Cardiopulmonary Arrest ✅ Flashcards Preview

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Flashcards in Cardiopulmonary Arrest ✅ Deck (55)
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1

What is the incidence of cardiopulmonary arrest in children in developed countries?

1-20 per 100,000 children per year

2

In which children do the majority of cases of cardiopulmonary occur in?

Children under 1

3

How does the cause of cardiopulmonary arrest differ in children compared to adults?

In adults, it is often due to primary cardiac disease, which occurs with near-normal function of circulatory and respiratory system until moment of arrest. In children, most occur secondary to hypoxia due to respiratory failure or circulatory failure

4

What are the most common causes of circulatory failure leading to cardiopulmonary arrest in children?

Fluid loss or fluid maldistribution

5

What is the result of most cases of cardiopulmonary arrest in children being secondary to respiratory or circulatory failure?

End organ damage is often already present at the time of cardiac arrest, and is responsible for their prognosis

6

In what % of children is there a cardiac cause for cardiopulmonary arrest?

30%

7

Give 3 cardiac causes of cardiopulmonary arrest?

- Congenital heart disease
- Cardiomyopathy
- Channelopathies

8

What is the result of survival from complex congenital heart disease improving?

Cardiopulmonary arrest in children is becoming more common

9

What might unrecognised cardiomyopathy or channelopathies cause?

Sudden unexpected ventricular fibrillation or pulseless VT

10

What should be done following an unexpected cardiac arrest or VT/VF arrest?

Referral to paediatric cardiologist
Family should also be referred

11

Why is it important to make a referral to a paediatric cardiologist after unexpected or VT/VF arrest?

Identifiable cause may be found following detailed investigations, and treatment can be given

12

What might be included in investigations for unexpected or VT/VF arrest?

- Genetic studies
- Pharmacological provocation tests

13

Why should the family also be referred to a paediatric cardiologist in unexpected or VT/VF arrest?

They may also be at risk of sudden death

14

What is achieved in CPR?

Delaying cell damage and death in the heart and brain by facilitating partial flow of oxygenated bloods to these organs

15

What is the purpose of CPR?

To provide a window of opportunity to restore breathing and spontaneous blood circulation

16

What does CPR consist of?

Chest compressions and breaths

17

What is the ratio of chest compressions to breaths in children?

15:2 (except in newborns, when 3:1 ratio required)

18

What is the best compression rate for CPR?

100-120 per minute

19

What is the recommended depth of compression?

1/3 of depth of chest

20

Why is it important that there is minimal interruption of chest compressions?

As coronary perfusion pressure has been shown to be greater with prolonged continuous compressions

21

How do the outcomes from bystander CPR compare in children to adults?

In adults, improves survival even if compression only. In children, doesn't improve survival if compression only

22

Why doesn't compression only bystander CPR improve survival in children?

Most out-of-hospital cardiac arrests are hypoxic in origin, and so rescue ventilation is important

23

What is prolonged resuscitation generally associated with?

Bad neurological outcome

24

What has a recent study into prolonged CPR in adults shown?

Neurological outcome is not directly correlated to duration of CPR

25

What is the result of it being shown that neurological outcome is not directly correlated with duration of CPR in adults?

Resuscitation Council does not recommend a specific duration for CPR, and instead clinicians should determine duration on case-by-case basis

26

When might prolonged resuscitation be appropriate?

When there is potential for a reversible cause

27

Does prolonged resuscitation in children have the same outcomes as in adults?

No they are worse

28

What improves the outcomes of prolonged resuscitation in children?

- Profound hypothermia (<30C)
- Intermittent return of spontaneous circulation

29

When is survival rate with prolonged resuscitation in children?

After 20-30 minutes

30

What is true of survivors of prolonged resuscitation in children?

They are likely to have significant neurological deficits