CPR and Defibrillation

Question 1

What are the indications to start CPR?

Answer 1

There are no signs of life (unresponsive, not breathing normally, carotid pulse cannot be confidently palpated within 10 secs) OR there are signs of inadequate perfusion (unresponsive, pallor or central cyanosis, inadequate pulse - less than 40bpm adults, less than 60bom for infants/newborns)

Question 2

Key priorities that help to improve cardiac arrest outcomes?

Answer 2

Continuous high quality compressions, timely and effective defib, early airway management, pharmacology prioritisation, non-technical skill, reflections

Question 3

Can you do CPR on a bed?

Answer 3

No, you need a firm surface

Question 4

How many compressions per minute?

Answer 4

Between 100-120 compressions

Question 5

Compression to ventilation ratio for adults?

Answer 5

30:2

Question 6

Indications for defibrillation?

Answer 6

Ventricular Fibrillation and PULSELESS Ventricular Tachycardia

Question 7

Contraindication for defibrillation?

Answer 7

Non-shockable rhythms (asystole, pulseless electrical activity PEA, perfusing rhythms)

Question 8

Complications/Precautions for defibrillation?

Answer 8

Patient injury, including burns
If pads are incorrectly placed
Foreign bodies between pads and patient
Pads with insufficient or degraded conductant
Explosion
Transmitted shock to the operator or bystanders

Question 9

What are the joules set at on a corpuls?

Answer 9

200J

Question 10

What are the joules set on a LifePack?

Answer 10

200J, 300J, 360J

Question 11

What are the four safety questions stated before a defib charge is given?

Answer 11

Non-Conductive?
Explosives?
No patient contact?
No movement?

Question 12

After how many minutes of CPR do you then shock?

Answer 12

Two Minutes

Question 13

What is the FIVE STEP method for VT

Answer 13

Rate: Over 100
Rhythm: Regular
P Wave: Not visible
PR Interval: N/A
QRS Complex: Wide

Question 14

Why do you need to check carotid pulse for VT?

Answer 14

It may be perfusing or non-perfusing

Question 15

FIVE STEP method for VF?

Answer 15

Rate: Fast
Rhythm: Irregular
P Wave: Not present
PR Interval: N/A
QRS Complex: Wide and bizarre

Question 16

What are the two STOP criteria?

Answer 16

General Discontinuation Criteria and Rapid Discontinuation Criteria

Question 17

What is the criteria for the General Discontinuation Criteria?

Answer 17

CPR can be stopped after 20 minutes if there is no return of spontaneous circulation are any stage, cardiac arrest was not witnessed by QAS, no shockable rhythm at any stage during resuscitation

Question 18

What is the criteria for the Rapid Discontinuation Criteria?

Answer 18

CPR can be stopped before 20 minutes if patient was observed to be unconscious, unresponsive, not breathing and pulseless for 10 minutes prior to QAS arrival, no CPR was provided during this time and the patient’s cardiac rhythm is asystole or broad PEA (less than 40 minutes)

Question 19

Recognition of life extinct?

Answer 19

No palpable carotid pulse, no heart sounds heard for 30 continuous seconds, no breath sounds heard for 30 continuous seconds, fixed and dilated pupils and no response to central stimuli

Question 20

What do you do if the heart rhythm changes during CPR?

Answer 20

Continue with resuscitation until the end of the current two minute cycle, then reassess patient.
Reassessment starts from the beginning including response and pulse checks
Only exception is if the patient begins to make purposeful movement during CPR