Resuscitation Flashcards
what is clinical death
period of respiratory, circulatory and brain arrest during which initiation of resuscitation can lead to recovery with pre-arrest CNS function
is clinical death reversible
yes
is biological death reversible
no
what is biological death
irreversible state of cellular destruction
how long does clinical death last
under normal temperature, won’t last longer than 3-6 minutes
chest compressions to rescue breaths should be in what ratio
30:2
where should chest compressions be
middle of the chest in the nipple line
how deep should chest compressions be
5-6 cm
it is important to allow ____ after chest compressions
recoil
when would you do rescue breaths before chest compressions
paediatric CPR or non-cardiac cause e.g. drowning
what rate should chest compressions be
100-120bpm
how many chest compressions per second
2 per second
after how long should you change CPR provider to prevent fatigue
after every 2 min cycle
how many rescue breaths in 10s
2
what should you be wary of with chest compressions
gastric inflation
what is transthoracic impedance
the body’s resistance to current flow - determining factor to successful defibrillation
____ transthoracic impedence reduces current flow
high
when should chest compressions be paused
check rhythm
allow shock
should you do chest compressions when charging the defib
yes
what arrhythmias are shockable
Pulseless VT
VF
will VT or VF have a pulse
no
what are non-shockable arrhythmias
PEA
asystole
what should be given after 3 rounds of CPR
adrenaline
what should be given every 3 rounds there after
amiodarone
what is the pneumonic for reversible causes of cardiac arrest
4 Hs
4Ts
what are the 4 Hs
hypoxia
hypothermia
hypovolaemia
hypo/hyperkalaemia
what are the 4 Ts
toxins
tamponade (cardiac)
tension pneumothorax)
thrombosis
what should be given if someone is hypoxic
high flow oxygen and ensure airway patent
what should be given if someone is hypovolaemic
IV fluids and stop haemorrhage if there is one
what is the most common cause of cardiac sudden death
MI
what are 2 things that can be seen with cardiac arrest
agonal breathing
myoclonus
what is agonal breathing
gasping and laboured breathing, may be snorts
not true breaths
what is myoclonus
abnormal jerky irregular movements which accompany agonal breathing in cardiac arrest
when should amiodarone not be given
polymorphic VT with LQTS as amiodarone makes it worse
how do you work out the HR from a regular ECG
300/no. of large boxes between QRS complexes
how do you work out the HR from an irregular ECG
no. of QRS complexes in 30 small boxes x 10
what is given in hyperkalaemia
IV calcium gluconate/chloride
dextrose and insulin
consider nebulised salbutamol
what does hyperkalaemia look like on ECG
tall tented t waves
flattened QRS complexes
how can hypothermia be treated
active rewarming techniques
consider cardiopulmonary bypass
if someone that is intubated has a tension pneumothorax what should you check
tube position
what are clinical signs of tension pneumothorax
decreased breath sounds
hyper-resonant percussion note
tracheal deviation
how is tension pneumothorax treated
needle decompression or thoacostomy
when should cardiac tamponade be considered as a possibility
penetrating chest trauma or after cardiac surgery
how is cardiac tamponade treated
pericardiocentesis or resuscitative thoracotomy
how is a PE treated
fibrinolytic therapy
if fibrinolytic therapy is given how long should CPR be continued for before discontinuing
up to 60-90 mins
what is the purpose of CPR
push blood out of and suck blood into chest hence importance of recoil
what is the most common cause of PEA
hypovolaemia
could also be distributive shock
