L&J Chi 5 Anesthetic Emergencies and Resuscitation Flashcards
At the time of publication, what are the most recent measures of anesthetic-associated mortality in veterinary medicine?
Canine: 0.17%
Feline: 0.24%
Rabbits: 1.39%
What is the most common cause of anesthetic complications?
70% involved human error
Cardiopulmonary arrest
CPA
Dynamic, time-dependent process occurring secondary to failed cardiac contractility –> results in either ventricular asystole, PEA, pulseless VT, ventricular fibrillation
Aims of CPR?
Provide blood flow to the heart and brain until restoration of spontaneous circulation
Use of the term “cardiopulmonary resuscitation”
-Not used as a medical term until 1958 when tx of CPA shifted from open chest cardiac massage to closed chest compressions, defibrillation
At time of publication: initial CPR success/return of spontaneous circulation
Dogs: 28-35%
Cats: 42-44%
At time of publication: what are the survival to discharge rates following CPR?
Dogs: 4.1-6.0%
Cats: 7-9%
Every minute spent performing CPR adds significant morbidity and risk and the success rate decreases rapidly
Outcome of CPR
- Depends on timely intervention of effective interventions
- Regardless of initial training, there is always time-related decay of skills
- Recommend refresher courses/simulation practice Q6 mo
CPR Equipment
- Necessary emergency drugs, equipment should be organized in one place (ie crash cart)
- Cart should be adequately stocked, regularly audited, placed in readily accessible area
- Include supplies for venous access, airway management, initial pharmacological therapy
- Surgery kit: emergency thoracotomy, tracheostomy, venous dissection
History Human CPR Guidelines:
- 1992: International Liaison Committee on Resuscitation (ILCOR) was created to develop an internationally accepted CPR protocol
- Composed of American Heart Association (AHA), European Resuscitation Council, and Heart and Stroke Foundation of Canada
What were the ILCOR protocols designed on?
Protocols based on research discussed at the International Consensus Conference for CPR and Emergency CV Science and Treatment
Publication of the ILCOR guidelines
-Published first international CPR guidelines in in 2000, revised protocol in 2005 and 2010
Veterinary CPR guidelines
- 2012: Reassessment Campaign on Veterinary Resuscitation
- Goal: provide evidence-based CPR guidelines for veterinary medicine, combo of ACVAA and ACVECC diplomates
- Collaborative initiative that systematically evaluated published evidence regarding 75 topics relevant to SA CPR and generated CPR guidelines
BLS
Basic Life Support
Basic Life Support (BLS)
- Recognition of CPA
- Initiation of chest compressions
- Airway management
- Assisted ventilation
Quality of BLS performed directly related to ROSC and survival rate