Medical Cardiac Arrest

Question 1

Recite the Medical Cardiac Arrest CPG

Answer 1

Question 2

What are the two clinical signs that indicate a cardiac arrest requiring management under this guideline?

Answer 2

• Unconscious and pulseless
• Unsure of pulse in the presence of gasping/agonal respirations

Question 3

What are the four components of HP-CPR?

Answer 3

• High-quality compressions / minimise interruptions
• Charge defibrillator during chest compressions
• On-screen interpretation in manual mode
• Pulse checks only for potentially perfusing rhythms

Question 4

What is the first action in VF/VT?

Answer 4

Defibrillate 200 J and immediately recommence compressions.

Question 5

When is amiodarone 300 mg IV given?

Answer 5

After the 3rd shock.

Question 6

When is lidocaine 100 mg IV used?

Answer 6

After the 5th shock, if amiodarone has been given.

Question 7

What drug and dose is given after the 7th shock?

Answer 7

Amiodarone 150 mg IV.

Question 8

What is the final antiarrhythmic dose given after the 9th shock?

Answer 8

Lidocaine 50 mg IV.

Question 9

What is the immediate action in asystole/PEA?

Answer 9

Disarm defibrillator and recommence compressions.

Question 10

List 8 reversible causes of PEA (the 8 Hs and Ts).

Answer 10

4 H’s, 3 T’s, 3 A’s

• Hypovolaemia
• Hypoxia
• Hyperkalaemia
• Hypothermia
• Tension Pneumothorax
• Pulmonary Embolism (thrombus)
• Toxins
• Anaphylaxis
• Asthma
• Upper Airway obstruction

Question 11

What is the CPR ratio post-SGA insertion?

Answer 11

15:1 compressions to ventilations.

Question 12

How often is adrenaline administered?

Answer 12

Every 2nd cycle (every 4 minutes).

Question 13

When is adrenaline given in shockable rhythms?

Answer 13

After the 2nd shock.

Question 14

What size fluid boluses are used to flush medications?

Answer 14

20–30 mL Normal Saline.

Question 15

When should ETT be considered? (MICA)

Answer 15

If it can be placed without interrupting compressions or if there is SGA failure.

Question 16

What fluid and volume is used for asthma, anaphylaxis, or hypovolaemia?

Answer 16

1000–2000 mL Normal Saline IV.

Question 17

What is the dose of ketamine IV for interfering consciousness?

Answer 17

50–100 mg IV every 1–2 minutes (no max dose).

Question 18

If IV access is unavailable, how is ketamine given?

Answer 18

200 mg IM.

Question 19

What is given for PE if witnessed or strongly suspected?

Answer 19

Thrombolysis after consultation with AV Medical Advisor and if HP-CPR can be maintained.

Question 20

What age group is covered by the Medical Cardiac Arrest CPG?

Answer 20

Patients aged ≥ 16 years.