99 Medical Cardiac Arrest Flashcards

(66 cards)

1
Q

What are the INDICATIONS for the MEDICAL CARDIAC ARREST medical directive

A
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2
Q

Which cardiac arrests are 1 analyse and go

A

Trauma
Pregnant over 20 weeks
Hypothermia
Airway Obstruction
Non-opioid OD
Reversible causes

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3
Q

With repeated pulseless VT/VF when do we leave scene?

A

Following 3 rounds of EPI (or 3 shocks, no access)

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4
Q

What is refractory VF/VT

A

VF/VT after 3 consecutive shocks

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5
Q

What are the Hs in Hs/Ts

A

Hypoxia
Hypovolemia
Hypoglycemia
Hydrogen
Hyper/Hypokalemia
Hypo/Hyperthermia

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6
Q

What are the Ts in Hs/ Ts

A

Thrombosis (cardiac and pulmonary)
Tamponade
Tn Pneumo
Trauma
Toxins

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7
Q

What are the CONDITIONS for EPI in CARDIAC ARREST?

A

24 hours
altered
IM: anaphylaxis

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8
Q

What are the CONTRAINDICATIONS for EPI in CARDIAC ARREST?

A

allergy

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9
Q

What is the dose of EPI in CARDIAC ARREST for ANAPHYLAXIS

A

0.01mg/kg (MAX 0.5mg)

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10
Q

What is the dose of EPI in CARDIAC ARREST for 24 hours to 12 years IV/IO/CVAD?

A

0.01mg/kg (MIN 0.05 mg)

0.1ml/kg (MIN 0.5 ml)

1:10,000 epi

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11
Q

What is the dose of EPI in CARDIAC ARREST for 24 hours to 12 years ETT?

A

0.1mg,ml/kg (MAX 2mg ) (MIN 0.5mg)

1:1000 epi

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12
Q

What is the dose of EPI in CARDIAC ARREST for ADULT IV/IO/CVAD?

A

1mg

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13
Q

What is the dose of EPI in CARDIAC ARREST for ADULT ETT?

A

2mg

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14
Q

What is the interval between doses for EPI in CARDIAC ARREST?

A

4 minutes

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15
Q

What are the CONDITIONS for AMIO in CARDIAC ARREST?

A

24 hours
altered
VF/VT

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15
Q

How do we round epinephrine for cardiac arrest?

A

Nearest 0.05mg

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16
Q

What are the CONDITIONS for LIDO in CARDIAC ARREST?

A

24 hours
altered
VF/VT

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17
Q

What is the max initial dose of AMIO in CARDIAC ARREST?

A

300mg

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18
Q

What is the max second dose of AMIO in CARDIAC ARREST?

A

150mg

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19
Q

What are the routes for amiodarone?

A

IV/IO/CVAD

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20
Q

What is the interval between doses for AMIO in CARDIAC ARREST?

A

4 minutes

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21
Q

What is the pediatric dose (24 hours to 12 years) formula for AMIO in CARDIAC ARREST?

A

5mg/kg

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22
Q

How does amiodarone come?

A

150ml/3ml

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23
Q

How MANY doses are given of AMIO in CARDIAC ARREST?

A

2

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24
What is the dose of LIDO in CARDIAC ARREST for PEDIATRIC IV/IO/CVAD?
1mg/kg
25
What is the dose of LIDO in CARDIAC ARREST for PEDIATRIC ETT?
2mg/kg
26
What is the initial dose of LIDO in CARDIAC ARREST for ADULT (12+) IV/IO/CVAD?
1.5mg/kg
27
What is the SECOND dose of LIDO in CARDIAC ARREST for ADULT (12+) IV/IO/CVAD?
0.75mg/kg
28
What is the initial dose of LIDO in CARDIAC ARREST for ADULT (12+) ETT?
3mg/kg
29
What is the SECOND dose of LIDO in CARDIAC ARREST for ADULT (12+) ETT?
1.5mg/kg
30
How MANY doses are given of LIDO in CARDIAC ARREST?
2
31
What is the interval between doses for LIDO in CARDIAC ARREST?
4 minutes
32
For LIDO, how do we remember the ETT dose?
Double to IV/IO/CVAD dose
33
What is the infusionof NaCL given in a Cardiac Arrest?
20ml/kg
34
What is the max volume of NaCl given in a Cardiac Arrest?
2000ml
35
What are extenuating circumstances to patch early for a TOR?
Prolonged Egress Prolonged Transport Significant clinical limitations
36
What happens during patch failure?
Transport to closest, most appropriate hospital
37
Why should NaCl be considered during PEA
NaCl increases preload, which increases force of contraction
38
When is a TOR applicable for Medical Cardiac Arrest?
No reversible causes 16 years old altered Not witnessed by medics No ROSC No Defib
39
How does Lidocaine come?
100mg/5ml
40
What route is preferred for EPI in cardiac arrest?
IV/IO ETT if IV/IO is delayed by 5 minutes
41
What is the chemical name for Sodium Bicarb?
NaHCO3
42
What class of medication is epinephrine?
sympathomimetic
43
What class of medication is Amiodarone
Class 3 antiarrhythmic (potassium channel blocker)
44
What class of medication is Lidocaine?
Class 1b antiarrhythmic (Sodium channel blocker)
45
What class of medication is Sodium Bicarbonate?
Buffer/alkalizer/electrolyte
46
What are the indications of Sodium Bicarbonate
severe acidosis, prolongued VSA
47
How does Sodium Bicarbonate work?
Increases pH Decreased Potassium in blood
48
What medication should not be in the same line as Sodium Bicarbonate?
Dopamine
49
Why is Sodium Bicarb not used in Hyperkalemia?
It works slower and the ion shift is not sustained.
50
How is sodium bicarbonate stored?
50mEq/50ml Preload
51
What actions of epinephrine is useful during cardiac arrest?
A1 vasocontriction B2 Positive inotrophy, chronotrophy and dromotrophy
52
How does amiodarone work?
1: Blocks sodium channels (SLOW conduction) 2: Beta blocking effects (decrease HR) 3: Blocks Potassium to nodal cells -PROLONG repolarization -lengthens action potential -increases refractory period 4: Blocks calcium
53
How does Lidocaine work in Cardiac Arrest?
Increases time for the myocyte to reach threshold potential (slows conduction) Decreases Ventricular irritability Terminate re-entry pathways
54
Class 1 antiarrhythmics
Sodium Channel Blocker
55
Class 2 antiarrhythmics
Beta Blocker
56
Class 3 antiarrhythmics
Potassium Channel Blocker
57
Class 4
Calcium Channel Blocker
58
What happens in phase 0 of the cardiac action potential?
Rapid Sodium in thorugh FAST Sodium channels
59
What happens in phase 1 of the cardiac action potential?
Potassium Out Chloride Out
60
What happens in phase 2 of the cardiac action potential?
Slow Calcium in Potassium Out
61
What happens in phase 3 of the cardiac action potential?
Potassium Out
62
What happens in phase 4 of the cardiac action potential?
Potassium out @ 90mV Resting potential
63
What treatments can be given to 24 hours to 8 years old undergoing Cardiac Arrest?
Epi IV/IO/CVAD 0.01mg/kg Epi ETT 0.1mg/kg (MAX 2mg) (MIN 0.5mg) amio 5mg/kg (MAX 300mg, 150) lidocaine IV/IO/CVAD 1mg/kg Lidocaine ETT 2mg NaCl (20ml/kg, reassess 100ml) Defib 2J/kg, 4J/kg Adjusted CPR
64
What treatments can be given to an 8-12 year old undergoing cardiac arrest?
Epi IV/IO/CVAD 0.01mg/kg Epi ETT 0.1mg/kg (MAX 2mg) (MIN 0.5mg) amio 5mg/kg (MAX 300mg, 150) lidocaine IV/IO/CVAD 1mg/kg Lidocaine ETT 2mg NaCl (20ml/kg, reassess 100ml) Adult Defib 2 handed CPR
65
What treatments can be given to an ADULT undergoing cardiac arrest?
Epinephrine IV/IO/ETT 1mg Epinephrine ETT 2mg Amio 300mg, 150) Lidocaine IV/IO/CVAD 1.5 /kg, 0.75 mg/kg Lidocaine ETT 3mg/kg, 1.5mg/kg NaCl (20ml/kg, reassess 250ml) Adult Defib 2 handed CPR