5: Resuscitation

Question 1

What is the most common cause of sudden death?

Answer 1

Coronary heart disease

i.e MI

Question 2

What is clinical death?

Answer 2

Absence of circulation and respiration with brain arrest

Lasts 3 - 6 minutes

Reversible

Question 3

How long does clinical death last without CPR?

Answer 3

3 - 6 mins

Question 4

Clinical death is (reversible / irreversible).

Answer 4

reversible

Question 5

What does clinical death progress to if not reversed?

Answer 5

Biologic death

which isn’t reversible

Question 6

How long does clinical death last in the absence of CPR?

Answer 6

3 - 6 minutes

Then becomes biologic death (which is irreversible)

Question 7

What is agonal breathing?

Answer 7

Dodgy breathing indicative of cardiac arrest

Question 8

At what depth should you do chest compressions?

Answer 8

5 - 6cm

Question 9

At what rate should you do chest compressions?

Answer 9

100 - 120bpm

Question 10

You should avoid ___ during CPR.

Answer 10

any interruptions

outcome is worse

Question 11

In which situations should you do rescue breaths before chest compressions?

Answer 11

Paediatric CPR

Non-cardiac causes of cardiac arrest e.g drowning

Question 12

Which arrhythmias are

a) shockable
b) not shockable?

Answer 12

a) VT / VF

b) PEA / Asystole

Question 13

What should be given after 3 rounds of CPR and every 3 rounds thereafter?

Answer 13

IV adrenaline

IV amiodarone

Question 14

What antiarrhythmic drug should be given alongside adrenaline for shock-resistant cardiac arrest?

Answer 14

IV amiodarone

Question 15

What are the criteria for

a) tachycardia
b) bradycardia?

Answer 15

a) HR > 100 bpm

b) HR < 60 bpm

Question 16

What are the 4 Hs and 4 Ts of reversible cardiac arrest?

Answer 16

Hypoxia, hypovolaemia, hypothermia, hyperkalaemia

Tamponade, tension pneumothorax, thrombus, toxins

Question 17

Which investigation is crucial for diagnosing hyperkalaemia?

Answer 17

ECG - tall, tented T waves; flattened QRS complexes

Question 18

How is hyperkalaemia managed acutely?

Answer 18

IV calcium gluconate

IV insulin and dextrose

Also consider salbutamol NEB

Question 19

What abnormal movements accompany agonal breathing in cardiac arrest?

Answer 19

Myoclonus

jerky, irregular muscle movements

Question 20

During CPR, you should allow the chest to ___.

Answer 20

recoil

Question 21

Where should you place your hands during chest compressions?

Answer 21

Centre of the chest at the level of the nipples

Question 22

In which case should you not give amiodarone for shock-resistant cardiac arrest?

Answer 22

Polymorphic VT associated with long QT syndrome

Amiodarone makes it worse

Question 23

When would you start CPR with 2 rescue breaths rather than 30 chest compressions?

Answer 23

In children

Non-cardiac causes of cardiac arrest (e.g drowning)

Question 24

Is VF or VT compatible with a heartbeat?

Answer 24

No

So the patient will not have a pulse

Question 25

What is **polymorphic ventricular tachycardia** also known as? In which **inherited cardiac condition** is it commonly seen?

Answer 25

**Torsades de pointes** **Long QT syndrome**

Question 26

Where are the **limb electrodes** of an ECG placed?

Answer 26

**Ride your green bike** **Red** - right arm **Yellow** - left arm **Green** - left leg **Blue** - right leg

Question 27

Where are the **chest electrodes** of an ECG placed?

Answer 27

**V1** - right sternal border, 4th intercostal space **V2** - left sternal border, 4th intercostal space **V4** - left 5th intercostal space, midclavicular line **V3** - between V2 and V4 **V5** - left 5th intercostal space, anterior axillary line **V6** - left 5th intercostal space, midaxillary line

Question 28

How do you calculate the **heart rate** off an ECG when the rhythm is **regular?**

Answer 28

**HR = 300 / No. of large boxes between QRS complexes**

Question 29

How do you calculate the **heart rate** off an ECG when the rhythm is **irregular**?

Answer 29

**HR = (No. of QRS complexes in 30 small boxes) x 10**

Question 30

Which **arrhythmia** can **torsade de pointes** progress to?

Answer 30

**VF** Which is an emergency