Acute Care - Arrest, Brady and Tachy Flashcards Preview

AB 4th Year Acute Care + Anaesthetics > Acute Care - Arrest, Brady and Tachy > Flashcards

Flashcards in Acute Care - Arrest, Brady and Tachy Deck (21)
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1
Q

where are pacemaker cells found?

A

SA node

2
Q

what happens in pacemaker cells?

A

decreased K efflux + increased Na influx

then Ca influx causes the spike

once at the top, K efflux increases and Ca influx decreases

3
Q

what happens in ventricular muscle cells?

A

increased Na and Ca influx

plateau occurs, Na channels close

after this, Ca influx increases and K efflux occurs

Ca channels close and K efflux continues

4
Q

what can cause bradycardia?

A

hyperkalaemia
BBB
heart block
physiological

5
Q

Tx for bradycardia?

A

observe if no adverse features

500mcg IV atropine (repeat up to 6 times)

can give adrenaline IV

transcutaneous pacing

6
Q

how does atropine work?

A

inhibits muscarinic actions (parasympathetic)

7
Q

what are causes of tachy - broad vs narrow?

A

narrow =
atrial flutter
AF
re entrant SVT

broad =
AF + BBB
VT
SVT +BBB

8
Q

what is the Tx for narrow QRS, regular rhythm tachycardia?

A

vagal manouvres

adenosine 6mg IV

9
Q

how does adenosine work?

A

activates K channels to hyperpolarise and cause delay between AV node

10
Q

what is the Tx for narrow QRS, irregular rhythm tachycardia?

A

probably AF

Bblocker/CCb
or
digoxin/amiodarone if HF

11
Q

what is the Tx for broad QRS, regular rhythm tachycardia?

A

probably VT

amiodarone 300mg IV

12
Q

what is the Tx for broad QRS, irregular rhythm tachycardia?

A

AF with BBB - treat alike narrow complex

polymorphic VT - magnesium 2mg

13
Q

4H’s of cardiac arrest?

A

Hypovolaemia
Hypothermia
Hypo/hyperkalaemia
Hypoxia

14
Q

4T’s of cardiac arrest?

A

Tension pneumothorax
Thrombus
Tamponade
Toxins

15
Q

what is the specifications of good chest compressions?

A

30:2
100-120 a min
5-6cm depth

16
Q

what are the shockable rhythms?

A

VF

pulseless VT

17
Q

when and what drugs are given during CPR?

A

adrenaline 1mg IV every 3-5 mins (alternate shocks)

30mg amiodarone after 3 shocks

18
Q

how long should CPR be done for between shocks?

A

2 mins

19
Q

how is paediatric CPR done?

A

head tilt after 1yr

5 rescue breaths: 15 compressions

20
Q

when is adrenaline given if it is confirmed to be a non shockable rhythm?

A

as soon as

21
Q

if a non shockable rhythm, what is the CPR pathway?

A

recheck every 2 mins

regive adrenaline every 3-5mins