15952654
Description
Flashcards by Amelia Tuffley, updated more than 1 year ago
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Created by Amelia Tuffley
about 6 years ago
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| Question | Answer |
| Survival rates of out of hospital cardiac arrests by rhythm types | - VF/VT, 41% - Nonshockable, 17% - Unwitnessed, 14.3% - Paramedic witnessed, 45% - Paramedic witnessed with VF/VT, 70% |
| Define cardiopulmonary arrest | Cessation of cardiac function with the pt displaying no pulse, no regular breathing and unresponsiveness (Can still have HR <40 and be considered an arrest) |
| Primary causes of cardiac arrest | - AMI - CHF - Cardiomyopathy - Pericarditis - Valvular stenosis |
| Secondary causes of cardiac arrest | - Acute asthma - Tension pneumo - Drug overdose - Drowning - Trauma - Electrolytes - Anaphylaxis - Electrocution |
| Chain of survival in cardiac arrest | - Early intervention - CPR - Defib - ACLS - Post resus care |
| Baby CPR | - Thumbs on lower third of sternum - 3:1 - Indicated when HR less than 60 despite ventilation for 30 sec |
| Paediatric CPR | - 15:5 - One hand - 12 years and under QAS |
| Defibrillation rationale | - Produces simultaneous depolarisation of a critical mass of myocardium and may enable resumption of coordinated electrical activity - Critical mass of >70% of myocardium need to be sent into absolute refractory for defib to be successful |
| Pad placement | - Para-sternal, over second intercostal space - Mid-axillary line over sixth intercostal space - Anterior-posterior for children |
| Safety considerations for defib | - Has excess hair been removed - Is pad placement correct - Pt dry - O2 away - Everyone clear |
| Joules for defib | - 200J for all shock Corepuls - Lifepak12, 200, 300, 360 - 4J/kg for kids |
| Benefits of using EtCO2 | - Confirm airway - Assess adequacy of CPR - Significant increase in CO2 = early sign of ROCS |
| 4H/4T | - Hypoxia - Hypovolaemia - Hypo/hyperkalaemia/electrolytes - Hypo/hyperthermia - Tension pneumothorax - Tamponade - Thromoembolism - Toxins |
| Pathophysiology of cardiac arrest in asthma | 1. Severe bronchospasm and mucous plugging leading to asphyxia 2. Cardiac arrhythmias due to hypoxia 3. Dynamic hyperinflation causing gradual increase of pressure 4. Reduction of venous return and BP 5. Tension pneumo |
| Signs of life extinct | - No palpable carotid pulse - No heat sounds for 30 continuous secs - No breath sounds for 30 sec - Fixed and dilated pupils - No response to centralised stimuli |
| General resuscitation discontinue criteria | - CPR administered by paramedic for at least 20 mins then - Exhibiting signs of life extinct - PEA or asystole, 30 mins for VT/VF |
| Rapid discontinuation criteria | - Can be withdrawn before 20 mins if: - Pt was observed as unresponsive and pulseless for at least 10 mins prior to paramedic arrival - No CPR commenced during this period - Pt exhibiting signs of life extinct - Asystole |
| Aims of ROSC management | - Continue respiratory support - Maintain cerebral perfusion - Treat and prevent arrhythmias - Determine cause of arrest |
| ROSC management | - SITREP - Swap defib pads for lead II - Posture as per LOC - BGL - CCP for sedation, antidysrhythmic drugs, seizure control - Oxygen therapy as per SpO2 and EtCO2 - ABCs - Resp status assessment - Neurological status assessment - Perfusion status assessment |
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