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1
Q

What are non-shockable rhythms?

A
  • PEA
  • Asystole
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2
Q

If your patient is in a non-shockable rhythm when do you administer adrenaline?

A

Straight away and then every second loop

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3
Q

What are the two shockable rhythms that present with cardiac arrest?

A
  1. VF
  2. VT
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4
Q

How does adrenaline help in cardiac arrest?

A

Helps maintain diastolic BP and hence coronary blood flow

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5
Q

How much energy should you use for a shock?

A

200 J

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6
Q

What is the chain of survival?

A
  • Early recognition and call for help
  • Early CPR
  • Early Defibrillation
  • Post resucitation care
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7
Q

What is involved in post-resusitation care?

A
  • Re-evaluating ABCDE (disability, exposure)
  • 12 lead ECG
  • Treating precipitating causes
  • Re-evaluating oxygenation and ventilation
  • Use of targeted temperature management
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8
Q

What should the depth of chest compressions be?

A

One-third AP diameter

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9
Q

How should you treat choking?

A
  • Encourage coughing if they are already coughing
  • If not coughing but responsive 5 back blows then 5 chest thrusts
  • If unresponsive CPR
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10
Q

What is the dose of adrenaline for anaphylaxis?

A

0.5mg IM

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11
Q

What is the dose of adrenaline for a child with anaphylaxis?

A

10mcg/kg (0.01mL/kg of 1:1000)

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12
Q

What does the ISBAR tool stand for?

A
  • Identify yourself
  • Situation
  • Background
  • Assessment
  • Response
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13
Q

What is a recap tool that can be used?

A
  • Stop
  • Notify the team of the situation
  • Assess
  • Plan
  • Prioritise
  • Invite idease
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14
Q

What does the acronym PACER stand for?

A

Probe

Alert

Challenge

Emergency

React

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15
Q

What are the 4 H’s and T’s?

A

Hypoxia

Hypovolaemia

Hypothermia

Hypokalamia

Tension pneumothorax

Toxins

Thrombosis

Tamponade

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16
Q

During CPR what else should we be doing?

A
  • Airway adjuncts
  • Oxygen
  • Waveform capnography
  • IV/IO access
  • Plan actions before interrupting compressions
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17
Q

If you are breathing for somone how many breaths per minute should you be doing?

A

6-10 a minute

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18
Q

When should amiodarone be given

A

Shockable rythm

Third defibrillation attempt

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19
Q

What should your target temperature be in post-resusitation care?

A

32-36 degrees

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20
Q

How many joules should you be shocking a child with?

A

4J/kg

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21
Q

How much amiodarone should you give a child?

22
Q

What % of oxygen should be used for those in cardiac arrest?

23
Q

What is the normal ETC02?

24
Q

If the ETC02 is <10mmHg what does this imply?

A

The resuscitation is ineffective

25
When is amiodarone used in cardiac arrest?
* Refractory VF/VT * When 3 loops of CPR followed by a shock have failed to restore a rhythm
26
What drug can be used instead of amiodarone?
Lignocaine 1mg/kg
27
What is the adult dose of amiodarone?
300mg IV
28
When should calcium be administered in a cardiac arrest?
* hyperkalaemia * Hypermagnesaemia * Calcium channel blocker overdose * Profound hypocalcaemia (ie following massive blood transfusion)
29
What is the major acid base abnormality in cardiac arrest?
Respiratory acidosis
30
How can rewarming of an individual be most rapidly acheived?
cardiopulmonary bypass
31
What is malignant hyperthermia?
sensitivity of skeletal muscles to volatile anaesthetics and suxamethonium.
32
How do you treat malignant hyperthermia?
Dantrolene 2-5mg/kg
33
How can you treat hyperkalaemia?
* Calcium gluconate * Insulin * Salbutamol * Bicarbonate
34
What are the classic signs of a tension pneumothorax?
* deviation of trachea away from tension * Hyper-expanded chst * Increased percussion note
35
How do you treat tension pneumothorax?
14G cannula into the second rib space mid-clavicular line
36
What is Beck's triad?
* 3 clinical signs associated with cardiac tamponade: * Hypotension * Jugular vein distension * Absent or distant heart sounds
37
What drug can you give in local anaesthetic toxicity?
Intralipid
38
What drug can you give in an opiate overdose?
Naloxone
39
What drug can you give in a panadol overdose?
N-acetyl cysteine
40
What are the priorities in the management of acute hypoxic brain injury?
* airway * Breathing * Circulatory control * Temperature management
41
What happens with hypercapnia? (PCO2 \>45mmhg)
Cerebral vasodilation
42
In post resusitation care what is targeted temperature management?
32-36 degrees
43
What are the 3 key abnormalities of asthma?
* Bronchoconstriction * Airway inflammation * Mucous plugging
44
What clinical features in an asthmatic make you suspect a near fatal asthma attack?
* PEF \<33% * 02 \<92% * Normal C02 * SIlent chest * Cyanosis * Bradycardia * Arrhythmia * Exhaustion * Confusion
45
What management should you give to an asthmatic?
* Oxygen * Salbutamol nebulised 5mg every 15 mins * Hydrocortisone 200mg IV * Nebulised anticholinergic ie ipratropium bronide 0.5mg q4-6h * Magnesium sulphate 2g over 20 minutes * IV salbutamol
46
When should peri-mortem caesarean be considered?
4 minutes of onset of cardiac arrest if ROSC has not returned
47
What is the survival rate of cardiac arrest in the OT?
30%
48
what are the two most important preventable causes of death following trauma?
1. airway obstruction 2. Blood loss
49
What is the sequence for trauma care?
1. Primary survery 2. Resuscitation 3. Adjuncts to primary survery 4. Secondary survey 5. Definitive care
50
What are the priorities of the primary survey?
* Airway * Breathing * Circulation * Disability (neurological status) * Exposure (undress)
51
Should you be using c-spine collars in a pre-hospital setting?
No

ACLS (2 decks)

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