Shock/Ischemia/CPR

Question 1

Regarding CPR, how does survival in anesthetized patients compare to overall survival?

Answer 1

47% vs. 4-9.6%

Question 2

From RECOVER, due to decay of skills, refresher training is recommended every?

Answer 2

6 months

Question 3

T/F: veterinarians or technicians may be considered leaders of a CPR team

Answer 3

TRUE

Question 4

From RECOVER, recommended chest compression depth:

Answer 4

1/3 to 1/2 the width of the chest

Question 5

From RECOVER, in large and giant breed dogs, hands should be placed…

Answer 5

over the widest portion of the chest

Question 6

From RECOVER, in keel-chested dogs, hands should be placed…

Answer 6

directly over the heart

Question 7

From RECOVER, in barrel-chested dogs, you should consider chest compression in which position?

Answer 7

dorsal recumbency with sternal chest compressions

Question 8

From RECOVER, recommended chest compression rate

Answer 8

100-120 compressions/min

Question 9

From RECOVER, in nonintubated patients or single-rescuer CPR, what C:V ratio is recommended?

Answer 9

30:2

Question 10

From RECOVER, recommended ventilation rate and tidal volume?

Answer 10

10 bpm and 10 ml/kg

Question 11

From RECOVER, CPR should be performed in cycles of how many minutes?

Answer 11

2

Question 12

From RECOVER, what is the low dose of epi? High dose? How often?

Answer 12

0.01 mg/kg (low), 0.1 mg/kg (high), and q 3-5min

Question 13

From RECOVER, dose of vasopressin? How often?

Answer 13

0.8 U/kg q3-5min

Question 14

From RECOVER, dose of external defibrillation with monophasic vs biphasic?

Answer 14

4-6 J/kg (mono), 2-4 J/kg (bi)

Question 15

From RECOVER, immediate defibrillation is recommended in cases of CPA due to VF of duration of how many minutes or less?

Answer 15

4 minutes or less

Question 16

From RECOVER, T/F: immediate defibrillation may be considered if VF is diagnosed during a rhythm check b/w cycles of CPR

Answer 16

TRUE

Question 17

From RECOVER, T/F: 2-minute cycle of CPR should PREcede defibrillation in cases of CPA due to VF of known or suspected duration of greater than 4 minutes.

Answer 17

TRUE

Question 18

From RECOVER, which drug can be considered in cases of pulseless VT/VF resistant to defibrillation?

Answer 18

amiodarone

Question 19

From RECOVER, what class is amiodarone? (Vaughan Williams classification)

Answer 19

Class III

Question 20

From RECOVER, what is the MOA of amiodarone?

Answer 20

Classified as class III (potassium channel blocker), but also has Class I, II, and IV activity!

Question 21

From RECOVER, what is the SECOND choice drug for pulseless VT/VF resistant to defibrillation?

Answer 21

Lidocaine

Question 22

MgSO4 may be considered for which arrhythmia?

Answer 22

Torsades de pointes

Question 23

MOA of impedance threshold device?

Answer 23

more negative intrathoracic pressure = more venous return = more cardiac output

Question 24

ITD not recommended in patients weighing less than? Why?

Answer 24

10kg. Cannot generate cracking pressure (-12 mmHg)

Question 25

T/F: the use of FIO2 of 21% may be considered

Answer 25

TRUE

Question 26

What is the equation for coronary perfusion pressure?

Answer 26

CPP = aortic diastolic pressure - right atrial diastolic pressure

Question 27

What is the dose of NaHCO3? After how many minutes of CPA would you consider administration?

Answer 27

1 mEq/kg. 10-15 min

Question 28

T/F: Fine VF is associated with a better prognosis

Answer 28

FALSE. Coarse is better.

Question 29

T/F: Arterial blood gas is preferred to venous blood gases

Answer 29

FALSE.

Question 30

From RECOVER, post-arrest target of PaCO2 in dogs vs cats?

Answer 30

Dog: 32-43 mmHg Cat: 26-36 mmHG

Question 31

From RECOVER, post-arrest targets for PaO2 and SpO2?

Answer 31

PaO2 = 80 - 100 mmHg | SpO2 94-98%

Question 32

From RECOVER, hypothermic dogs and cats post-arrest should be rewarmed at what rate?

Answer 32

0.25 - 0.5 C/h | fast rewarming at >1C/h is NOT recommended

Question 33

From RECOVER, for comatose patients after ROSC, mild therapeutic hypothermia is recommended for how long? What temps?

Answer 33

32-34C for 24-48h

Question 34

From RECOVER, mild hypothermia post-arrest should not be initiated if...

Answer 34

mechanical ventilation and advanced critical care infrastructure not available

Question 35

From RECOVER, recommendations regarding corticosteroids?

Answer 35

not routinely recommended. can be considered for hemodynamically unstable despite fluids and inotropes/pressors (1 mg/kg followed by either 1 mg/kg q6h or 0.15 mg/kg/h)

Question 36

From RECOVER, ,bundle of care targets post-arrest?

Answer 36

34C for 12 hours post, normocapnia 35-40 mmHg for 24 hours, and sustained hypertension 140 mmHg (mean) for 4 hours

Question 37

From RECOVER, dose of INTERNAL defibrillation with monophasic vs biphasic?

Answer 37

0. 5 - 1.0 J/kg (mono) | 0. 2 - 0.4 J/kg (bi)

Question 38

What is the low-dose epinephrine dose in ml for a 10kg dog?

Answer 38

0.1 ml

Question 39

MOA of dobutamine?

Answer 39

beta1 agonist: inotrope

Question 40

MOA of dopamine

Answer 40

beta1 agonist: inotrope alpha1 agonist: vasoconstriction DA1 agonist: vasodilation

Question 41

MOA of vasopressin

Answer 41

V1 agonist: vasoconstriction

Question 42

MOA of norepinephrine

Answer 42

alpha1 agonist: vasoconstriction

Question 43

Name of retractor used to spread ribs?

Answer 43

Finochietto

Question 44

Structures to avoid when performing open chest CPR

Answer 44

Intercostal artery, vein, and nerves Intrathoracic artery Phrenic nerve

Question 45

Where does the phrenic nerve originate from?

Answer 45

C5-7

Question 46

What is the Pringle Maneuver?

Answer 46

clamping of the hepatoduodenal ligament