Cardiac arrest - Full summary

Question 1

What are the 4Hs that can cause cardiac arrest?

Answer 1

Hypoxia
Hypovolaemia
Hypothermia
Hypo/hyperkalaemia (+other metabolic)

Question 2

What are the 4Ts that can cause cardiac arrest?

Answer 2

Tension pneumothorax
Tamponade
Toxins (Opiates and benzodiazepines)
Thrombus

Question 3

What are some signs of cardiac arrest?

Answer 3

Unresponsive
Abnormal, agano breathing
Absent pulse

Question 4

What is the number to call for a cardiac arrest in public?

Answer 4

999

Question 5

What is the number to call for a cardiac arrest in hospital?

Answer 5

2222

Question 6

What are the 2 methods of recording patient response?

Answer 6

ACVPU
Glasgow Coma Scale

Question 7

What does ACVPU stand for?

Answer 7

A - Alert
C - Confusion
V - Voice
P - Pain
U - Unresponsive

Question 8

What is the Glasgow coma scale?

Answer 8

A scale from 3-15
3 - Coma
15 - Fully alert

Question 9

What should be performed before CPR in a patient with a suspected cardiac arrest?

Answer 9

Check alertness
Check airway
Check breathing
Check pulse

Question 10

What is meant by good quality CPR?

Answer 10

Delivered to the lower half of the sternum
Compress chest by 5-6cm
Done with straightened arms
Performed at 100-120 bpm
Allow chest to fully recoil between compressions
Deliver chest compressions and breaths at a ratio of 30:2

Question 11

What are the 4 possible rhythms in cardiac arrest?

Answer 11

Ventricular fibrillation
Pulseless ventricular tachycardia
Pulseless electrical activity
Asystole

Question 12

What are the shockable rhythms of cardiac arrest?

Answer 12

Ventricular fibrillation
Pulseless ventricular tachycardia

Question 13

What are the non-shockable rhythms of cardiac arrest?

Answer 13

Pulseless electrical activity
Asystole

Question 14

What rhythm of cardiac arrest can be seen in the following ECG?

Answer 14

Ventricular fibrillation

Question 15

What are the 2 forms of ventricular tachycardia?

Answer 15

Monomorphic
Polymorphic

Question 16

What rhythm of cardiac arrest can be seen in this ECG?

Answer 16

Monomorphic ventricular tachycardia

Question 17

What is Torsades du Point?

Answer 17

This is a form of highly irregular, polymorphic ventricular tachycardia, translating to “Twisting of the peaks”

Question 18

What rhythm of cardiac arrest is seen on this ECG?

Answer 18

Torsades du Pointes

Question 19

What is a precordial thump?

Answer 19

This is a thump to the chest that can be given to the lower half of the sternum in patients with Ventricular fibrillation or ventricular tachycardia (rarely effective)

Question 20

What are the 2 main drugs that should be given in cardiac arrest?

Answer 20

Adrenaline
Amiodarone

Question 21

When should adrenaline be given in cardiac arrest?

Answer 21

Every 3-5 minutes, after 3 shocks

Question 22

When should amiodarone be given in cardiac arrest?

Answer 22

After 3 shocks

Question 23

What is meant by ROSC?

Answer 23

Return of Spontaneous Circulation
This is the movement of the heart beat back into a functioning beat

Question 24

What is the main sign of return to spontaneous circulation?

Answer 24

Rise in ETCO2 (End Tidal CO2)

Question 25

What should be performed after return to spontaneous circulation?

Answer 25

ABCDE approach Urgent cardiac catheterisation and PCI if required ICU management Neuro-protective ventilation Neurological assessment after 72 hours

Question 26

What does ABCDE stand for?

Answer 26

Airway Breathing Circulation Disability Exposure

Question 27

What is a DNAR?

Answer 27

Do Not Attempt Resuscitation This is a pre-agreed document that prevents the person from receiving CPR if they go into cardiac arrest

Question 28

What can still be performed under a DNAR?

Answer 28

Fluids Antibiotics Medication

Question 29

Why would someone sign a DNAR?

Answer 29

This is usually because the patient is too ill to fully recover from cardiac arrest and their quality of life will be significantly reduced if they were resuscitated

Question 30

What are some reasons why CPR would not be administered?

Answer 30

DNAR In cases of obvious mortal injury If there is a safety threat to the ALS provider If there is persistent asystole for >20 minutes

Question 31

What is checked for in A of ABCDE?

Answer 31

Talking Difficulty breathing Noisy breathing See-saw breathing

Question 32

What is checked for in B of ABCDE?

Answer 32

Respiratory rate Respiratory effort Equal air entry Added sounds Tracheal deviation Chest expansion Percussion Oxygen saturations

Question 33

What is checked for in C of ABCDE?

Answer 33

Colour Temperature to touch Capillary refill time Heart rate Pulse character Heart sounds Blood pressure

Question 34

What is checked for in D of ABCDE?

Answer 34

Hypoxia Hypercapnia ACVPU Pupils Blood glucose Temperature

Question 35

What is done in E of ABCDE?

Answer 35

Clothing removed to allow thorough examination Avoid heat loss Maintain dignity