Resus in special circumstances Flashcards
(170 cards)
1
Q
What can cause life-threatening cardiac arrhythmias or cardiorespiratory arrest?
A
Electrolyte abnormalities
2
Q
Which electrolyte disorder is most commonly associated with life-threatening arrhythmias?
A
Hyperkalaemia
3
Q
Define hyperkalaemia.
A
A serum potassium concentration > 5.5 mmol L-1
4
Q
What are the main causes of hyperkalaemia?
A
- Renal failure
- Drugs (e.g. ACE-I, ARB)
- Tissue breakdown (e.g. rhabdomyolysis)
- Metabolic acidosis
- Endocrine disorders
- Diet
- Spurious (pseudo-hyperkalaemia)
5
Q
What are common symptoms of hyperkalaemia?
A
Weakness, flaccid paralysis, paraesthesia, depressed deep tendon reflexes
6
Q
What ECG changes are associated with hyperkalaemia?
A
- First degree heart block
- Flattened or absent P waves
- Tall, peaked T waves
- ST-segment depression
- S and T wave merging
- Widened QRS
- Ventricular tachycardia
- Bradycardia
- Cardiac arrest
7
Q
What are the five key steps in treating hyperkalaemia?
A
- Cardiac protection
- Shifting potassium into cells
- Removing potassium from the body
- Monitoring serum potassium concentration
- Prevention of recurrence
8
Q
What is the definition of hypokalaemia?
A
A serum potassium level < 3.5 mmol L-1
9
Q
What are the main causes of hypokalaemia?
A
- Gastrointestinal loss
- Drugs (e.g. diuretics)
- Renal losses
- Endocrine disorders
- Metabolic alkalosis
- Magnesium depletion
- Poor dietary intake
10
Q
What are some ECG features of hypokalaemia?
A
- U waves
- T wave flattening
- ST segment changes
- Arrhythmias, especially with digoxin
- Cardiac arrest
11
Q
What is the maximum recommended IV dose of potassium?
A
20 mmol h-1
12
Q
What should be done during IV potassium infusion?
A
Continuous ECG monitoring is essential
13
Q
What modifications to CPR are recommended in the presence of severe hyperkalaemia?
A
- Confirm hyperkalaemia
- Protect the heart with calcium chloride
- Shift potassium into cells with glucose/insulin
- Administer sodium bicarbonate if severe acidosis
- Consider dialysis for hyperkalaemic cardiac arrest resistant to treatment
14
Q
What is the most common cause of death in haemodialysis patients?
A
Sudden cardiac death
15
Q
What should be done if cardiac arrest occurs during haemodialysis?
A
- Call the resuscitation team
- Start standard ALS protocols
- Stop ultrafiltration and give a fluid bolus
- Disconnect from the dialysis machine
16
Q
What are the causes of hypercalcaemia?
A
- Primary or tertiary hyperparathyroidism
- Malignancy
- Sarcoidosis
- Drugs
17
Q
What are the presentations of hypercalcaemia?
A
- Confusion
- Weakness
- Abdominal pain
- Hypotension
- Arrhythmias
- Cardiac arrest
18
Q
What ECG changes are associated with hypercalcaemia?
A
- Short QT interval
- Prolonged QRS interval
- Flat T waves
- AV block
- Cardiac arrest
19
Q
What is the treatment for hypercalcaemia?
A
- Fluid replacement IV
- Furosemide 1 mg kg-1 IV
- Hydrocortisone 200–300 mg IV
- Pamidronate 30–90 mg IV
- Treat underlying cause
20
Q
What is the total calcium level that indicates hypocalcaemia?
A
< 2.1 mmol L-1
21
Q
What are the causes of hypocalcaemia?
A
- Chronic renal failure
- Acute pancreatitis
- Calcium channel blocker overdose
- Toxic shock syndrome
- Rhabdomyolysis
- Tumour lysis syndrome
22
Q
What are the presentations of hypocalcaemia?
A
- Paraesthesia
- Tetany
- Seizures
- AV block
- Cardiac arrest
23
Q
What ECG changes are associated with hypocalcaemia?
A
- Prolonged QT interval
- T wave inversion
- Heart block
- Cardiac arrest
24
Q
What is the treatment for hypocalcaemia?
A
- Calcium chloride 10% 10–40 mL IV
- Magnesium sulfate (2–4 mL: 4–8 mmol) IV if necessary
25
What is the magnesium level that indicates hypermagnesaemia?
> 1.1 mmol L-1
26
What are the causes of hypermagnesaemia?
* Renal failure
* Iatrogenic
27
What are the presentations of hypermagnesaemia?
* Confusion
* Weakness
* Respiratory depression
* AV block
* Cardiac arrest
28
What ECG changes are associated with hypermagnesaemia?
* Prolonged PR and QT intervals
* T wave peaking
* AV block
* Cardiac arrest
29
What is the treatment for hypermagnesaemia?
* Consider treatment when magnesium > 1.75 mmol L-1
* Calcium chloride 10% 5–10 mL IV repeated if necessary
* Ventilatory support if necessary
* Saline diuresis–0.9% saline with furosemide 1 mg kg-1 IV
* Haemodialysis
30
What is the magnesium level that indicates hypomagnesaemia?
< 0.6 mmol L-1
31
What are the causes of hypomagnesaemia?
* GI loss
* Polyuria
* Starvation
* Alcoholism
* Malabsorption
32
What are the presentations of hypomagnesaemia?
* Tremor
* Ataxia
* Nystagmus
* Seizures
* Arrhythmias – torsade de pointes
* Cardiac arrest
33
What ECG changes are associated with hypomagnesaemia?
* Prolonged PR and QT intervals
* ST-segment depression
* T-wave inversion
* Flattened P waves
* Increased QRS duration
* Torsade de pointes
34
What is the treatment for severe hypomagnesaemia?
2 g 50% magnesium sulfate (4 mL; 8 mmol) IV over 15 min
35
What are common sources of infection leading to sepsis?
* Chest
* Abdomen
* Urinary tract
* Skin and soft tissues
36
What are the signs of septic shock?
Sepsis with a serum lactate > 4 mmol L-1 or hypotension unresponsive to fluid resuscitation
37
What are the steps in the Sepsis Six?
* Give high-flow oxygen
* Take blood cultures
* Give broad-spectrum antibiotics
* Initiate fluid resuscitation
* Measure lactate
* Measure urine output
38
What is a common cause of cardiac arrest in young patients?
Poisoning
39
What should be avoided in the presence of chemical poisoning?
Mouth-to-mouth breathing
40
What is the role of activated charcoal in poisoning?
Adsorbs certain drugs but is not routinely recommended
41
What is the specific antidote for paracetamol poisoning?
Acetylcysteine
42
What is the initial dose of naloxone for opioid poisoning?
400 mcg IV
43
What are the effects of opioid poisoning?
* Respiratory depression
* Pinpoint pupils
* Coma
44
What can benzodiazepine overdose cause?
* Loss of consciousness
* Respiratory depression
* Hypotension
45
What is the antidote for benzodiazepine overdose?
Flumazenil
46
What should be used with caution in patients suspected of opioid dependence?
Naloxone reversal of opioid intoxication
## Footnote
Due to the risk of withdrawal symptoms.
47
What can benzodiazepine overdose cause?
Loss of consciousness, respiratory depression, hypotension
## Footnote
Overdose can lead to severe complications.
48
What is flumazenil used for?
To reverse sedation caused by benzodiazepines
## Footnote
Not recommended for patients with a history of seizures.
49
What are common symptoms of tricyclic antidepressant overdose?
Hypotension, seizures, coma, life-threatening arrhythmias
## Footnote
Symptoms may occur within the first 6 hours after ingestion.
50
What is the recommended pH target for bicarbonate therapy in tricyclic overdose?
7.45–7.55
## Footnote
This is commonly accepted despite no specific studies.
51
What are the signs of local anaesthetic toxicity?
Severe agitation, loss of consciousness, sinus bradycardia, conduction blocks
## Footnote
Can occur after inadvertent injection into an artery or vein.
52
What is the initial treatment for local anaesthetic toxicity?
Administer intravenous 20% lipid emulsion
## Footnote
Followed by an infusion until stable or maximum dose is reached.
53
What are the symptoms of cocaine toxicity?
Agitation, symptomatic tachycardia, hypertensive crisis, hyperthermia
## Footnote
Symptoms are due to sympathetic overstimulation.
54
What is the first-line treatment for cocaine-induced myocardial ischaemia?
Small doses of intravenous benzodiazepines
## Footnote
Effective in managing symptoms.
55
What treatment can be considered for refractory bradycardia caused by poisoning?
Atropine
## Footnote
Especially for organophosphate or nerve agent poisoning.
56
What causes cardiac arrest in asthma patients?
Severe bronchospasm, hypoxia, cardiac arrhythmias
## Footnote
Often a terminal event after hypoxaemia.
57
What immediate management steps should be taken for severe local anaesthetic toxicity?
Stop injecting the LA, maintain airway, give oxygen, confirm intravenous access
## Footnote
Critical for patient stabilization.
58
What is the maximum cumulative dose of lipid emulsion for severe local anaesthetic toxicity?
12 mL kg–1
## Footnote
Cumulative doses should not exceed this limit.
59
True or False: Propofol is a suitable substitute for lipid emulsion in local anaesthetic toxicity.
False
## Footnote
Propofol should not be used as an alternative.
60
Fill in the blank: Cardiac arrhythmias in asthma can be caused by _______.
Hypoxia
## Footnote
This is the most common cause of arrhythmias in asthma patients.
61
What is the maximum number of boluses that can be given?
A maximum of three total boluses can be given.
62
What is the recommended intravenous infusion rate of lipid emulsion?
Start an intravenous infusion of lipid emulsion at 15 ml.kg–1.h–1.
63
True or False: The severity of wheezing correlates with the degree of airway obstruction.
False.
64
What might the absence of wheezing indicate?
The absence of wheezing may indicate critical airway obstruction.
65
What is the main therapy for acute asthma?
Salbutamol (5 mg delivered by oxygen driven nebuliser) is the main therapy.
66
What should be given early in treatment for acute severe asthma?
Steroids (prednisolone or hydrocortisone) should be given early.
67
What are common triggers for anaphylaxis?
Common triggers include food, drugs, stinging insects, and latex.
68
What is the case fatality ratio of anaphylaxis in most population-based studies?
Less than 1%.
69
What are the three criteria for diagnosing anaphylaxis?
1. Sudden onset and rapid progression of symptoms. 2. Life-threatening airway and/or breathing and/or circulation problems. 3. Skin and/or mucosal changes.
70
What is a potential gastrointestinal symptom of anaphylaxis?
Vomiting or abdominal pain.
71
What are signs of airway problems in anaphylaxis?
Airway swelling, hoarse voice, and stridor.
72
What should be done if a patient with severe asthma requires intubation?
Intubate the trachea early to avoid gastric inflation and hypoventilation.
73
What is the recommended respiratory rate during CPR?
10 breaths per minute.
74
What is dynamic hyperinflation?
A condition where air enters the lungs and cannot escape, increasing pressure and reducing venous return.
75
What does ECLS stand for?
Extracorporeal life support.
76
List the signs of shock.
* Pale, clammy skin
* Tachycardia
* Hypotension
* Decreased conscious level or loss of consciousness
## Footnote
These signs indicate that the body's organs are not receiving enough blood flow.
77
What can cause myocardial ischaemia and ECG changes during anaphylaxis?
Anaphylaxis can lead to myocardial ischaemia and ECG changes even in individuals with normal coronary arteries.
## Footnote
This highlights the severity of anaphylactic reactions and their impact on heart function.
78
What are common skin and mucosal changes associated with anaphylaxis?
* Erythema
* Urticaria
* Angioedema
## Footnote
Skin changes are often the first feature of anaphylaxis and can vary in appearance and severity.
79
What are some life-threatening conditions that can mimic anaphylaxis?
* Life-threatening asthma
* Septic shock
## Footnote
Differentiating between these conditions is crucial for appropriate treatment.
80
What should be the initial position of a patient suspected of anaphylaxis with low blood pressure?
Lying flat with or without leg elevation
## Footnote
This position helps maintain blood flow to vital organs.
81
What is the recommended initial intramuscular dose of adrenaline for adults experiencing anaphylaxis?
0.5 mg (0.5 mL of 1:1000 adrenaline)
## Footnote
This dosage can be repeated every 5 minutes as needed.
82
What is the best site for intramuscular injection of adrenaline?
Anterolateral aspect of the middle third of the thigh
## Footnote
Proper injection technique is critical for effective delivery of adrenaline.
83
What fluids are suitable for initial resuscitation in anaphylaxis?
* Hartmann’s solution
* 0.9% saline
## Footnote
These fluids help restore intravascular volume during anaphylaxis.
84
True or False: Intravenous magnesium can cause hypotension.
True
## Footnote
Intravenous magnesium is a vasodilator and should be used cautiously.
85
What is the first line vasopressor for the treatment of anaphylactic reactions?
Adrenaline
## Footnote
Other vasopressors may be considered if initial resuscitation with adrenaline and fluids is unsuccessful.
86
What warning signs indicate airway obstruction in severe anaphylaxis?
* Swelling of the tongue
* Swelling of the lips
* Hoarseness
* Oropharyngeal swelling
87
What should be considered early in the management of airway obstruction due to anaphylaxis?
Early tracheal intubation
## Footnote
Delay may make intubation extremely difficult.
88
What is the standard dose of IV adrenaline if there has been no response to at least 2 IM doses?
1 mg as an infusion in saline
## Footnote
Consider 0.5 mg IM adrenaline if cardiac arrest is imminent or has just occurred.
89
What specific test helps confirm a diagnosis of an anaphylactic reaction?
Measurement of mast cell tryptase
90
When should the first mast cell tryptase sample be taken after the onset of symptoms?
1–2 hours after the start of symptoms
91
What should be done before discharging a patient who has had suspected anaphylaxis?
* Review and treatment plan
* Clear instructions to return if symptoms return
* Consider adrenaline auto-injector
* Plan for follow-up
92
What is the incidence of mortality related to pregnancy in the UK?
1 per 36,000 pregnancies
93
What physiological changes occur during pregnancy that affect resuscitation?
* Increased cardiac output
* Increased circulatory volume
* Increased minute ventilation
* Increased oxygen consumption
94
What are the most common causes of cardiac arrest in pregnancy?
* Cardiac disease
* Pulmonary embolism
* Psychiatric disorders
* Hypertensive disorders
* Sepsis
* Haemorrhage
* Amniotic fluid embolism
* Ectopic pregnancy
95
What position should a distressed or compromised pregnant patient be placed in?
Left lateral position
96
What modifications should be made for CPR in a pregnant woman?
* Summon expert help
* Start CPR according to ALS guidelines
* Ensure high quality chest compressions
* Manually displace the uterus to the left
97
What is the optimal angle for left lateral tilt during CPR in pregnancy?
Between 15–30 degrees
98
What should be done if resuscitation efforts fail in a pregnant patient?
Consider emergency caesarean section
99
What are the reversible causes of collapse and cardiac arrest in pregnancy?
* Haemorrhage
* Drugs
* Cardiovascular disease
* Pre-eclampsia and eclampsia
* Amniotic fluid embolism
* Pulmonary embolus
100
What is the treatment for magnesium toxicity in pregnant women receiving magnesium sulfate?
Calcium
101
At what gestational age is urgent caesarean delivery not typically considered necessary?
Gestational age < 20 weeks
102
When is the best survival rate for infants after peri-mortem caesarean section?
When delivery occurs within 5 minutes after the mother's cardiac arrest
103
What is the purpose of targeted temperature management (TTM) post-resuscitation in pregnancy?
To ensure favourable maternal and fetal outcomes
104
What should follow post-resuscitation care according to standard guidelines?
Targeted temperature management (TTM) with fetal heart monitoring.
105
What should units dealing with cardiac arrest in pregnancy have in place?
* Plans and equipment for resuscitation of both the pregnant patient and the newborn child
* Early involvement of obstetric, anaesthetic, and neonatal teams
* Regular training of staff in obstetric emergencies
106
What factors are associated with survival from traumatic cardiac arrest?
* Presence of reactive pupils
* Organised ECG rhythm
* Respiratory activity
107
What causes cardiac arrest in trauma patients?
* Severe traumatic brain injury
* Hypovolaemia from massive blood loss
* Hypoxia from respiratory arrest
* Direct injury to vital organs and major vessels
* Tension pneumothorax
* Cardiac tamponade
108
What is commotio cordis?
Actual or near cardiac arrest caused by a blunt impact to the chest wall over the heart.
109
What is the correlation between duration of CPR and survival from traumatic cardiac arrest?
Survival is correlated with duration of CPR and pre-hospital time.
110
What is the recommended approach for managing traumatic cardiac arrest in the out-of-hospital setting?
Undertake only essential life-saving interventions on scene before rapid transfer to the nearest appropriate hospital.
111
How should compressible external haemorrhage be treated?
* Elevation and direct pressure
* Use tourniquets if needed
* Apply topical haemostatic agents
112
What is the guideline provided by NICE for pre-hospital fluid replacement in trauma?
Give 250 mL boluses of crystalloid solution until a radial pulse is achieved.
113
What should be done to decompress the chest in traumatic cardiac arrest?
Perform bilateral thoracostomies in the 5th intercostal space.
114
What is cardiac tamponade?
When the pericardial sac is filled with fluid under pressure, compromising cardiac function.
115
What is the recommended intervention for patients with penetrating torso trauma?
Consider resuscitative thoracotomy.
116
What are common causes of perioperative cardiac arrest?
* Hypovolaemia
* Cardiac problems
* Anaesthesia related problems
117
What is the primary arrest rhythm associated with the best chance of survival during perioperative cardiac arrest?
Asystole.
118
What is a common cause of cardiac arrest in the context of anaesthesia?
Failure of ventilation.
119
What is the recommended dose of adrenaline in case of cardiac arrest?
Give initial doses in increments (e.g., 50–100 micrograms IV).
120
What should be done to address excessive vagal activity during cardiac arrest?
Stop any surgical activity likely causing it and administer atropine.
121
What is the incidence of cardiac arrest following major cardiac surgery?
0.7–8%.
122
What should be done early in cases of cardiac arrest after cardiac surgery?
Perform emergency resternotomy if necessary.
123
What are some specific causes of cardiac arrest?
Tamponade, hypovolaemia, myocardial ischaemia, tension pneumothorax, pacing failure
## Footnote
These causes are potentially reversible if treated promptly.
124
What is the key to successful resuscitation after cardiac surgery?
Early recognition of the need for emergency resternotomy, especially in cases of tamponade or haemorrhage.
125
What should be done if VF or asystole is detected?
Attempt external defibrillation or emergency temporary pacing at maximum amplitude.
126
What can ineffective chest compressions indicate?
Possible cardiac tamponade and/or hypovolaemia.
127
What should be considered as reversible causes during resuscitation?
* Hypoxia
* Tension pneumothorax
* Pacing failure
128
What is the recommended action for a witnessed VF/pVT cardiac arrest?
Immediate defibrillation attempts, up to three quick successive attempts.
129
What indicates the need for emergency resternotomy after defibrillation attempts?
Three failed shocks in the post-cardiac surgery setting.
130
What should be done if three defibrillation attempts fail in VF/pVT?
Undertake emergency resternotomy without delay.
131
What is the definition of drowning?
A process resulting in primary respiratory impairment from submersion/immersion in a liquid medium.
132
What is the difference between submersion and immersion?
Submersion: face underwater; Immersion: head above water, often with support.
133
What physiological response occurs after submersion?
Initial breath holding, followed by hypoxia, hypercapnia, and potential laryngospasm.
134
What should bystanders do when attempting a water rescue?
Try to save the victim without entering the water, using a rescue aid or throwing a rope.
135
What is the recommended action for submersion durations of less than 10 minutes?
Very high chance of a good outcome.
136
What should be done if the victim is pulseless and apnoeic after removal from water?
Remove them from the water quickly while limiting neck flexion and extension.
137
What is the recommended CPR ratio for drowning victims?
30 compressions to 2 ventilations.
138
What should be done if massive amounts of foam come from a drowning victim's mouth?
Continue rescue breaths until an ALS provider arrives.
139
What should be given to a spontaneously breathing drowning victim?
High-flow oxygen (10–15 L min-1) ideally through a mask with a reservoir bag.
140
What is the classification of hypothermia based on core temperature?
* Mild: 32–35°C
* Moderate: 28–32°C
* Severe: < 28°C
141
What should be used to confirm the diagnosis of hypothermia?
A low-reading thermometer for core temperature.
142
What is the risk factor for accidental hypothermia?
Increased by alcohol or drug ingestion, exhaustion, illness, injury, or neglect.
143
What is the Swiss staging system for hypothermia?
* Stage I: Mild hypothermia (conscious, shivering)
* Stage II: Moderate hypothermia (impaired consciousness)
* Stage III: Severe hypothermia (unconscious)
* Stage IV: Cardiac arrest
* Stage V: Death due to irreversible hypothermia
144
What happens to cellular oxygen consumption with cooling?
Decreases by about 6% per 1°C decrease in core temperature.
145
What should be done if signs of life are absent in a hypothermic patient?
Be cautious in diagnosing death, as hypothermia can produce irregular pulses and unrecordable BP.
146
What protective effect can hypothermia have on the brain?
Hypothermia can exert a protective effect on the brain and vital organs, allowing for intact neurological recovery after prolonged cardiac arrest if deep hypothermia develops before asphyxia.
147
Why should caution be exercised when diagnosing death in a hypothermic patient?
Hypothermia can produce a very slow, small-volume, irregular pulse and unrecordable blood pressure, making no signs of life unreliable for declaring death.
148
At what temperature can the brain tolerate circulatory arrest for significantly longer durations?
At 18 ̊C, the brain can tolerate periods of circulatory arrest for ten times longer than at 37 ̊C.
149
What is the significance of dilated pupils in hypothermic patients?
Dilated pupils can be caused by various insults and should not be regarded as a sign of death.
150
What is the recommended CPR strategy for patients with a core temperature < 28°C?
In patients with a core temperature < 28°C, give 5 min of CPR, alternating with periods ≤ 5 min without CPR.
151
What should be considered in the prehospital setting for resuscitation?
Resuscitation should be withheld only for lethal injury, fatal illness, prolonged asphyxia, or if the chest is incompressible. The principle 'no one is dead until warm and dead' should be applied.
152
What factors influence the survival chances of avalanche victims?
Avalanche victims are unlikely to survive if they are buried for > 60 min or if the initial core temperature is < 30°C and in cardiac arrest.
153
What should be done if there is doubt about signs of life in a hypothermic patient?
If there is any doubt, start CPR immediately.
154
What is a significant complication of hypothermia during resuscitation?
Hypothermia can cause stiffness of the chest wall, making ventilations and chest compressions difficult.
155
What is the recommended approach for drug administration in hypothermic patients?
Withhold adrenaline and other CPR drugs until the patient has been warmed to a core temperature ≥ 30°C.
156
What arrhythmias are expected as core temperature decreases in hypothermia?
Sinus bradycardia tends to give way to atrial fibrillation, followed by VF and asystole.
157
What are the two forms of heat stroke?
* Classic non-exertional heat stroke
* Exertional heat stroke
158
What factors increase the risk of heat-related illness in the elderly?
* Underlying illness
* Medication use
* Declining thermoregulatory mechanisms
* Limited social support
159
What are some clinical features of heat stroke?
* Core temperature ≥ 40°C
* Hot, dry skin
* Cardiovascular dysfunction
* CNS dysfunction
* Liver and renal failure
160
What is malignant hyperthermia?
Malignant hyperthermia is a life-threatening genetic sensitivity of skeletal muscles to volatile anaesthetics and depolarising neuromuscular blocking drugs.
161
What are some common cooling methods for heat stroke?
* Cool drinks
* Fanning the patient
* Ice packs over large superficial blood vessels
* Immersion in cold water (if stable)
162
What factors influence the severity of electrical injury?
Factors include:
* Type of current (AC or DC)
* Voltage
* Magnitude of energy delivered
* Resistance to current flow
* Pathway of current through the patient
* Area and duration of contact
* Skin resistance affected by moisture.
## Footnote
Moisture decreases skin resistance, increasing the likelihood of injury.
163
What is the consequence of contact with AC current?
Contact with AC may cause tetanic contraction of skeletal muscle, preventing physical release from the source of electricity.
## Footnote
This can lead to additional injuries or fatal outcomes.
164
What are the potential causes of immediate death from electrical injuries?
Potential causes include:
* Respiratory arrest due to central respiratory depression or paralysis of respiratory muscles
* Ventricular fibrillation if current traverses the myocardium during a vulnerable period
* Asystole, which may be primary or secondary to asphyxia following respiratory arrest.
165
How much voltage can a lightning strike deliver?
Lightning strikes can deliver as much as 300 kV over a few milliseconds.
166
What injuries are typically caused by lightning strikes?
Injuries may include:
* Deep burns at the point of contact
* Blunt trauma from explosive force
* Cardiac or respiratory arrest
* Central and peripheral neurological problems.
167
What is a common initial arrhythmia after high voltage AC shock?
Ventricular fibrillation (VF) is the commonest initial arrhythmia after high voltage AC shock.
168
What should be monitored in survivors of electrical injury?
Survivors should be monitored for:
* History of cardiorespiratory problems
* Loss of consciousness
* Cardiac arrest
* Electrocardiographic abnormalities
* Soft tissue damage and burns.
169
True or False: There is a specific therapy for electrical injury.
False. There is no specific therapy for electrical injury; management is symptomatic.
170
What percentage of traumatic arrests also have a tension pneumothorax?
13%
