Flashcards in SA med CPR cards CSV Deck (87)
~What does CPA stand for?
~What does CPR stand for?
~What does ROSC stand for?
Return Of Spontaneous Circulation (goal of CPR)
~What does BLS stand for?
Basic Life Support
~What does ALS stand for?
Advanced Life support
~What is Cardiopulmonary Arrest?
Complete cessation of ventilation & circulation
~What are indications for CPR?
~What is the sequence of events during CPA?
Absence of tissue perfusion —> no O2 or glucose to tissues—>hypoxic - ischemic brain injury —> global hypoxia —> Cell Death —> Multiple organ dysfunction —> Irreversible injury —> Death
~What is the biggest concern with CPA?
hypoxic/ischemic brain injury
~What is the overall survival for animals that undergo CPA?
~Under what circumstances does the survival % go up for animals that undergo CPA?
~What are the odds of survival for an animal that undergoes Anesthetic CPA?
~What causes anesthetic CPA?
~What are negative prognostic indicators for animals undergoing CPA?
~Are there evidence based guidlines and standards for CPR in Vet Med?
YES! historically no
~What are the 5 stages of CPR in Vet med?
Recognition & prevention/preparedness
~What are important factors to successful CPR?
~What are the most important pieces of monitoring equipment on a crash cart?
~Why is a defibrillator nice to have but not necessary?
Most common arrest rhythm in vet med is asystole NOT ventricular fibrillation/flutter (thats humans)
~What is the best way to train your staff in CPR?
In house simulations on dummies or mock scenarios
~What should be done after every CPR case?
Debrief with staff and talk about what worked and what didn't
~How many people should be in a CPR team?
~What is the “chain of survival” concept?
Early Recognition of CPA
~If you suspect a pt is in CPA what should you do?
Start CPR right away!
~What will happen if you do CPR on an animal that really isn't in CPA?
They will “wake up” and possibly bite you
~Why should you not delay CPR to hook up or rely on monitors to tell you if a pt is in CPA?
Heat can give off electrical signals with out beating. Auscultation or palpation is best bet to tell
~What is the order of events in CPR for Vet Med?
~What is the bottom line in CPR?
~What are the 4 components of basic life support (BLS)?
Recogition of CPA
~What is the goal of CPR?
Get O2 to brain and heart until ROSC occurs
~How many seconds should you take to assess a pt before beginning CPR?
~What should be preformed together with BLS?
~How should the animal be placed when doing chest compressions?
In Lateral Recumbency (right if think going to open CPR) or Dorsal recumbency
~What is the only breed we really do CPR on in dorsal recumbency?
BullDogs or other barrel chested breeds
~How far should you compress the chest during CPR?
1/2 -1/3 the width & allow to recoil completely before you compress again
~What are the 2 pump theories of CPR?
~What animals can you do cardiac pumping in?
Small dogs, puppies, cats or Thin (Keel) chested dogs
~Where do you place your hand in the thoracic pump CPR?
widest portion of chest when in lateral recumbency (caudel to actual heart)
~Where do you place your hand in the cardiac pump CPR?
Over the heart
~What rate should you preform chest compressions at?
100-120 beats per minute
~What song can you sing in your head to help you keep time?
Another one bites the dust or staying alive
~When doing chest compressions on a dog in lateral recumbency where should the spine be?
Against you so they dont slide off the table
~What is important in securing an airway or ventilation?
SECURE THE TUBE!
~How can you give IPPV with out and ET tube?
Mouth to snout
~If you are doing CPR on your own how many compressions to breaths to you give?
~What is interposed abdominal compressions?
When you let chest recoil some one else pushes on the abdomen to return the blood to thorax
~What are the pros of interposed abdominal compressions?
May increase venous return
~What are the cons of interposed abdominal compressions?
Minimal Abdominal trauma (there dead anyway might as well go for it)
~What is the CPR cycle?
2 Minutes of continuous CPR then rotate positions
~When do you administer ALS?
After BLS and onward to ROSC
~What tx are included in ALS?
Catheter (IV best)
~Do all CPA patients need fluids?
~What is the best location for a catheter in a CPR patient (1-4)?
~What is the caveat when giving rescue meds IT?
Must give 3-5x the regular dose
~What is the caveat when giving rescue meds IP?
Takes a long time to absorb, last resort
~When should you give rescue meds inter cardiac?
NEVER! Big No No
~Best place for IO catheter?
Femur! In-between neck & greater trochanter
~What bones can you place and IO catheter in?
~When do administer rescue meds (drugs) during CPR?
Every other BLS cycle
~What are the two primary drugs used in CPR?
~Why do we give Epinephrine during CPR?
Vasoconstriction so when ROSC occurs it increases CO
~Do we use the high or low does of Epinephrine during CPR?
LOW DOSE ONLY
~Why do we give Atropine during CPR?
When ROSC occurs it will increase the heart rate increasing CO
~What other drugs can be given during CPR & why?
Vasopressin - vasoconstriction
~When are fluids indicated in CPR?
~What heart rhythm is the ONLY on you use a defibrillator on?
~What is the goal of defibrillation?
~How many shocks per round of BLS?
~When monitoring the ECG what are the most common arrhythmias from most to least?
~When should you assess ECG?
During rotation of 2min cycle or at direction of leader
~Should you monitor BP during CPR?
NO its not true anyway
~What should you do instead of monitoring BP?
Someone monitor femoral pulse
~What can monitoring femoral pulse tell you during CPR?
If you are compressing the chest enough to move blood (you should be creating a pulse with each compression)
~Why is ETCO2 such a good monitor to have during CPR?
First indicator of ROSC
~What will ETCO2 be during CPR before ROSC?After?
Very Low 2-5 then once ROSC it shoots up!
~Are taking an ABG or Electrolytes indicated during CPA? After ROSC?
~What are the indications for open chest CPR?
Thoracic wall defect/trauma
~What additional equipment is needed to preform open chest CPR?
~Do you need to sterilely prep the pt to open the chest for CPR?
No they are dead
~What are the steps to open chest CPR?
Rt Lat Recumbency
~Why should you stay above the chondral costal jxn when entering the thorax for open CPR?
Don’t what to cut the internal thoracic artery and cause them to bleed out
~What are some complications that can occur with open chest CPR?
~How can you try to prevent lung laceration when entering the thoracic cavity for open CPR?
Have IPPV person pause and allow the lungs to deflate
~What should you do after ROSC?
~What should you monitor after ROSC?
~What may you need if ROSC happens during open CPR?
Anesthesia (propofol, iso)