Arrest Flashcards

(33 cards)

1
Q

Defib used when?

A

Pulseless Vtach or Vfib

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2
Q

Defib mode?

Starting joules?

A

Immedate (not synchronized)

200 j (max amount unit can deliver)

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3
Q

Airway mgmt: 1st intervention?

Air vol delivered?

BLS delivered how?

A

BVM (bag-valve-mask)

500 to 800 mls

GENTLE inflation w/ Synch’d 30:2 delivery

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4
Q

Airway mgmt: Advanced?

Max vent interruption?

Tube size?

Delivered how?

A

Trach intubation preceded by pre-oxygenation

30 sec

8mm

8-10 bpm w/ asynch’d compressions (don’t interrupt compressions)

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5
Q

Trach intubation placement confirmed how? (2)

Monitored how*?

A

Auscultation
Capnography

Continuous waveform

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6
Q

Capnography (PETCO2) End Tidal goal during compressions*?

If less than goal, CPR is what*?

A

≥ 10 mmHg

Ineffective

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7
Q

Pulseless VT/Vf 1° mgmt steps ? (3)

Goal of mgmt*?

A

1) Establish pulselessness
2) Start CPR:BVM of 30:2
3) Defib in single shocks (biphasic 200j)

Defib (shock and return imm to CPR w/o waiting to see result of shock)

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8
Q

Pulseless VT/Vf 2° mgmt steps? (3)

Sequencing? (5)

A

1) Establish anticubital peripheral IV (or IO)
2) Pre-O2 then intubate
3) Check placement

1) 2 min CPR
2) Assess rhythm/pulse
3) Shock if nec
4) Return to CPR
5) Meds

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9
Q

Maximum CPR interruption?

A

10 sec

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10
Q

Perfusion meds in arrest delivered how often?

A

Q 4min

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11
Q

Epi class?

Action?

A

Catecholamine (sympathomimetic)

α1 = Vasoconstriction (primary reason we use this, ↓SA of vascular bed will move blood faster)

β = ↑HR, conduction and contractility

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12
Q

Epi indications?

A

DOC for all types of arrest

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13
Q

Epi dosage: Initial?

Repeat?

Special inst?

A

Initial: 1 mg

Repeat: 1 mg Q 4 min

Give IV push, IO or ETT

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14
Q

Add’l meds for Pulseless Vtach/Vfib?

A

Amiodarone

Mg

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15
Q

Amiodarone dosing for Arrest: Initial?

Repeat?

Special inst?

Max?

Continuous infusion?

A

Initial: 300 mg

Repeat: 150 mg Q 4 min

Dilute to 20 mls, IV push

Max: 2.2 gm/24 hrs

Infuse: 1 mg/min x 6 hrs, 0.5 mg/min x 18 hrs

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16
Q

Magnesium indications?

A

DOC for Torasde

2nd line for dysrhy not responding to Amiodarone

17
Q

Magnesium dosing for Arrest: Initial?

Repeat?

Special inst?

Max?

A

Initial: 1 to 2 gm

Repeat: 1 gm if 1st dose was 1 gm Q 4 min

Dilute in 10 mls over 2 min (NO IV PUSH)

Max: 2 gm

18
Q

Rule for drug use in Arrest?

A

One drug at a time, push thru max dose

Then move to next drug if needed

19
Q

Summary: Pulseless VT/Vfib tx?

A

Defib 200 j
Epi 1 mg
Amiodarone 300 mg/ 150 mg
Mg 2 gm

20
Q

Primary Electrical Activity (PEA) is?

tx? (3)

A

Rhythm that should produce a pulse but isn’t

1) CPR, BMV
2) Establish IV and intubate
3) Epi
NO ELECTRICAL

21
Q

Causes of PEA (stroke volume problems): 5 Hs?

A
Hypovolemia (start here -> fill the tank)
Hypoxia
Hydrogen ion (acidosis)
Hyper/HypoK+
Hypothermia
22
Q

Causes of PEA: 5 Ts?

A
Toxins
Tamponade
Tension pneumo
Thrombosis, coronary
Thrombosis, pulmonary
23
Q

Asystole mgmt steps? (3)

A

1) CPR, BVM
2) IV, intubate
3) Epi
NO ELECTRICAL

24
Q

CPR steps*? (6)

A

1) ≥ 100 bpm w/ ≥ 2 in
2) Allow for complete recoil
3) Rotate compressors every 2 min
4) < 10 sec interruption
5) Non-advanced 30:2
6) Advanced asynch compression/slow gentle vents 8-10/min

25
ROSC mgmt steps*? (3)
1) Support O2/vent 2) Support BP w/ fluids 3) Support BP w/ pressors
26
ROSC O2/Vent support*? (3)
Waveform capnography Goal PETCO2 35-40 mmHg Goal O2 94%
27
ROSC BP fluid support*? (2)
Goal SBP 90 mmHg | Bolus 1-2 L NS if < 90
28
ROSC BP pressor support*? (2)
1° Norepi | 2° DA
29
Noreip action?
α - vasoconstriction
30
Norepi indications*?
SBP < 70 mmHg
31
DA action*?
Rate-related: 1-5 ug/kg/min = dilation of gut 5-10 ug/kg/min = β contractility > 10 = α vasocontriction
32
DA indication*?
ROSC support if | SBP 70 - 100
33
Use of hypothermia?
For ROSC comatose pt | Not for conscious pts