Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPS > CPR > Flashcards

CPR Flashcards

1
Q

What does CPR stand for?

A

Cardiopulmonary resuscitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant by basic life support?

A
  • Establishing airway and ventilation

- Providing chest compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give some signs of progress with CPR

A
  • Pulse can be palpated during compressions
  • Colour of mucus membranes improving
  • Eye position changes from central to ventromedial
  • Pupil size changes, responsive
  • ECG changes
  • Palpebral, corneal and gag reflex return
  • breathing or chest movements
  • Muscle twitches
  • lacrimation
  • Animal regaining consciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When should you progress to advanced life support?

A

If no signs of improvement are seen after 2 minutes of basic life support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What monitoring methods may be used during CPR?

A
  • Continous ECG monitoring
  • End tidal capnography
  • ET tube placement needs to be regularly checked
  • SPO2%
  • Blood gas analysis
  • Blood pressure
  • CO2 production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What may indicate effective CPR?

A
  • CO2 production, shown on capnograph by traice of high teens, ideally <15-20mmHg
  • Indicates that organ perfusion is occurring and blood is reaching the lungs in order for CO2 to be breathed ou
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe cardiopulmonary arrest

A
  • Characterised by acute failure of respiratory and circulatory systems
  • Lack of oxygen delivery to tissues and removal of CO2
  • Unconsciousness and systemic cellular death
  • Cerebral hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What may cause cardiopulmonary arrest?

A
  • Anaesthetic complications
  • Severe trauma (leading to hypovolaemia)
  • Severe electrolyte disturbace
  • Cardiac disorders
  • Cardiorespiratory disorders
  • Debilitating or end-stage disease
  • Vagal stimulation
  • Myocardial hypoxia
  • Drugs/toxins
  • pH abnormalities
  • Temperature problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 2 classifications of cardiopulmonary arrest?

A
  • Reversible disease process

- advanced disease status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give examples of reversible disease processes that may lead to cardiopulmonary arrest

A
  • Anaesthetic overdose
  • Bradycardia prior to arrest
  • Electrolyte imbalances e.g. hyperkalaemia due to urethral obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give examples of advanced disease statuses that may lead to cardiopulmonary arrest

A
  • Sepsis
  • Cancer
  • Severe cardiac disease
  • Severe lung disease
  • Severe CNS disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the signs of cardiopulmonary arrest

A
  • Apnoea/agonal gasping
  • No palpable pulse
  • Loss of consciousness
  • No heart sounds
  • Central eye position, pupils fixed and dilated, dry cornea, no corneal or palpebral reflex
  • Bleeding stops at surgical site
  • CRT altered
  • Mucus membrane grey/blue/white
  • General muscle flaccidity
  • ECG arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the possible actions following identification of CPA?

A
  • Do nothing
  • Provide basic life support
  • Provide basic and advanced/aggressive life support
  • Provide basic life support and if there is no response, provide advanced/aggressive life support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are potential methods for accessing the airway in CPA?

A
  • Orotracheal intubation

- Emergency tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How may breaths be delivered to a patient in CPA?

A
  • Mouth to nose ventilation
  • Compression of the chest whilst giving oxygen by mask
  • Stimulation of GV26 needle (Jen Chung) acupoint may stimulate breathing
  • AMBU bag attached to ET tube, or tube in tracheostomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can ventilation be provided to horses?

A
  • AMBU bag/bag on breathing circuit attached to ET tube

- Nasal tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the recommendations for PPV during CPR?

A
  • ~10 breaths/minute
  • Do not exceed 20cm H2O
  • Care not to overinflate
  • Ensure chest wall is moving adequately
  • Check femoral pulse, colour and heart sounds within 30 seconds of initiating PPV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some potential causes of inadequate chest wall excursion during CPR?

A
  • Tube malposition
  • Obstruction
  • Pneumothorax
  • Diaphragmatic hernia
  • Pleural disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the risk with too much ventilation?

A
  • May lead to hypocapnia

- No stimulation for animal to breath by itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is cardiac massage used in CPR?

A

To artificially generate stroke volume and maintain tissue perfusion, as normal heart activity is reliant on early restoration of myocardial oxygenation and blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the cardiac pump

A
  • Compression of the thorax
  • Forces blood through the heart and large vessels
  • Each compression forces blood out of the heart, and each release of pressure draws blood back into the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the method of performing the cardiac pump

A
  • Start as soon as CPA identified
  • Place patient in lateral recumbency on hard surface
  • Wedge under thorax to maintain stability if needed
  • Compress thorax over ventral 1/3rd of thorax between 3rd and 6th ribs (directly over, or encircling the heart)
  • Aim for 100-120 compressions/minute
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What modification of the cardiac pump can be used in cats and neonates?

A

Thorax compressed between thumb and forefinger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the modification of the cardiac pump in barrel or broad chested dogs

A

Sternal compressions carried out in dorsal recumbency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When is the thoracic pump used in CPR?

A
  • Cardiac pump ineffective in deep chested animals >20kg, obese animals, animasl with microcardia, pericardial effusion or low thoracic compliance (e.g. pneumothorax)
  • Instead use thoracic pump
26
Q

Describe the method of the thoracic pump

A
  • Use both ventricular chambers of herat and the intrathoracic vascular system to generate stroke volume
  • Place in lateral recumbency on hard surface, tilt head down slightly
  • Compress thorax over widest part of ribcage
  • Use whole thorax to generate stroke volume
  • 60-12 compressions/min
27
Q

In what conditions will the thoracic pump be ineffective?

A
  • Animals with severe hypovolaemia

- Incompetent tricuspid valves

28
Q

What should the ratio of compressions to breaths be if performing CPR alone?

A

30 compressions to 2 breaths

29
Q

What other actions may aid the efficiency of external cardiac compressions?

A
  • Alternating with abdominal compressions to push blood towards heart during diastole and prevent pooling in abdomen
  • Apply bindings to abdomen and hindlimbs to prevent pooling
30
Q

What are the potential ECG rhythms that may be seen?

A
  • Asystole
  • Ventricular fibrillation
  • Sinus bradycardia
  • Electromechanical dissociation (EMD) aka Pulseless Electrical Activity (PEA)
31
Q

What is EMD/PEA?

A

Normal ECG but no pulse

32
Q

List the drugs that may be used in CPR

A
  • Adrenaline/epinephrine
  • Vasopressin
  • Atropine
  • Naloxalone
  • Flumazenil
  • Lidocaine
33
Q

What is the mechanism of action of adrenaline/epinephrine?

A
  • Adrenergic agonist

- Stimulates alpha and beta receptors

34
Q

Explain why adrenaline is used in CRP

A
  • Increases myocardial contractility
  • Increases heart rate
  • Increases myocardial automaticity
  • Mainly used for alpha2 effects
  • Shunting of blood to brain, heart and lungs
  • Increases blood pressure by increasing systemic vascular resistance
  • Peripheral arteriolar vasoconstriction increasing coronary and cerebral perfusion pressure
35
Q

In what conditions is adrenaline commonly used during CPR?

A
  • Asystole
  • Atropine resistant bradyarrhythmias
  • poor diastolic filling
36
Q

Describe the beta2 agonist effects of adrenaline

A
  • Smooth muscle relaxation
  • Peripheral vasodilation
  • Systemic hypotension
  • Bronchial dilation
37
Q

Describe the alpha1 agonist effects of adrenaline

A
  • May be detrimental to myocardium by increasing myocardial oxygen demands
  • Cause intramyocardial coronary arteriolar vasoconstriction
  • Enhance the reduction in myocardial perfusion
38
Q

Describe the mechanism of action of vasopression

A

Stimulates specific V1A receptors in the smooth muscle of the vasculature, leading to non-adrenergic vasoconstriction

39
Q

Explain why vasopressin may be used during CPR

A
  • Causes peripheral, coronary and renal vasoconstriction
  • May improve cerebral perfusion by causing dilatation of cerebral vasculature
  • Less constriction in coronary and renal blood vessels vs peripheral tissue, therefore preferential shunting of blood to CNS and heart
40
Q

In what conditions is atropine used during CPR?

A
  • Vagally mediated bradycardia

- Vagal induced asystole

41
Q

What are the effects of atropine?

A
  • Increases heart rate
  • Controls hypotension
  • increases systemic vascular resistance
42
Q

What is the mechanism of action of atropine?

A

Is an anticholinergic parasympatholytic that is effective at muscarinic receptors

43
Q

What are the dosage recommendations for adrenaline?

A
  • Start low, for 2 cycles, 10 mins apart
  • Then a dose of high
  • Then 2 doses of low
44
Q

What is naloxalone used for?

A

Opioid reversal

45
Q

What is flumazenilin used for?

A

Benzodiazepine reversal

46
Q

What is lidocaine used for?

A

Treatment of ventricular tachycardia

47
Q

What are the routes of administration for drugs used in CPR?

A
  • Cranial vena cava
  • Intraosseous
  • Intratracheal
  • Pulmonary vein
  • Intralingual
  • Cephalic vein
48
Q

Outline cranial vena caval administration of drugs during CPR

A
  • Route of choice for drugs and fluids
  • Difficult in CPR due to movement
  • Jugular venous cut down, other veins not as effective
49
Q

Outline intraosseous administration of drugs during CPR

A
  • As rapid as peripheral veins
  • Useful in small animals, collapsed animals and birds
  • Sites used: greater tubercle of humerus, tibial crest, trochanteric fossa of the femur
50
Q

Outline intratracheal administration of drugs during CPR

A
  • Dilute the drug and use urinary catheter inserted beyond the carina
  • Give several large chest inflations to distribute the drugs
  • Higher doses needed
51
Q

Outline pulmonary vein administration of drugs during CPR

A
  • Rare
  • Small needles (23-25G) required
  • Only where have access during open chest resuscitations
52
Q

Outline the intracardiac administration of drugs during CPR

A
  • Not recommended
  • Could be used during open chest resuscitations
  • 1/2 dose used for IV admin
  • If not open chest, then difficult to get correct placement and high risk of severing coronary artery
53
Q

Outline cephalic vein administration of drugs during CPR

A
  • No blood flow, will not get to heart to be distributed quickly
  • Need to add 20ml fluid behind the drug in order to get it into the jugular and the heart
54
Q

Outline the use of intravenous fluids during CPR

A
  • No need in euvolaemic or hypervolaemic patients, would add pressure to heart
  • Only used with documented or suspected pre-existing hypovolaemia
  • Not a priority
55
Q

When is electrical defibrillation used?

A

To convert ventricular fibrillation arrest rhythm into normal rhythm

56
Q

What method, other than electrical defibrillation, can be used to correct ventricular fibrillation?

A

Precordial thump (large hit to chest with fist)

57
Q

What is ROSC?

A

Return Of Spontaneous Cirulation

58
Q

What are the risks for an animal following ROSC?

A
  • Acute anuric renal failure
  • DIC
  • Shock gut (gut reperfusion syndrome)
  • SIRS
  • Brain injury (blindness, coma, seizure)
  • Hypothermia
59
Q

How is neurological recovery controlled post-arrest?

A
  • Cerebral perfusion protected
  • Ensure mean arterial pressure is optimal
  • Achieved with fluid therapy, inotropes and vasopressors
  • Use post-ROSC algorithm
60
Q

Describe the follow up following CPR

A
  • Most animals require intensive care
  • Head up to alleviate intracranial pressure increase
  • Oxygen rich environment
  • Seizures common
  • Maintain temperature 33-34degreesC
  • Maintain renal function
  • Catheterise bladder and monitor urine output
  • Consider analgesia and sedation

CPS (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions