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1
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~What does CPA stand for?

Cardiopulmonary Arrest

2
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~What does CPR stand for?

Cardiopulmonary Resuscitation

3
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~What does ROSC stand for?

Return Of Spontaneous Circulation (goal of CPR)

4
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~What does BLS stand for?

Basic Life Support

5
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~What does ALS stand for?

Advanced Life support

6
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~What is Cardiopulmonary Arrest?

Complete cessation of ventilation & circulation

7
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~What are indications for CPR?

Respiratory

8
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~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

9
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~What is the biggest concern with CPA?

hypoxic/ischemic brain injury

10
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~What is the overall survival for animals that undergo CPA?

6% survival

11
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~Under what circumstances does the survival % go up for animals that undergo CPA?

Anesthetic CPA

12
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~What are the odds of survival for an animal that undergoes Anesthetic CPA?

45-50%

13
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~What causes anesthetic CPA?

Hypoxemia

14
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~What are negative prognostic indicators for animals undergoing CPA?

DOA

15
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~Are there evidence based guidlines and standards for CPR in Vet Med?

YES! historically no

16
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~What are the 5 stages of CPR in Vet med?

Recognition & prevention/preparedness

17
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~What are important factors to successful CPR?

Good Leadership

18
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~What are the most important pieces of monitoring equipment on a crash cart?

ECG

19
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~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)

20
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~What is the best way to train your staff in CPR?

In house simulations on dummies or mock scenarios

21
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~What should be done after every CPR case?

Debrief with staff and talk about what worked and what didn't

22
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~How many people should be in a CPR team?

Ideally 3:

23
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~What is the “chain of survival” concept?

Early Recognition of CPA

24
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~If you suspect a pt is in CPA what should you do?

Start CPR right away!

25
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~What will happen if you do CPR on an animal that really isn't in CPA?

They will “wake up” and possibly bite you

26
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~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

27
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~What is the order of events in CPR for Vet Med?

ABC:

28
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~What is the bottom line in CPR?

Avoid chaos

29
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~What are the 4 components of basic life support (BLS)?

Recogition of CPA

30
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~What is the goal of CPR?

Get O2 to brain and heart until ROSC occurs

31
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~How many seconds should you take to assess a pt before beginning CPR?

5-10

32
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~What should be preformed together with BLS?

ALS

33
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~How should the animal be placed when doing chest compressions?

In Lateral Recumbency (right if think going to open CPR) or Dorsal recumbency

34
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~What is the only breed we really do CPR on in dorsal recumbency?

BullDogs or other barrel chested breeds

35
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~How far should you compress the chest during CPR?

1/2 -1/3 the width & allow to recoil completely before you compress again

36
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~What are the 2 pump theories of CPR?

Cardiac

37
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~What animals can you do cardiac pumping in?

Small dogs, puppies, cats or Thin (Keel) chested dogs

38
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~Where do you place your hand in the thoracic pump CPR?

widest portion of chest when in lateral recumbency (caudel to actual heart)

39
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~Where do you place your hand in the cardiac pump CPR?

Over the heart

40
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~What rate should you preform chest compressions at?

100-120 beats per minute

41
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~What song can you sing in your head to help you keep time?

Another one bites the dust or staying alive

42
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~When doing chest compressions on a dog in lateral recumbency where should the spine be?

Against you so they dont slide off the table

43
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~What is important in securing an airway or ventilation?

SECURE THE TUBE!

44
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~How can you give IPPV with out and ET tube?

Mouth to snout

45
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~If you are doing CPR on your own how many compressions to breaths to you give?

30:2

46
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~What is interposed abdominal compressions?

When you let chest recoil some one else pushes on the abdomen to return the blood to thorax

47
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~What are the pros of interposed abdominal compressions?

May increase venous return

48
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~What are the cons of interposed abdominal compressions?

Minimal Abdominal trauma (there dead anyway might as well go for it)

49
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~What is the CPR cycle?

2 Minutes of continuous CPR then rotate positions

50
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~When do you administer ALS?

After BLS and onward to ROSC

51
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~What tx are included in ALS?

Catheter (IV best)

52
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~Do all CPA patients need fluids?

No

53
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~What is the best location for a catheter in a CPR patient (1-4)?

1. IV

54
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~What is the caveat when giving rescue meds IT?

Must give 3-5x the regular dose

55
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~What is the caveat when giving rescue meds IP?

Takes a long time to absorb, last resort

56
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~When should you give rescue meds inter cardiac?

NEVER! Big No No

57
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~Best place for IO catheter?

Femur! In-between neck & greater trochanter

58
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~What bones can you place and IO catheter in?

Femur

59
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~When do administer rescue meds (drugs) during CPR?

Every other BLS cycle

60
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~What are the two primary drugs used in CPR?

Epinephrine

61
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~Why do we give Epinephrine during CPR?

Vasoconstriction so when ROSC occurs it increases CO

62
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~Do we use the high or low does of Epinephrine during CPR?

LOW DOSE ONLY

63
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~Why do we give Atropine during CPR?

When ROSC occurs it will increase the heart rate increasing CO

64
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~What other drugs can be given during CPR & why?

Vasopressin - vasoconstriction

65
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~When are fluids indicated in CPR?

Active hemorrhage

66
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~What heart rhythm is the ONLY on you use a defibrillator on?

Ventricular Fibrillation/flutter

67
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~What is the goal of defibrillation?

Asystole

68
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~How many shocks per round of BLS?

1 only

69
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~When monitoring the ECG what are the most common arrhythmias from most to least?

Asystole

70
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~When should you assess ECG?

During rotation of 2min cycle or at direction of leader

71
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~Should you monitor BP during CPR?

NO its not true anyway

72
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~What should you do instead of monitoring BP?

Someone monitor femoral pulse

73
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~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)

74
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~Why is ETCO2 such a good monitor to have during CPR?

First indicator of ROSC

75
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~What will ETCO2 be during CPR before ROSC?After?

Very Low 2-5 then once ROSC it shoots up!

76
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~Are taking an ABG or Electrolytes indicated during CPA? After ROSC?

CPA: NO

77
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~What are the indications for open chest CPR?

Thoracic wall defect/trauma

78
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~What additional equipment is needed to preform open chest CPR?

Clippers

79
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~Do you need to sterilely prep the pt to open the chest for CPR?

No they are dead

80
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~What are the steps to open chest CPR?

Rt Lat Recumbency

81
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~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

82
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~What are some complications that can occur with open chest CPR?

Lung Laceration

83
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~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

84
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~What should you do after ROSC?

Monitor!

85
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~What should you monitor after ROSC?

ECG

86
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~What may you need if ROSC happens during open CPR?

Anesthesia (propofol, iso)

87
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~Why is debriefing after CPR so important?

Improves team work