Cardiac Arrest Flashcards
(58 cards)
What is cardiac arrest
Effective cessation of the heart so there is no circulation and no oxygen delivered
How to recognise a cardiac arrest
Unresponsive patient, not breathing normally, no pulse
Presenting rhythm in most cardiac arrests
Ventricular fibrillation or ventricular tachycardia
What happens if there is not a shockable rhythm in cardiac arrest?
Cardiopulmonary resuscitation should commence in order to obtain a shockable rhythm
How to get better outcomes for patients suffering cardiac arrest
Early recognition of abnormal physiology, identifying patients at risk, identify when resuscitation is important
Core standards in cardiac arrest
- Deterioration recognised early with effective help system to prevent arrest
- Arrest recognised early and CPR started immediately
- Help summoned as soon as arrest is recognised (if not already)
- Defibrillation, if appropriate, within 3 minutes of arrest where achievable
- Appropriate post-arrest care if resuscitated including safe transfer
- Standards measured continually and identified problems dealt with
- At least annual training and updates in CPR
- Staff understanding of decisions relating to CPR
- Appropriate equipment available for resuscitation
Chain of survival
Early recognition and call for help, early CPR (to buy time), early defibrillation (to restart the heart), post-resuscitation care to restore quality of life
What are most cardiac arrests caused by?
Problems with airway, breathing, circulation
How can we improve oxygen delivery factors:
- SaO2
- [Hb]
- BP and heart rate
- Preload
- Contractility
- Afterload
- SaO2 = increase FiO2, clear airway, adequate breathing
- [Hb] = transfusion trigger, treat anaemia
- BP/HR = atropine or beta stimulant for bradycardia and pace
- Preload = IV fluids, raise legs
- Contractility = treat cause
- Afterload = If excess, use vasodilators, reduced, use vasoconstrictors
How can we assess SaO2?
Clinical, pulse oximetry, arterial blood gas (gold standard)
How can we assess [Hb]?
Clinical, part of FBC, bedside
How can we assess heart rate?
Pulse, pulse oximetry, ECG monitor with sound, arterial BP monitor
What can airway obstruction be caused by?
CNS depression, lumen blocked, swelling, muscle
What can cause CNS depression?
Tongue
What can cause a blocked lumen?
Blood, vomit, foreign body
What can cause swelling?
Trauma, infection, inflammation
What muscular causes of airway obstruction are there?
Laryngospasm, bronchospasm
Recognition of airway obstruction
Talking, difficulty breathing, distressed, choking, SOB, noisy breathing (wheeze, stridor, gurgling), using accessory muscles
Treatment of airway obstruction
Airway opening - head tilt chin lift, simple adjuncts, LMA, tracheal tube, oxgyen
Causes of breathing problems
Airway problems, decreased respiratory drive, decreased respiratory effort, lung disorders
Recognition of breathing problems
Look - respiratory distress, accessory muscles, cyanosis, respiratory rate, chest deformity, conscious level
Listen - noisy breathing, breath sounds
Feel - expansion, percussion, tracheal position
Treatment of breathing problems
Airway, oxygen, treat underlying cause, support breathing if adequate
Primary causes of circulatory problems
Acute coronary syndromes, dysrhythmias, hypertensive heart disease, valve disease, drugs, hereditary cardiac disease, electrolyte abnormalities, electrocution
Secondary causes of circulatory problems
Asphyxia, hypoxaemia, blood loss, hypothermia, septic shock
