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Flashcards in CPR Deck (76):
1

What is cardiopulmonary arrest?

Cessation of both the respiratory and circulatory systems

2

Is apnea the same as respiratory arrest?

No, apnea usually is a temporary cessation but it can least to complete respiratory arrest

3

What is respiratory arrest typically due to?

A pathologic process where the patient cannot initiate a breath (medullary ischemia)

4

What are the survival to discharge rates following CPR?

Dogs- 3-6%
Cats- 2-10%

5

How long does it take for cerebral death due to ischemia take?

>4-7min

6

What kind of pathology has the least likelihood of survival even with CPR?

Cardiopulmonary arrest due to progressive illness

7

What is the most important aspect of resuscitating a CPA patient?

Early recognition and response

8

What conditions are classified as a respiratory emergency?

Tension pneumothorax, pulmonary or airway disease

9

What is a crash cart?

A box/cart that is stocked with all drugs and equipment necessary to resuscitate a patient

10

How many people are required for proper CPR?

At lease 4

Compressions, prepare drugs/monitors, provide ventilation, keep records

11

What drug is used to sedate animals in respiratory distress?

Acepromazine

12

What are the CS of upper airway obstruction and what breeds are predisposed?

Brachycephalics are predisposed

Inspiratory stridor, cynosis

13

What is the immediate step necessary for upper airway obstruction?

Induction and intubation

May need immediate surgery

14

What procedure can be done until definitive correction of an upper airway obstruction can be performed?

Tracheostomy

15

What are the CS due to an airway obstruction from a foreign body or tumor?

Inspiratory effort with abdominal effort and cynosis

16

Can a tracheostomy be performed with an airway obstruction?

Yes- go below the obstruction

17

What procedure is performed to visualize the obstruction?

Bronchostomy

18

What are the CS of a collapsed trachea and what breeds are predisposed?

Small and toy breed dogs

Marked inspiratory and exspiratory effort with a goose-honking noise

19

Should tracheal collapse patients be intubated?

Yes

20

What are the clinical signs of a pneumothorax?

Dyspnea, rapidly decreased SpO2, collapse

21

What are some causes of pneumothorax?

Thoracic trauma, spontaneous, barotrauma (closed pop-off!)

22

Can a pneumothroax lead to respiratory arrest?

Yes

23

What is done to treat a pneumothorax?

Oxygenation and evacuation of air from the chest (needle of chest tube)

Fluids recommended to improve circulation

Atropine if HR is decreased

24

If an anesthetized patient on a ventilator stops breathing, does this count as respiratory arrest?

Nope!

25

What value will suddenly decrease in an anesthetized patient in respiratory arrest?

EtCO2 (

26

How with the MMs look in animals in CPA?

Blue/gray

May still be pale pink if early

27

What is the procedure for CPA during anesthesia?

1. Turn off anesthesia and flush circuit
2. Start compression
3. Ventilate 10bpm

28

What is the procedure for CPA walking through the door?

Compressions and "mouth to snout" ventilation until you can intubate

29

What should be restarted first in CPR? Circulation, breathing or airway?

Circulation- start compressions

30

What percentage of CO is generated in closed CPR?

25-40%

31

What should you use for your compression rate?

100-120 bpm

32

How far should you compress the chest?

1/3-1/2 the width of the chest

33

Where should compressions be performed on the chest with thoracic pump theory?

With hands over the highest point of the thorax

34

Is the thoracic pump theory more effective in larger or smaller animals?

Larger

Dogs especially

35

Where are compressions performed in cardiac pump theory?

Over the heart and compress with thumb and fingers

Similar to open chest CPR

36

Cardiac pump theory is more effective in what kind of animals?

Smaller

37

What is the inspiratory/expiratory times for ventilation?

1 sec for inspiration
5-6 sec for expiration

38

If only one person is performing CPR, what is the protocol?

Continuous compression with 1-2 breaths every 2-3min

39

Why is an ECG necessary in cardiac arrest?

Determine the rhythm of arrest

40

What is the most common arrest ECG in small animals?

Asystole

41

What is the most common arrest ECG in humans?

Ventricular fibrillation

42

What drug can induce ventricular fibrillation?

Epiephrine

43

What does pulseless electrical activity look like on ECG?

Wide QRS, no perception of heart function

Looks almost normal

44

PEA is often observed in animals after what procedure?

Euthanasia

45

Is a slower PEA or faster PEA a better prognosis?

Faster has a better prognosis

46

What is the concern with PEA arrhythmias?

Depletion of global myocardial energy substrates

47

What three drugs are administered in advanced support?

Vasopressors (vasopressin/epi)

Atropine

48

How long can compressions be halted to check ECG?

No longer than 10 seconds

49

Is there any advantages between the vasopressor drugs during CPR?

Nope

50

Which vessels are preferred to gain IV access in an arrested patient?

Jugular > cephalic > saphenous

51

Can drugs be administered intratracheally?

Yes!

52

What drug cannot be given intratracheally?

NaHCO3

53

Can intraossesous catheters be used in an arresting patient?

Yes, may be the only option if very small

54

What are interposed abdominal compressions?

Compressions timed in between chest compressions to enhance venous return to the heart

55

What are three complications of abdominal compressions?

1. Diaphramatic hernia
2. Hemoabdomen
3. Hepatobilliary sx

All are rare but possible

56

Where is open chest CPR performed?

On the left lateral at the 6th rib space

or

Via the diaphragm in abdominal sx

"Hack and slash" thorocotomy

57

What are some indications for open chest CPR?

- Cardiac tamponade
- Large volume pericardial effusions
- Chest trauma/fractures
- Diaphragmatic hernia
- If closed chest is not effective after ~5-10min
- If EtCO2

58

Is palpating a pulse useful to assess compression quality?

No

59

What should be done to assess quality of compression?

Doppler probe over the cornea or over an artery

60

What is the EtCO2 expected to be if compressions are working?

>15 mmHg

61

Is SpO2 useful for assessing compressions?

No

62

What fluids should be given in cases of hypovolemia?

Colloids or crystalloids

63

When is giving NaHCO3 appropriate?

Arrest due to metabolic acidosis

64

When is giving Ca gluconate appropriate?

Arrest due to hypocalcemia, hyperkalemia, or Ca channel blocker toxicosis

65

When should CPR be discontinued?

If EtCO2

66

When is a defibrillator appropriate?

In ventricular fibrillation cases

67

Can alcohol be used with defibrillator paddles?

NO

68

If defibrillation is unsuccessful the first time, how long should compressions be continued before trying again?

At least 2min

69

Should the energy of the shock be increased for successive shocks?

Yes, 50%

70

What does ROSC stand for?

Return of spontaneous circulation

71

Should ventilation be maintained after ROSC?

Yes

72

What is the prognosis of a patient after ROSC depend on?

1. Cause of arrest
2. Duration of arrest
3. Other physiologic/pathologic processes after reperfusion

73

Medullary ischemia is likely unless circulation is restored in how many minutes?

74

What is a beneficial treatment to prevent hypoxic injury to neural tissues?

Therapeutic hypothermia

Use either cold packs or cooled fluids

75

When should CPR patients be extubated?

When they can ventilate adequately to maintain PaCO2 on their own and is actively objecting to the tube

76

If spontaneous breathing has not returned withing in how many hours, the prognosis is poor.

6-12