Cardiopulmonary Resuscitation Flashcards
(25 cards)
What is the most important factor that could lead to successful CPR?
Immediate recognition of arrest
Define CPR…
Cardiopulmonary resuscitation - a means to support the body and try and restart the circulatory and respiratory systems when a patient stops breathing or its heart stops beating.
Define respiratory arrest…
Cessation of effective breathing
Define cardiorespiratory arrest….
Cessation of cardiac output and breathing
How do you assess whether a patient has arrested?
Look for spontaneous breathing
Auscultate the heart
Feel for apex beat
Palpate pulses
What are the clinical signs that often precede arrest?
Hypoventilation
Bradycardia
What is vasovagal syncope/vagal arrest?
Stimulation of vagus nerve by V+ Defecation/urination Resp/abdo disease Ocular/neck surgery
How is vasovagal syncope/vagal arrest treated?
Oxygen
Atropine IV
How can anaesthesia cause arrest? What are the possible complication of this?
Overdose of anaesthetic agent or hypoventilation
- Blindness
- Dysphoria
- Neuro dysfunction
What are the roles within the CPR team?
Ventilation Compressions IV access ECG monitoring Runner Scribe Pulse taker Team leader
Outline the ABCs of CPR
A - establish and secure a patent airway
B - provide +ve pressure ventilation
C - chest/cardiac compressions
Outline how breathing is restored in CPR…
Ambu bag/anaesthesia system \+ve pressure ventilation 100% oxygen 10-12 BPM Deliver breaths with compression
How many breaths should be delivered per minute in CPR? What can hyperventilation cause?
10-12BPM
- Increased intrathoracic pressure
- Reduced CO
- Reduced cerebral/coronary perfusion
How many compressions should be delivered /minute in CPR? Why is it important not to interrupt compressions? Where are you trying to maximise perfusion?
100BPM
Effectiveness of compressions builds up and plateaus - an interruption starts it back at base level.
- Myocardium
- Cerebrum
Outline how compressions are carried out in CPR…
Widest part of the chest
100BPM
Allow chest to fully expand after each compression
Lateral recumbency
1 hand in cats/small dogs, 2 in large dogs
Switch person every 2 minutes
Don’t stop!
When is open chest CPR indicated?
Large dogs Pleural space disease Chest wall disease Pericardial effusions Intraop arrest Haemabdomen
What are the issues related to open chest CPR?
Need experienced personnel
Need financial and surgical back up
Risk of infection
What can occur following chest compressions and adrenaline and atropine administered together? How is this treated?
Ventricular fibrillation
Electrical defibrillation, pre-cordial thump if unavailable
Which drugs can be administered via and ET tube and how?
Lipid soluble drugs only: Naloxone Atropine Vasopressin Epinephine Lidocaine Apply double the dose down ET tube, flush down with 10ml of saline follwed by a big breath.
What routes are suitable for administering drugs during CPR?
IV
Intra-osseous
ET Tube
Name 7 drugs and reasons for administration during CPR…
Atropine - arrests due to vagal stimulation
Ca - Hyperkalaemia or hypocalaemia
Epinephine or vasopressin - Increases myocardial perfusion
Glucose - Hypoglycaemia
Lidocaine - Ventricular tachycardia
Na bicarbonate - Hyperkalaemia/metabolic acidosis
What always indicates atropine, how is it administered?
Bradycardia, one dose early in CPR
How is fluid therapy used in CPR?
Infusion after drug administration
Treat existing hypovolaemia
What factors affect when CPR is stopped?
Time from arrest to CPR Time of efforts Pre-arrest health status Consensus between staff Owner informed early
