Resuscitation Flashcards
2 categories of patients requiring resuscitation?
- peri-arrest patients
- patients in cardiorespiratory arrest
basic principles? (applies to both categories)
- GET HELP IMMEDIATELY (medical, nursing, HAN)
- Resus requires a coordinated team response: follow ABCDE and frequently reassess
Assessment and possible interventions for A?
Assessment and possible interventions for B?
Assessment and possible interventions for C?
Assessment of D?
Assessment and possible interventions in E?
With all critically unwell patients, consideration of escalation of level of care should be considered e.g. to…?
Coronary Care, HDU (Medical or Surgical) or even ICU
Components of APVU?
A – Alert and Communicating
V – Responds only to Voice
P – Responds only to Pain
U – Unresponsive
min and max score possible in GCS?
min 3, max 15
3 componetns of GCS? (and how much each is scored?
M6, V5, E4
(Think M6 - motorway, and 4 eyes)
Eye components of GCS?
E 4 Eyes open spontaneously
E 3 Eyes open to Voice
E 2 Eyes open to Pain
E 1 No opening of the eyes
motor components of GCS?
M 6 Obeys Commands
M 5 Localises to Stimulus
M 4 Flexes to Painful Stimulus
M 3 Abnormal Flexion to Pain
M 2 Extends to Painful Stimulus
M 1 No Motor Response
Voice components of GCS?
V 5 Orientated Speech
V 4 Confused content of Speech
V 3 Inappropriate Speech (random words)
V 2 Incomprehensible Speech (moaning, no words)
V 1 No Vocal Response
which blood samples could be requested from the lab during C?
- FBC, Coagulation Screen / INR
- U+E’s, Calcium, Magnesium, LFT’s, CRP, Amylase, Troponin
- Lactate, Glucose
- Group and Save, Cross Match
- Blood Cultures – Peripheral and Central
Life-threatening airway insults can be summarised using the mnemonic ATOMICFC. What does this stand for?
A – Airway Loss
T – Tension Pneumothorax
O – Open Pneumothorax
M – Massive Haemothorax
F – Flail Chest
C – Cardiac Tamponade
Traditional ATLS mantra is “GCS _, intubate”
8
Traumatic brain injury can be categorised by severity using GCS: mild =?, moderate=?, severe =?
- mild: 13-15
- moderate: 9-12
- severe: 8 or less
management of unstable adult tachycardia?
(i.e. adverse features e.g. shock, syncope, MI, heart failure
- synchronised DC shock (up to 3 attempts)
- seek expert help
- amiodarone 300mg IV over 10-20 mins
- repeat shock
- amiodarone 900mg IV over 24h
treatment of narrow complex (QRS <0.12s) tachycardia with regular rhythm
- vasal maneuvres
- adenosine 6mg rapid IV bolus (if no effect give 12mg, if no effect give further 12mg)
treatment of narrow complex (QRS <0.12s) tachycardia with irregular rhythm
probable AF
- control rate with beta blocker or diltiazem
- if in heart failure consider digoxin or amiodarone
management of bradycardia with adverse features (e.g. shock, syncope, MI, heart failure, risk of asystole)
atropine 500 mcg IV
repeat to max of 3mg if no satisfactory response OR transcutaneous pacing
what alternative mediation may be given for bradycardia caused by a beta-blocker or CCB?
glucagon
paediatric CPR?
5 initial rescue breaths then compressions and breaths in ratio of 15:2
Newborn life support
- immediate step to maintain temperature?
- assess tone, breathing and rate rate
- if gasping or not breathing…
- reassess. If no increase in HR, look for chest movement during inflation
- if chest not moving
- dry the baby
- .
- open airway, give 5 inflation breaths. Consider SpO2 +/- ECG monitoring
- .
- recheck head position, consider 2 person airway control and other airway manouvres. Repeat inflation breaths
