Cardiac Arrest Flashcards Preview

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Flashcards in Cardiac Arrest Deck (14)
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1
Q

What is the definition of Cardiac Arrest?

A

Acute cessation of cardiac function. Accompanied by loss of consciousness.

2
Q

What are the common cardiac rhythm abnormalities?

A

Ventricular fibrillation
Ventricular tachycardia
Asystole
Pulseless electrical activity.

3
Q

What are the characteristics of ventricular fibrillation on pulse and ECG?

A

Px pulseless

Irregular chaotic baselin with broad complex QRS waveforms.

4
Q

What are the characteristics of ventricular fibrillation on pulse and ECG?

A

Can be associated with a pulse.

Regular, broad-comlex tachycardia.

5
Q

What are the characteristics of asystole on pulse and ECG?

A

Pulses absent.

Flat baseline with low-grade fluctuation.

6
Q

WHat are the characteristics of pulseless electrical activity?

A

A rhythm that would usually be expected to accompany an adequate cardiac output is identified but pulse absent.

7
Q

What are the classical reversible causes of cardiac arrest?

A
4 H's and 4 T's
Hypoxia
Hypothermia
Hypovolaemia
Hypo- or Hyperkalaemia

Tamponade
Tension pneumothorax
Thromboembolism
Toxins and other metabolic disorders.

8
Q

What are the clinical features of cardiac arrest?

A

Sudden collapse with loss of consciousness. Other features vary.
May be recent chest pain or breathlessness if cardiac arrest is secondary to ventricualr arrhythmia.

Cardiac arrest is diagnosed when there is no palpable proximal pulse un an unconscious patient with no respiratory effort.

9
Q

How would you manage a patient that you believe to have had a cardiac arrest?

A

ABCDE Summon help immediately.

Basic life support underpins management in cardiac arrest.
30:2.

Once defib is available ALS can begin.

If patient begins to breathe they can be moved to recovery position.

Drugs routinely used in cardiac arrest:
Adrenaline
Atrophine
Amiodarone

10
Q

How often and why should you give adrenaline to cardiac arrest patients?

A

every 3-5 mins.
Has both alpha and beta adrenergic effects resulting in vasoconstriction and increased venous return as well as increasing HR.

11
Q

Why give atropine in cardiac arrest?

A

Blocks parasympathetic action of vagus nerve and may increase HR.

12
Q

Why give amiodarone in cardiac arrest?

A

May be of use in refractory ventricular arrhythmias.

13
Q

How should care proceed after resuscitation?

A

High dependency setting
Full physical examination is required.

Investigations include:
Blood electrolytes, lipids,glucose, cardiac enzumes or troponin.
12 lead ECG chest X ray
Arterial blood gases

14
Q

Give a brief overview of ALS

A
  1. Attach cardiac monitor and defib.
  2. Assess the rhythm, if pulseless ventricular tachycardia or ventricular fibrillation:
    - defib once 150-350 J biphasic, 360J monophasic.
    - Resume CPR for 2 mins and return to 2.
  • Give adrenaline after second defib and every 3-5 min
  • If shockable rhythm persists after third shock give amiodarone