Topic 1 - Cardiac Arrest Flashcards Preview

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Flashcards in Topic 1 - Cardiac Arrest Deck (34)
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1
Q

ROLE criteria for non-obvious death

A
  • No palpable carotid pulse
  • No heart sounds (30 seconds)
  • No breath sounds (30 seconds)
  • No response to centralised stimuli
  • Fixed and dilated pupils
2
Q

Reportable deaths under S8 of the Coroners Act 2003

A
  • The identity of the person is unknown
  • The death was violent or unnatural
  • The death happened under suspicious circumstances
  • The death was healthcare related
  • It is unlikely that a death certificate will be issued
  • The death was in care
  • The death was in custody
  • The death occurred during police operations
3
Q

Reasons for withholding CPR

A
  • Where the patient is exhibiting obvious signs of death such as decomposition, hypostasis or rigor mortis
  • Where the patient has sustained injuries that are totally incompatible with life such as decapitation, cerebral destruction, hemicorporectomy, incineration or foetal maceration.
4
Q

General CPR discontinuation criteria

A
  • CPR for 20 minutes
  • General ROLE criteria are fulfilled
  • The patient’s rhythm is asystole or PEA at a rate of less than 10 bpm (If in shockable rhythm after 30 minutes - consult)
5
Q

Rapid CPR discontinuation criteria

A
  • Patient was unresponsive and pulseless for at least ten minutes prior to paramedic arrival
  • No CPR was provided during this time
  • Genera ROLE criteria are fulfilled
  • Asystole rhythm
6
Q

Health attorney decisions in withholding CPR

A

Consent from a health attorney or guardian cannot operate unless the health provider reasonably consider that the commencement or continuation of life-sustaining measures for the patient would, having regard for all the circumstances, be inconsistent with good medical practice

7
Q

Patient decision (Advance Health Directive) - withholding CPR - appropriate conditions

A
  • The patient has impaired decision making capacity
  • There is no reasonable prospect that the patient will regain capacity
8
Q

CPR adult compression rate

A

100-120/minute

9
Q

LMA, ETT and IV access urgency and timing in cardiac arrest

A
  • No LMA or IV access in first 6 minutes of CPR unless a glottic foreign body is suspected
  • No ETT in first 10 minutes of CPR unless there is LMA failure
10
Q

Cardiac Arrest - Reversible Causes

A
  • Hypoxia
  • Hypothermia
  • Hypovolemia
  • Hypo/hyperkalemia
  • Hydrogen ion (acidosis)
  • Tension pneumothorax
  • Tamponade
  • Toxins
  • Thrombosis
11
Q

Newly born resuscitation - target heart rate

A

>100bpm

12
Q

Newly born - assisted ventilation rate

A

40-60 bpm

13
Q

Resuscitation of a Newly born - guideline

A
14
Q

Traumatic cardiac arrest causes

A
  • Airway obstruction and poor ventilation
  • Tension pneumothorax
  • Hypovolemia secondary to hemorrhage
15
Q

Adult versus pediatric transport priority in traumatic cardiac arrest

A
  • Adult patients should not be transported until airway management, chest decompression and IV access are established on scene
  • Pediatric patients will be transported on all occasions if resus has been initiated unless in special circumstances
16
Q

Traumatic cardiac arrest guidlines

A
17
Q

Hypothermia and cardiac arrest

A
  • Lack of signs of life cannot be reliably used
  • As temperature decreases - sinus bradycardia - AF - asystole
  • Withhold adrenaline and other pharmacological resuscitation measures until the patient has been warmed to a temperature higher than approximately 30 degrees
  • Above 30 degrees, the interval between adrenaline doses should be doubled
  • Normal drug administration above 35 degrees
  • If under 30 degrees and the patient is in VF/VT - maximum shock charge should be used
  • After 3 shocks at maximum joules, withhold until patient is over 30 degrees
18
Q

Defib paddle placement where ICD is insitu

A

Paddles should be positioned around 8 cm from the generator position

19
Q

Paramedic witnessed cardiac arrest and early defibrillation

A

Unless a delay of greater than 30 seconds is suspected, shock should be given before initiation of compressions

20
Q

Primary aims in ROSC

A
  • Support ABC’s
  • Maintain cerebral perfusion
  • Manage cardiac dysrhythmias (all patients should receive a 12-lead ECG)
21
Q

ROSC vital sign goals

A
  • Maintain SpO2 over or equal to 94%
  • Consider advanced airway
  • Maintain EtCO@ of 24-40 mmHg or 8-12 breaths/minute
  • SBP of over or equal to 100 (adults) or 80 (children)
22
Q

Adrenaline (Precautions)

A
  • Hypertension
  • Hypovolemic shock
  • Concurrent MAOI therapy
  • MS
23
Q

Adrenaline (Side Effects)

A
  • Anxiety
  • Hypertension
  • Palpitations
  • Pupil dilation
  • Tremor
24
Q

Adrenaline (Contraindications)

A

Nil

25
Q

Adrenaline (Indications)

A
  • Anaphylaxis or severe allergic reaction
  • Severe life-threatening bronchospasm OR silent chest (patients must only be able to speak in single words or have hemodynamic compromise or ALOC)
  • Cardiac arrest
  • Croup (with stridor at rest)
26
Q

Adrenaline cutt-off for IM half dose

A

6 years of age

27
Q

Waveform capnography indications

A
  • CPR
  • Sedation and procedural sedation
  • Endotracheal intubation
  • Ongoing monitoring of ventilation
28
Q
A

Reduced EtCO2 levels - causes of this waveform include shock, PE and effective CPR

29
Q
A

Endotracheal tube in oesophagus

30
Q
A

Inadequate seal around ETT

31
Q
A

Increased EtCO2 levels - causes of this waveform include shock, PE and effective CPR

32
Q
A

Decreased EtCO2 levels from normal - ROSC

33
Q
A

Obstruction in breathing circuit or airway

34
Q
A

Increased EtCO2 values towards normal - causes of this waveform include restoration of normal respiratory activity, improved cardiac output or improved integrity of airway seal.