva, carotid sinus massage
adenosine IV
ST elevation in leads I, aVL, V5, V6 affects which part of the heart and which vessel in occluded
lateral
circumflex artery
ST elevation in leads II, III, aVF affects which part of the heart and which vessel is occluded
inferior
right coronary artery
ST elevation in V1-4 affects which part of the heart and which vessel in occluded
anterior
LAD artery
what is the antidote to paracetamol poisoning
N acetylcysteine
what is the antidote to benzodiazepines
flumazenil
what is the antidote to morphine
naloxone
what is the antidote to B blockers
glucagon
what is the antidote to cyanides
amyl nitrite
what is the antidote to digoxin
digiband
what is the antidote to iron
desferroxamine mesylate
what is the antidote to warfarin
vitamin K
what is the antidote to OP compounds
atropine
what must be done before cardioversion
sedate the patient
general anaesthesia
