Treatable Causes

Question 1

Overview

Answer 1

VF is the most treatable of all cardiac arrest causes

- CPR and defibrillation are the treatments of choice and by far the most successful

Question 2

Cause - Hypoxia

Answer 2

• Asthma
• COPD
• CHF
• Anaphylaxis
• Tension pneumothorax

Question 3

Treatments - Hypoxia

Answer 3

• 2 person BVM
• High flow nasal cannula
• Early intubation
• Consider 5cm PEEP
  - for known CHF etiology
  - for profuse blood up the ET tube
• Inline suctioning
• MDI Ventolin
• Consider bilateral needle decompression

PRE/POST ARREST
target - 94% SPO2
position - 45o
consider 5cm PEEP (unless COPD)

Question 4

Causes - known acidosis (H+)

Answer 4

• DKA
• Sepsis
• Post-workout

Question 5

Treatments - known acidosis (H+)

Answer 5

• Sodium Bicarbonate
• Fluid bolus (500ml)
• Ventilate 14-16/min

PRE/POST ARREST
Prioritize ventilation
Consider detaching BVM from ETT
     - If rapid underlying RR
     - Secure ETCO2 and O2

Question 6

Causes - Hyperkalemia

Answer 6

• Kidney failure
• Pressure sores
• Crush injury
• Burns

Question 7

Treatments - Hyperkalemia

Answer 7

• Calcium
• Sodium Bicarbonate
• Fluid bolus (500ml)

PRE/POST ARREST
Consider Ventolin
Consider treatment consult w/ CliniCall
Avoid atropine for bradycardia

Question 8

Causes - Hypothermia

Answer 8

As a cause not a result

• Submersion
• Cold weather
• Found on floor

Question 9

Treatment - Hypothermia

Answer 9

• Transport early
• Consider ECMO facility
• 1mg Epi max
• 1 Defib max
• Ventilate 8-10
• Longer pulse checks
• No rewarming <30o

PRE/POST ARREST
Gentle handling
Delayed intubation to avoid stimulus
Supine position
>30C: passive rewarming
<30C: prevent further heat loss

Question 10

Causes - Toxins

Answer 10

• Ingestion
• Injection
• Inhalation
• dec excretion

Question 11

Treatments - Toxins

Answer 11

• Appropriate antidote
• Poison Control 1-800-567-8911
• Consider early transport

PRE/POST ARREST
Gather pills
Consider PS or CCT for cyanide antidote

Question 12

Causes - Tamponade (cardiac)

Answer 12

• Post cardiac surgery
• Infectious
• IVDU
• Trauma

Question 13

Treatment - Tamponade (cardiac)

Answer 13

• Early transport
• Fluid bolus (500ml)

PRE/POST ARREST
Upright position for drainage

Question 14

Causes - Tension Pneumothorax

Answer 14

• Trauma
• COPD
• Asthma
• Marfan’s

Question 15

Treatment - Tension Pneumothorax

Answer 15

• Needle decompression
• Gentle ventilation
• Avoid PEEP

PRE/POST ARREST
Watch BP
Monitor for re-tensioning

Question 16

Causes - Thrombosis-pulmonary

Answer 16

• Sudden death
• IVDU
• Pregnancy
• Fractures
• Flights
• Bed rest
• Cancer

Question 17

Treatments - Thrombosis-pulmonary

Answer 17

• Recognize!
• Early transport
• Fluid bolus (250ml)

PRE/POST ARREST
Rapid transport
Conservative fluid

Question 18

Causes - Thrombosis-coronary

Answer 18

• Sudden death

- CAD hx

Question 19

Treatment - Thrombosis-coronary

Answer 19

• Standard ACLS

PRE/POST ARREST
Rapid transport
Pads on for pre-arrest pt
12-lead ECG 5-10min post arrest