Chapter 3

Question 1

How often is there clinical deterioration prior to cardiac arrest?

Answer 1

80% have deterioration in clinical signs in the few hours prior to cardiac arrest

Question 2

Components of the chain of prevention

Answer 2

Education
Monitoring
Recognition
Call for help
Response

Question 3

Causes of airway obstruction

Answer 3

Central nervous system depression e.g. head injury, drugs
Blood
Vomitus
Foreign body
Direct trauma to face/throat
Epiglottitis
Pharyngeal swelling
Laryngospasm
Bronchospasm
Bronchial secretions
Blocked tracheostomy

Question 4

Consequences of partial airway obstruction

Answer 4

Cerebral or pulmonary oedema
Exhaustion
Secondary apnoea
Hypoxic brain injury
Cardiac arrest

Question 5

Oxygen saturation target in arrest

Answer 5

94-98%

Question 6

Signs of breathing compromise

Answer 6

Tachypnoea (early sign)
Low oxygen saturations - not reliable, may need ABG
–> Increased pCO2 and decrease in pH

Question 7

Causes of VF

Answer 7

ACS
Hypertensive heart disease
Valve disease
Drugs e.g. antiarrhythmics, tricyclic antidepressants, digoxin
Inherited cardiac disease e.g. long QT
Acidosis
Deranged electrolytes
Hypothermia
Electrocution

Question 8

First steps in assessing a critically ill patient

Answer 8

1. Personal safety e.g. PPE
2. Look at patient ?looks unwell
3. If awake ‘How are you?’
4. Call for help
5. If unconscious, unresponsive, not breathing normally - start CPR
6. Monitor vital signs - attach pulse oximeter, BP cuff
7. Insert IV cannula ASAP, take bloods