AMP 18: Defibrillation Flashcards

1
Q

Name 8 reported extra-cardiac causes for Vfib in dogs and cats

A
  • shock
  • hypoxemia
  • electrolyte disorders
  • acid-base disorders
  • electrical shock
  • excessive sympathetic tone
  • hypothermia
  • drug reactions
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2
Q

List factors within or outside of the clinicians control that affect impedance to current during defibrillation

A

Within clinician’s control:
* paddle size
* quality of contact between tissue and paddles
* amount of air inchest (give shock and end-exhalation!)
Outside of clinician’s control:
* absolute amount of air and tissue in the chest
* chest width

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3
Q

Do defibrillators use a direct (DC) or alternating current (AC(?

A
  • direct current
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4
Q

List safety precautions that should be taken to prevent accidental shocking of personnel during defibrillation

A
  • patient should be on a nonconducting surface (E.g., rubber mat)
  • no one is touching the patient
  • contact gel should not extend beyond the surface of the pad
  • warning shout “clear” with sufficient time for personnel to step away
  • operator must visually verify that everyone is clear before giving shock
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5
Q

What are risk factors for accidental patient burning during defibrillation

A
  • poor contact –> arcing of electrical current
  • isopropyl alcohol used
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6
Q

How commonly does a shockable rhythm occur in in-hospital CPA in dogs and cats?

A

28% in dogs, 16% in cats (Kass, Haskins, Survival following CPR in dogs and cats, 1992 JVECC)

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7
Q

Fill the gaps:

Survival rates decrease by ——- for each minute the ventricles fibrillate and thus survival approaches zero after —— min of ventricular fibrillation

A

Survival rates decrease by 7-10% for each minute the ventricles fibrillate and thus survival approaches zero after 10-12 min of ventricular fibrillation

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8
Q

What is “fine ventricular fibrillation”?

A

form of ventricular fibrillation where the undulations of the baseline are so small that it appears similar to asystole on the ECG

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9
Q

List the steps of internal defibrillation

A
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10
Q

When attempting cardioversion of VT or SVT, at what phase of the cardiac cycle should the shock occur?

A

R or S wave

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11
Q

At what phase during the cardiac cycle could attempted cardioversion cause ventricular fibrillation?

A

during the repolarization process, i.e., during the T wave

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12
Q

When attempting cardioversion of SVT or VT, what energy setting should be used?

A

for VT half of the energy setting used for defibrillation (i.e., 1-2 J/kg)
for SVT less energy is usually required for successful cardioversion (0.5-1 J/kg)

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13
Q

At what energy dose has defibrillation shown to injury dogs or be lethal in dogs

A
  • injury starts as low as 10 J/kg (median dose required for injury 30 J/kg)
  • median lethal dose 470 J/kg

Data from experiments using monophasic defibrillators march 19 9.50am

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14
Q

What energy dose should be used for internal defibrillation in veterinary patients?

A

10% of the external dose - about 0.2 -0.5J/kg

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15
Q

List drugs that have been shown to increase the defibrillation threshold (i.e., lead to requirement of higher dose for successful defibrillation)

A
  • amiodarone
  • lidocaine
  • mexiletine

Sotalol and beta-blockers decrease the threshold

less important in biphasic defibrillators though

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16
Q

List the steps of External defibrillation

A