Shock/Ischemia/CPR Flashcards
Regarding CPR, how does survival in anesthetized patients compare to overall survival?
47% vs. 4-9.6%
From RECOVER, due to decay of skills, refresher training is recommended every?
6 months
T/F: veterinarians or technicians may be considered leaders of a CPR team
TRUE
From RECOVER, recommended chest compression depth:
1/3 to 1/2 the width of the chest
From RECOVER, in large and giant breed dogs, hands should be placed…
over the widest portion of the chest
From RECOVER, in keel-chested dogs, hands should be placed…
directly over the heart
From RECOVER, in barrel-chested dogs, you should consider chest compression in which position?
dorsal recumbency with sternal chest compressions
From RECOVER, recommended chest compression rate
100-120 compressions/min
From RECOVER, in nonintubated patients or single-rescuer CPR, what C:V ratio is recommended?
30:2
From RECOVER, recommended ventilation rate and tidal volume?
10 bpm and 10 ml/kg
From RECOVER, CPR should be performed in cycles of how many minutes?
2
From RECOVER, what is the low dose of epi? High dose? How often?
0.01 mg/kg (low), 0.1 mg/kg (high), and q 3-5min
From RECOVER, dose of vasopressin? How often?
0.8 U/kg q3-5min
From RECOVER, dose of external defibrillation with monophasic vs biphasic?
4-6 J/kg (mono), 2-4 J/kg (bi)
From RECOVER, immediate defibrillation is recommended in cases of CPA due to VF of duration of how many minutes or less?
4 minutes or less
From RECOVER, T/F: immediate defibrillation may be considered if VF is diagnosed during a rhythm check b/w cycles of CPR
TRUE
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.
TRUE
From RECOVER, which drug can be considered in cases of pulseless VT/VF resistant to defibrillation?
amiodarone
From RECOVER, what class is amiodarone? (Vaughan Williams classification)
Class III
From RECOVER, what is the MOA of amiodarone?
Classified as class III (potassium channel blocker), but also has Class I, II, and IV activity!
From RECOVER, what is the SECOND choice drug for pulseless VT/VF resistant to defibrillation?
Lidocaine
MgSO4 may be considered for which arrhythmia?
Torsades de pointes
MOA of impedance threshold device?
more negative intrathoracic pressure = more venous return = more cardiac output
ITD not recommended in patients weighing less than? Why?
10kg. Cannot generate cracking pressure (-12 mmHg)
T/F: the use of FIO2 of 21% may be considered
TRUE
What is the equation for coronary perfusion pressure?
CPP = aortic diastolic pressure - right atrial diastolic pressure
What is the dose of NaHCO3? After how many minutes of CPA would you consider administration?
1 mEq/kg. 10-15 min
T/F: Fine VF is associated with a better prognosis
FALSE. Coarse is better.
T/F: Arterial blood gas is preferred to venous blood gases
FALSE.
From RECOVER, post-arrest target of PaCO2 in dogs vs cats?
Dog: 32-43 mmHg
Cat: 26-36 mmHG
From RECOVER, post-arrest targets for PaO2 and SpO2?
PaO2 = 80 - 100 mmHg
SpO2 94-98%
From RECOVER, hypothermic dogs and cats post-arrest should be rewarmed at what rate?
0.25 - 0.5 C/h
fast rewarming at >1C/h is NOT recommended
From RECOVER, for comatose patients after ROSC, mild therapeutic hypothermia is recommended for how long? What temps?
32-34C for 24-48h
From RECOVER, mild hypothermia post-arrest should not be initiated if…
mechanical ventilation and advanced critical care infrastructure not available
From RECOVER, recommendations regarding corticosteroids?
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)
From RECOVER, ,bundle of care targets post-arrest?
34C for 12 hours post, normocapnia 35-40 mmHg for 24 hours, and sustained hypertension 140 mmHg (mean) for 4 hours
From RECOVER, dose of INTERNAL defibrillation with monophasic vs biphasic?
- 5 - 1.0 J/kg (mono)
0. 2 - 0.4 J/kg (bi)
What is the low-dose epinephrine dose in ml for a 10kg dog?
0.1 ml
MOA of dobutamine?
beta1 agonist: inotrope
MOA of dopamine
beta1 agonist: inotrope
alpha1 agonist: vasoconstriction
DA1 agonist: vasodilation
MOA of vasopressin
V1 agonist: vasoconstriction
MOA of norepinephrine
alpha1 agonist: vasoconstriction
Name of retractor used to spread ribs?
Finochietto
Structures to avoid when performing open chest CPR
Intercostal artery, vein, and nerves
Intrathoracic artery
Phrenic nerve
Where does the phrenic nerve originate from?
C5-7
What is the Pringle Maneuver?
clamping of the hepatoduodenal ligament
