Managing ABCs Knowledge Questions Flashcards
(14 cards)
In the setting of a cardiac arrest, when is a carotid pulse check required?
When QRS complexes are present indicating a potentially perfusing rhythm at the end of a CPR cycle
In accordance with AV CPGs what are the correctable causes of PEA?
- Hypoxia
- Exsanguination
- Asthma
- Tension pneumothorax
- Anaphylaxis
- Upper airway obstruction
In accordance with AV CPGs how does the management of a hypothermic cardiac arrest pt differ to that of a normothermic arrest patient?
< 30 degrees:
- double interval for adrenaline administration
- primary goal of managing moderate to severe hypothermia should be the prevention of further heat loss prior to ROSC or transport
- Greater than 3 shocks are unlikely to be successful while patient remains severely hypothermic. No mechanical CPD - continue DCCS as per standard
- for pts in arrest where hypothermia is clearly the cause, tx with mechanical CPR in consultation with clinician and receiving hospital
In what circumstances should external cardiac compressions be performed on a paediatric patient?
- No palpable pulse
- HR <60 (infants)
- HR <40 (children)
What actions need to be performed when ROSC is achieved?
- 12-lead ECG (consider PHT)
- VT/VF arrest OR suspect cardiac cause OR post PHT
- Tx to 24hr PCI facility
- Consider AAV - Suspected non-cardiac cause (tx to closest appropriate hospital with notification)
How does the technique of external cardiac compressions differ for the infant, small child and medium child patient?
Infant:
- two finger or two thumb technique
- hands encircle the chest and thumbs compress sternum
Small child:
-one handed technique otherwise similar to that for adults
Medium child:
-two handed technique similar to that for adults
What are the compression and ventilation rates for infants (no ETT/SGA)?
- Two rescuers- 15:2
- One rescuer: 30:2
- Aim for 100-120 compressions per minute
- pause for ventilations
What are the compression and ventilation rates for Newborns?
- 3:1
- 90 compressions and 30 ventilations per minute with a 0.5 second pause for ventilation
- no pause for ventilation post intubation
What are the APGAR criteria?
Appearance Pulse Grimace Activity Respiratory Effort
What are the 5 ECG rhythm criteria for VF?
Ventricular rate: nil discernible Ventricular Rhythm: Bizarre, chaotic, amp >0.1mV P Waves: Nil PRI: Nil QRS: Nil
What are the common causes of cardiac arrest in a paed patient?
- Hypoxaemia
- Hypotension
- Trauma
- Drowning
- Septicaemia
- SIDS
- Asthma
- Upper Airway Obstruction
- Congenital heart abnormalities
What are the 6 clinical elements in the determinants of death?
- No palpable carotid pulse
- No heart sounds heard for 2 minutes
- No breath sounds heard for 2 minutes
- Fixed and dilated pupils
- No response to centralised stimulus
- No motor response or facial grimace to painful stimulus
Adrenaline side effects
- Sinus tachy
- Supraventricular arrythmias
- Ventricular arrythmias
- Hypertension
- Dilated pupils
- May increase size of AMI
- Feelings of anxiety
What are the benefits of administering adrenaline for a cardiac arrest?
Alpha effects:
- causes peripheral vasoconstriction leading to
a. an increase in peripheral vascular resistance
b. increased venous return and eventually cardiac output and increased coronary perfusion pressures
c. along with effective CPR, this aids in perfusing the myocardium and providing us with a shockable rhythm
Beta effects:
- increases irritability of the ventricles and myocardial contractility
