CPCR Flashcards

(28 cards)

1
Q

What does CPCR stand for? What is it?

A

Cardiopulmonary Cerebral Resuscitation

Attempt to restore spontaneous circulation in a patient with CPA

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2
Q

What is CPA?

A

Cardiopulmonary Arrest

Sudden cessation of spontaneous and effective respiration/ventilation and heartbeat/circulation

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3
Q

Signs of impending arrest

A
Severe dyspnea
Hypoxemia 
Severe hypotension 
Weak pulses
Bradycardia 
Tachycardia
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4
Q

Signs of CPA

A

Apnea/agonal breathing
Absence of heart beat and palpable pulse
Fixed dilated pupils
Lack of bleeding from Sx site

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5
Q

Causes of CPA

A

Usually systemic illness (MODs)

Arrhythmias
Acid/Base/electrolyte abnormalities
Hemorrhage/hypovolemia
Neoplasia
Sepsis
Myocardial ischemia/failure
Trauma (polytrauma)
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6
Q

Cardiac Arrest Arrhythmias

A

Asystole (heart standstill, nothing contracting)
Pulseless Electrical Activity (PEA)
Pulseless ventricular tachycardia
Ventricular fibrillation

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7
Q

Causes of Asystole

A

Increased vagal tone

GI tract or thoracic cavity issue

Brachycephalic dogs

Severe ophthalmic disease

Neurologic

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8
Q

“Treatment” of Asystole

A

Do NOT defibrilate (do this for ventricular fibrilation)

Treat with anti-cholenergic (atropine)

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9
Q

Pulseless Electrical Activity

A

Can be seen with ventricular tachycardia; heart pumping so fast not having much CO

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10
Q

Basic Life Support for Vet Med

A

A: Airway
B: Breathing
C: Circulation (cardiovascular)

Usually doing things simultaneously; chest compressions while intubating

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11
Q

Chest compression rate

A

100 compressions/min

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12
Q

Respiration rate

A

10 breaths/min
Give a breath for 1 second

Too much breaths can decrease CO2 too drastically; can cause vasoconstriction which will decrease perfusion to brain

Tidal volume: 10 mL/kg

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13
Q

Basic Life Support

Compressions - How to

A

Lateral recumbency
1/3 and 1/2 width of the chest

Allow full chest wall recoil between compressions (do NOT lean on patient)

2 minute cycles

Can do interposed abdominal compressions (opposite of chest compression) -> moving blood to top half of body

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14
Q

Chest Compressions:

Large and Giant breed

A

Chest compressions with the hands placed over the widest portion of the chest

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15
Q

Chest Compressions:

Keel-chested dogs

A

Chest compressions with hands directly over the heart

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16
Q

Chest Compressions:

Barrel-chested dog

A

Sternal chest compressions in dorsal recumbency may be considered

17
Q

Chest Compressions:

Cats and Small Dogs

A

Circumferential compressions rather than lateral compressions

18
Q

Cardiac Pump Theory

A

Pumping on heart

Squeezing and relaxing of the heart directly

19
Q

Thoracic Pump Theory

A

Movement from changes in pressure
Entire chest moving
Moving blood through the lungs and heart

20
Q

Epinephrine Dosage

A

Low dose: 0.01 mg/kg administered every 3-5 minutes

High dose: 0.1 mg/kg (1 mL/10 kg) considered after prolonged CPR

21
Q

Atropine Usage (why)

A

Asystole or PEA

Increased vagal tone

22
Q

Vasopressin Dosage

A
  1. U/kg as a substitute or in combination with epinephrine every 3-5 minutes
23
Q

Defibrillation

A

Treatment of ventricular fibrillation/pulseless ventricular tachycardia (must have been occuring for <4 minutes)

Administer single shock

2 minute cycle of CPR should precede defibrillation if suspected duration of V-Fib is greater than 4 minutes

24
Q

Defibrillation

“Doses”

A

Little: 50 joules
Medium: 100 joules
Large: 150-200 joules

25
Monitoring EtCO2 ??
Should be monitored as indication of perfusion and assess effectiveness of CPCR (should be at a certain level) Once it reads 30-40 patient has come back
26
Monitoring | ECG
See what your patient is reading at; evaluate rhythms which may require specific therapeutic interventions Can rule out CPA
27
Post Arrest Care
Hemodynamic optimization strategy (give blood) Do not warm too quickly or potentially not at all; neurologic benefit of mild hypothermia - decreased metabolic rate Do not give corticosteroids, anti-seizure prophylaxis, mannitol (increase ICP), or metabolic protectants
28
Prognosis for Survival
Overall 4-9.6% Anesthesia related: survival 47%