Cardiorespiratory Arrest Flashcards
(21 cards)
What is cardiorespiratory arrest?
Unexpected cessation of heart and lung function that results in successful resuscitation
This can occur due to various underlying causes and may involve emergency medical interventions.
Define sudden cardiac death (SCD).
Unexpected death due to sudden irreversible cessation of heart and lung function
SCD is often a result of underlying cardiovascular diseases.
What are the main underlying causes of cardiac arrest?
- Ischemic heart disease (most common)
- Cardiovascular disease and structural abnormalities
- Cardiomyopathies and dysrhythmias (least common)
Ischemic heart disease includes conditions such as acute coronary syndrome (ACS) and myocardial infarction (MI).
List the differential diagnoses for sudden cardiac arrest.
- Structural: Cardiomyopathies, Aortic rupture, Valve disease (e.g., Mitral valve prolapse)
- Functional: Ischaemic heart disease
- Electrical: Long QT syndrome, WPW syndrome, Brugada syndrome, Post-op congenital heart disease
- Other: Drugs, Primary pulmonary hypertension
These categories help clinicians determine the underlying cause of cardiac arrest.
What is ventricular fibrillation?
Very rapid and irregular, uncoordinated ventricular activation with no mechanical effect
In ventricular fibrillation, the ventricles cannot pump blood effectively.
Describe pulseless ventricular tachycardia.
Rapid coordinated ventricular contractions where heart doesn’t have time to fill with blood, so cardiac output decreases markedly
An example of this condition is Torsades de pointes.
What is pulseless electrical activity (PEA)?
Unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge
PEA indicates a situation where the heart has electrical activity but fails to produce a detectable pulse.
Define asystole.
Cessation of heart electrical and mechanical activity, so there is no ventricular depolarisation and no cardiac output
Asystole is often referred to as a flatline on an ECG.
What are the 4 reversible factors of sudden cardiac arrest known as the 4Hs?
Hypoxia, Hypovolemia, Hypo/hyperkalemia, hypoglycemia, acidosis, Hypothermia
These factors can be addressed to potentially reverse cardiac arrest.
What are the 4 reversible factors of sudden cardiac arrest known as the 4Ts?
Thrombosis (pulmonary or cardiac), Tamponade (cardiac), Toxins/tablets, Tension pneumothorax
These factors are critical to identify and treat in cases of cardiac arrest.
List the three specific signs of sudden cardiac arrest.
- Sudden loss of consciousness
- No pulse
- No breathing or atonal gasps
Recognizing these signs is essential for immediate intervention.
What are the four non-specific signs of sudden cardiac arrest?
- Fatigue
- Chest pain
- Palpitations
- Weakness
These signs may indicate an underlying cardiac issue but are not definitive.
What is the first step in the initial investigations for sudden cardiac arrest if the patient is unstable?
ECG
It is crucial to assess the heart’s electrical activity as quickly as possible.
What is the second step in the initial investigations for sudden cardiac arrest?
Chest x-ray
This helps to identify any structural abnormalities or conditions affecting the heart and lungs.
What are the steps in the order of initial investigations for sudden cardiac arrest?
- ECG
- Chest x-ray
- Echocardiogram
- Lab tests for electrolyte levels and toxins
- Cardiac monitoring (e.g., Holter monitor)
- Coronary angiography
- Cardiac MRI with gadolinium contrast agent
This sequence optimizes the assessment of cardiac function and identifying underlying causes.
What is the aim of initial management in sudden cardiac arrest?
To preserve viability of vital organs whilst restoring spontaneous circulation as soon as possible
Timely intervention is crucial for survival and recovery.
What is the first step in the initial management of sudden cardiac arrest?
Basic life support
This includes immediate actions like CPR to maintain blood flow.
What is the management for shockable rhythms in sudden cardiac arrest?
Immediate life support with Automated External Defibrillators (AEDs)
Time to defibrillation is a major determinant of survival for ventricular fibrillation or pulseless ventricular tachycardia.
What should be done for non-shockable rhythms during cardiac arrest?
BLS until ECG shows shockable rhythm, then AED
This approach ensures continuous support until a defibrillation opportunity arises.
What does ACLS stand for in the context of cardiac arrest management?
Advanced Cardiac Life Support
ACLS protocols include advanced interventions for managing cardiac emergencies.
What is included in post-resuscitation care after a cardiac arrest?
Further investigations and treating underlying cause
This phase is critical for improving outcomes and preventing recurrence.
