Resuscitation and ECG Flashcards by Louise Emerson

how long till clinical death (reversible state) becomes biologic death (irreversible state of cellular destruction)

3-6 mins

How well did you know this?

Not at all

Perfectly

how do you confirm cardiac arrest

patient response
open airway
check for normal breathing
(caution agonal breathing)
Check for signs of life- pulse 
(this should take less than 10 seconds)

How well did you know this?

Not at all

Perfectly

what are good chest compressions

30:2

centre of chest
5-6 cm depth
2 per second (100-120 min-1)
minimal interruptions (<5secs)
After each compression,  release all the pressure on  the chest without losing  contact between your  hands and the sternum to allow for recoil

How well did you know this?

Not at all

Perfectly

how quickly should the ventilations be done

2 within 10 seconds

How well did you know this?

Not at all

Perfectly

what is important when putting on defib pads

shave chest if hairy

get good contact, avoid air trapping

How well did you know this?

Not at all

Perfectly

what is transthoracic impedance

bodys resistance to current flow

varies due to body mass, age, disease, skin resistance, tissue type and amount

How well did you know this?

Not at all

Perfectly

what is VF like on ECG

irregular waveform
no recognisable QRS complexes
random frequency and amplitude
uncoordinated electrical activity

exclude artefacts- movement/ electrical interference

How well did you know this?

Not at all

Perfectly

what are the shockable rhythms

VF and pulseless VT

How well did you know this?

Not at all

Perfectly

what is pulseless VT like on ECG

can be monomorphic:

broad complex rhythm
rapid rate
constant QRS morphology

or polymorphic:
-torsade de pointes

How well did you know this?

Not at all

Perfectly

when should you stop compression in defibrillation

to check rhythm
when shock delivered
(not when defib charging)

How well did you know this?

Not at all

Perfectly

in resus when do you give medications

give adrenaline every 3-5 mins

give amiodarine after 3 consecutive shocks

How well did you know this?

Not at all

Perfectly

what medications do you give in resus

adrenaline 1mg IV (potent vasoconstrictor)

amiodarone 300mg IV

How well did you know this?

Not at all

Perfectly

what is asytole like on ECG

absent ventricular activity
atrial activity (P waves) may persist
usually a wavy line

How well did you know this?

Not at all

Perfectly

what is the management for asytole

cant shock
CPR
adrenaline 1mg IV every 3-5 mins
DO NOT give amiodarone

How well did you know this?

Not at all

Perfectly

what is pulseless electrical activity like on ECG

usually associated with an output, can be normal

just no pulse and features of ardiac arrest

How well did you know this?

Not at all

Perfectly

what is the management for PEA

cant shock
CPR
adrenaline 1mg every 3-5 mins

How well did you know this?

Not at all

Perfectly

what does SVT look like on ECG

narrows QRS’s
P waves present
fast rate

How well did you know this?

Not at all

Perfectly

what are the reversible causes of cardiac arrest

hypoxia
hypothermia
hyperkalaemia
hypovolaemia

tamponade
thrombosis
toxins
tension pneumothorax

How well did you know this?

Not at all

Perfectly

what management for hyperkalaemia

calcium gluconate (protect heart)
insulin with dextrose
salbutamol

How well did you know this?

Not at all

Perfectly

what test for hypo/hyperkalaemia and metabolic disorders

ABG machine

How well did you know this?

Not at all

Perfectly

management for hypothermia

active rewarming techniques

consider cardiopulmonary bypass

How well did you know this?

Not at all

Perfectly

what are the clinical signs of a tension pnuemothorax

decreased breath sounds
hyper resonant percussion note
tracheal deviation

How well did you know this?

Not at all

Perfectly

treatment for cardiac tamponade

neddel pericardiocentesis/ resuscitative thoracotomy

How well did you know this?

Not at all

Perfectly

in PE how long should you continue CPR after fibrinolytic therapy given

60-90 mins

How well did you know this?

Not at all

Perfectly

what is the P wave

atrial depolarisation

what is the PR interval

delay of AV node to allow filling of ventricles

what is the QRS complex

depolarisation of ventricles

what is the T wave

ventricular repolarisation

what is the ST segment

ventricular systole

where does depolarisation start in the heart

pacemaker cells in SA node close to entry of SVC into RA

when in ECG is the depolarisation of the bundle of his

QRS complex

how long should a normal QRS complex be

<0.10 s (less than 3 squares)

how long should a p wave last

0.08-0.1 seconds

when in ECG is diastole

TP segment

what is the PR Interval

AV node delay

how long should the PR interval last

0.12-0.2 seconds

how long does a little square last in ECG

0.04 seconds

how long does a big square last on ECG

0.2 seconds

how do you calculate HR on ECG

300/ number of large squares either between beats or between RR interval or Number of cardiac cycles that occur in 6 s (30 large squares) and multiply by 10.

what is the role of the rhythm strip

allows detects of rhythms abnormalities

what are the 6 steps to analysing an ECG

``` name and DOB check date check calibration determine axis work out rhythm: 1 Is electrical activity present? 2 Is the rhythm regular or irregular? 3 What is the heart rate? 4 P-waves present? 5 What is the PR interval? 6 Is each P-Wave followed by a QRS complex? 7 Is the QRS duration normal? look at individual leads for ST or T waves changes ```

where on ECG is inferior

leads III, IIII, AVF

where on ECG is anterior

leads V1-6

where on ECG is anteroseptal

leads V1-4

where on ECG is lateral

lead I, AVL

where on ECG in anterolateral

lead I, AVL, V1-6

what does AF look like on ECG

no P waves, irregularily irregular, rate >300, normal QRS, irregular baseline

what does atrial flutter look like on ECG

saw tooth, fast atrial rate, normal QRS | Atrial rate 250-350bpm.

what does LBBB look like on ECG

W in V1 | M in V6 (william)

what does LBBB look like on ECG

M in V1 | W in V6

what does 1st degree HB look like on ECG

prolonged PR (>0.2sec)

what does 2nd degree heart block mobitz type 1 look like on ECG

progressively longer PR until a QRS dropped | regularly irregular

what does 2nd degree heart block mobitz type 2 look like on ECG

atrial rate faster than ventricle, more P waves than QRS complexes QRS normal/ wide, smae PR interval for all conducted beats (constant PR but not all followed by a QRS) can be 2:1 or 3:1

what does 3rd degree heart block look like on ECG

atrial rate faster than ventricle, PR absent, atria and ventricles beat independently

what does V fib look like on ECG

unmeasurable rate, absent P wave, irregular, wide QRS

what does VT look like on ECG

absent P waves, wide QRS, fast rate 100-120, regular

what does WPW look like on ECG

short PR QRS usually wide delta waves

tall tented T waves+ ?

hyperkalaemia

what QRS in leads V4,5 and 6 =?

left ventricular hypertrophy

PR depression and saddle shaped ST elevation =?

pericarditis

what does a broad QRS mean

ventricular problem

tall P waves and T wave depression =?

hypokalaemia

what are signs of a STEMI

ST elevation (at least 2mm in adjacent leads/ 1mm in associated leads) with Q wave formation

how do you work out the axis of an ECG

Right axis deviation= Lead 1 down, lead aVF up | Left axis deviation= Lead 1 positive, lead aVF negative

what does torsade de pointes look like on ECG

Twisting of the axis. Rate 200-250bpm. Regular or irregular. Sinusoidal pattern.

what drug for torsades de pointes

magnesium sulfate

what causes first degree heart block

block in AV node- medication, vagal stimulation, disease

what causes mobitz type 1

Diseased AV node with long refractory period

what coronary artery: leads I, aVL, V5, V6

(lateral) circumflex

what coronary artery: leads II, III, aVF

(inferior) RCA

what coronary artery: leads V1-2

(septal) LAD

what coronary artery: leads V3-4

(anterior) V3-4

what are the features of a non stemi

ST depression, T wave flattening/ inversion

treatment for hypoxia

high flow oxygen 15 litres non rebreather