SA med CPR cards CSV Flashcards
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~What does CPA stand for?
Cardiopulmonary Arrest
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~What does CPR stand for?
Cardiopulmonary Resuscitation
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~What does ROSC stand for?
Return Of Spontaneous Circulation (goal of CPR)
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~What does BLS stand for?
Basic Life Support
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~What does ALS stand for?
Advanced Life support
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~What is Cardiopulmonary Arrest?
Complete cessation of ventilation & circulation
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~What are indications for CPR?
Respiratory
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~What is the sequence of events during CPA?
Absence of tissue perfusion —> no O2 or glucose to tissues—>hypoxic - ischemic brain injury —> global hypoxia —> Cell Death —> Multiple organ dysfunction —> Irreversible injury —> Death
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~What is the biggest concern with CPA?
hypoxic/ischemic brain injury
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~What is the overall survival for animals that undergo CPA?
6% survival
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~Under what circumstances does the survival % go up for animals that undergo CPA?
Anesthetic CPA
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~What are the odds of survival for an animal that undergoes Anesthetic CPA?
45-50%
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~What causes anesthetic CPA?
Hypoxemia
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~What are negative prognostic indicators for animals undergoing CPA?
DOA
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~Are there evidence based guidlines and standards for CPR in Vet Med?
YES! historically no
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~What are the 5 stages of CPR in Vet med?
Recognition & prevention/preparedness
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~What are important factors to successful CPR?
Good Leadership
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~What are the most important pieces of monitoring equipment on a crash cart?
ECG
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~Why is a defibrillator nice to have but not necessary?
Most common arrest rhythm in vet med is asystole NOT ventricular fibrillation/flutter (thats humans)
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~What is the best way to train your staff in CPR?
In house simulations on dummies or mock scenarios
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~What should be done after every CPR case?
Debrief with staff and talk about what worked and what didn’t
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~How many people should be in a CPR team?
Ideally 3:
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~What is the “chain of survival” concept?
Early Recognition of CPA
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~If you suspect a pt is in CPA what should you do?
Start CPR right away!
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~What will happen if you do CPR on an animal that really isn’t in CPA?
They will “wake up” and possibly bite you
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~Why should you not delay CPR to hook up or rely on monitors to tell you if a pt is in CPA?
Heat can give off electrical signals with out beating. Auscultation or palpation is best bet to tell
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~What is the order of events in CPR for Vet Med?
ABC:
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~What is the bottom line in CPR?
Avoid chaos
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~What are the 4 components of basic life support (BLS)?
Recogition of CPA
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~What is the goal of CPR?
Get O2 to brain and heart until ROSC occurs
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~How many seconds should you take to assess a pt before beginning CPR?
5-10
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~What should be preformed together with BLS?
ALS
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~How should the animal be placed when doing chest compressions?
In Lateral Recumbency (right if think going to open CPR) or Dorsal recumbency
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~What is the only breed we really do CPR on in dorsal recumbency?
BullDogs or other barrel chested breeds
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~How far should you compress the chest during CPR?
1/2 -1/3 the width & allow to recoil completely before you compress again
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~What are the 2 pump theories of CPR?
Cardiac
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~What animals can you do cardiac pumping in?
Small dogs, puppies, cats or Thin (Keel) chested dogs
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~Where do you place your hand in the thoracic pump CPR?
widest portion of chest when in lateral recumbency (caudel to actual heart)
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~Where do you place your hand in the cardiac pump CPR?
Over the heart
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~What rate should you preform chest compressions at?
100-120 beats per minute
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~What song can you sing in your head to help you keep time?
Another one bites the dust or staying alive
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~When doing chest compressions on a dog in lateral recumbency where should the spine be?
Against you so they dont slide off the table
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~What is important in securing an airway or ventilation?
SECURE THE TUBE!
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~How can you give IPPV with out and ET tube?
Mouth to snout
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~If you are doing CPR on your own how many compressions to breaths to you give?
30:2
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~What is interposed abdominal compressions?
When you let chest recoil some one else pushes on the abdomen to return the blood to thorax
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~What are the pros of interposed abdominal compressions?
May increase venous return
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~What are the cons of interposed abdominal compressions?
Minimal Abdominal trauma (there dead anyway might as well go for it)
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~What is the CPR cycle?
2 Minutes of continuous CPR then rotate positions
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~When do you administer ALS?
After BLS and onward to ROSC
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~What tx are included in ALS?
Catheter (IV best)
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~Do all CPA patients need fluids?
No
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~What is the best location for a catheter in a CPR patient (1-4)?
- IV
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~What is the caveat when giving rescue meds IT?
Must give 3-5x the regular dose
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~What is the caveat when giving rescue meds IP?
Takes a long time to absorb, last resort
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~When should you give rescue meds inter cardiac?
NEVER! Big No No
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~Best place for IO catheter?
Femur! In-between neck & greater trochanter
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~What bones can you place and IO catheter in?
Femur
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~When do administer rescue meds (drugs) during CPR?
Every other BLS cycle
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~What are the two primary drugs used in CPR?
Epinephrine
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~Why do we give Epinephrine during CPR?
Vasoconstriction so when ROSC occurs it increases CO
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~Do we use the high or low does of Epinephrine during CPR?
LOW DOSE ONLY
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~Why do we give Atropine during CPR?
When ROSC occurs it will increase the heart rate increasing CO
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~What other drugs can be given during CPR & why?
Vasopressin - vasoconstriction
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~When are fluids indicated in CPR?
Active hemorrhage
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~What heart rhythm is the ONLY on you use a defibrillator on?
Ventricular Fibrillation/flutter
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~What is the goal of defibrillation?
Asystole
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~How many shocks per round of BLS?
1 only
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~When monitoring the ECG what are the most common arrhythmias from most to least?
Asystole
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~When should you assess ECG?
During rotation of 2min cycle or at direction of leader
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~Should you monitor BP during CPR?
NO its not true anyway
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~What should you do instead of monitoring BP?
Someone monitor femoral pulse
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~What can monitoring femoral pulse tell you during CPR?
If you are compressing the chest enough to move blood (you should be creating a pulse with each compression)
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~Why is ETCO2 such a good monitor to have during CPR?
First indicator of ROSC
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~What will ETCO2 be during CPR before ROSC?After?
Very Low 2-5 then once ROSC it shoots up!
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~Are taking an ABG or Electrolytes indicated during CPA? After ROSC?
CPA: NO
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~What are the indications for open chest CPR?
Thoracic wall defect/trauma
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~What additional equipment is needed to preform open chest CPR?
Clippers
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~Do you need to sterilely prep the pt to open the chest for CPR?
No they are dead
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~What are the steps to open chest CPR?
Rt Lat Recumbency
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~Why should you stay above the chondral costal jxn when entering the thorax for open CPR?
Don’t what to cut the internal thoracic artery and cause them to bleed out
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~What are some complications that can occur with open chest CPR?
Lung Laceration
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~How can you try to prevent lung laceration when entering the thoracic cavity for open CPR?
Have IPPV person pause and allow the lungs to deflate
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~What should you do after ROSC?
Monitor!
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~What should you monitor after ROSC?
ECG
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~What may you need if ROSC happens during open CPR?
Anesthesia (propofol, iso)
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~Why is debriefing after CPR so important?
Improves team work