CPR

Question 1

What are the 6 reversible “H’s” to remember during CPA/CPR

Answer 1

1. Hypoxemia
2. Hypothermia
3. Hyper/hypokalemia
4. Hypovolemia
5. H+ (acidemia)
6. Hypoglycemia

Question 2

What are the 6 reversible “T’s” to remember during CPA/CPR

Answer 2

1. Tamponade
2. Tension pneumothorax
3. Thrombosis (coronary)
4. Thrombosis (pulmonary)
5. Toxins (drugs)
6. Trauma

Question 3

Neurological changes that may indicate impending CPA include:

Answer 3

Seizures, rapidly decreasing levels of consciousness (LOC), dilated or unresponsive pupils, nystagmus, posture changes, vocalization.

Question 4

Cardiovascular changes that may indicate impending CPA:

Answer 4

Sudden changes in blood pressure (esp with drastic changes in HR), cardiac arrhythmias including V-Tach, V-Fib, PEA, and lack of palpable pulses.

Question 5

Other changes that may indicate impending CPA include:

Answer 5

Respiratory effort/rate, sounds, cyanosis, opisthotonus, hypercapnia, and hypoxemia.

Question 6

What are the 5 drugs that can be given endotracheally or intratracheal (IT) during CPR?

Answer 6

N - Naloxone
A - Atropine
V - Vasopressin
E - Epinephrine
L - Lidocaine

Increase the dose 10 times!!

Question 7

What bolus volume should be given following drug administration intravenously during CPR, to ensure drugs are being pushed into the central circulation?

Answer 7

0.5mL/kg

IE: 40kg x 0.5mL/kg = 20mL of saline or LRS post epinephrine administration

Question 8

Describe the effects of epinephrine during CPR

Answer 8

It exerts its vasoconstriction effects via stimulation of the alpha-1 adrenergic receptors on peripheral vessels (beneficial during CPR).

It also acts on beta-1 and beta-2 adrenergic AGONIST. The beta effects include increasing myocardial oxygen demand due to increased heart rate, and depression of myocardial function in the post-resuscitative stage. They are also proarrhythmic.

Question 9

Why is using steroids contraindicated during CPR?

Answer 9

Steroids suppress the immune system and interrupt protective prostaglandin production. The kidneys depend on protective prostaglandins to maintain perfusion in the face of hypotension. High doses have been implicated in gastrointestinal ulceration and bleeding (dogs).

Question 10

Define anoxic brain injury.

Question 11

Wha cluster of problems is characterized as post cardiac arrest syndrome?

Answer 11

1. Anoxic brain injury
2. Ischemic damage to the myocardium
3. Systemic ischemia-reperfusion injury
4. Persistence of the underlying cause of CPA