Cardiac Arrest Mnemonics & Protocols

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Questions and Answers

What is the significance of maintaining a compression fraction ≥80% during CPR, and how does it impact patient outcomes?

Maintaining a high compression fraction ensures consistent blood flow and oxygen delivery to vital organs, increasing the likelihood of successful resuscitation and neurological recovery.

Beyond simply listing them, explain why prompt identification and management of the '4 H's and 4 T's' are critical in PEA.

Addressing these reversible causes can directly impact the underlying issue causing the electrical activity without mechanical contraction, potentially restoring effective cardiac function.

Why is the timing of epinephrine administration different for shockable versus non-shockable cardiac arrest rhythms?

In shockable rhythms, initial defibrillation is prioritized, with epinephrine administered after the first failed shock. In non-shockable rhythms, epinephrine is given immediately to stimulate any potential cardiac activity.

What is the rationale behind the 0.5°C/hour rewarming rate in HTTM, and what are the potential consequences of deviating from this rate?

Slow rewarming helps prevent rapid vasodilation and potential hemodynamic instability, minimizing the risk of rebound hyperthermia or neurological damage. Signup and view all the answers

Besides STEMI, what specific clinical scenarios might prompt immediate PCI after ROSC, even without ST-segment elevation?

Consideration should be given if there's strong suspicion for acute coronary syndrome (ACS) without a clear alternative explanation for the arrest (e.g., massive trauma), weighing the risks and benefits of intervention. Signup and view all the answers

Explain how trending PETCO2 values can help differentiate between ineffective chest compressions, ROSC, and proper ventilation during CPR.

Low PETCO2 indicates poor perfusion needing compression optimization. A sudden rise suggests ROSC. Consistently adequate values confirm effective ventilation. Signup and view all the answers

Why might amiodarone be preferred over lidocaine in certain cases of refractory VF/pVT, and vice versa?

Amiodarone might be favored for broader antiarrhythmic effects, while lidocaine may be chosen when specific sodium channel blockade is desired or when amiodarone is contraindicated. Signup and view all the answers

Explain the physiological rationale for targeting a MAP ≥65 mmHg and ScvO2 ≥65% post-ROSC, and how these parameters relate to tissue oxygenation.

A MAP ≥65 mmHg ensures adequate organ perfusion pressure, while an ScvO2 ≥65% indicates sufficient oxygen delivery to tissues. Together, they reflect adequate systemic oxygenation. Signup and view all the answers

Explain the rationale behind using calcium chloride (or calcium gluconate) in hyperkalemia during cardiac arrest, considering its potential risks and benefits.

Calcium stabilizes the myocardial membrane, counteracting the effects of hyperkalemia. However, it can worsen digoxin toxicity or lead to hypercalcemia, requiring careful consideration of the clinical context. Signup and view all the answers

What are the ethical considerations surrounding the decision to initiate ECPR, particularly in cases with prolonged arrest times or uncertain neurological prognoses?

ECPR should be considered when there is a chance of survival, neurological prognosis is uncertain and there is a refractory arrest from reversible causes. Signup and view all the answers

How might the underlying cause of seizures during HTTM (e.g., metabolic, structural, infectious) influence the choice of specific anti-epileptic drugs?

The underlying cause guides AED selection. Structural lesions often need broader-spectrum AEDs; metabolic causes require metabolic correction alongside seizure control. Signup and view all the answers

What are the potential drawbacks or limitations of relying solely on mechanical CPR devices during prolonged transport, especially in complex or unstable patients?

While devices give consistent compressions, they may not adapt to changing patient conditions and require careful monitoring for complications like chest trauma. Signup and view all the answers

Explain the mechanisms by which hyperoxia can worsen oxidative brain injury post-ROSC, and how this guides oxygen titration strategies.

Hyperoxia generates excessive free radicals, exacerbating brain damage after ischemia. Titration aims to balance oxygen delivery with minimizing oxidative stress. Signup and view all the answers

Describe the specific ECG changes that would prompt sodium bicarbonate administration in TCA overdose during arrest, and explain the rationale behind this intervention.

Widened QRS complexes indicate sodium channel blockade. Bicarbonate helps overcome this blockade, improving cardiac conduction and contractility. Signup and view all the answers

How does identifying pseudo-EMD impact the urgency and approach to interventions during PEA, compared to true EMD?

Pseudo-EMD suggests correctable factors; rapid intervention is crucial. True EMD indicates more profound myocardial dysfunction. Signup and view all the answers

Why is ticagrelor often favored over clopidogrel post-PCI during HTTM, and what specific pharmacokinetic properties contribute to this preference?

Ticagrelor's faster onset and greater platelet inhibition are advantageous, especially under hypothermic conditions where clopidogrel's activation may be impaired. Signup and view all the answers

Explain the relationship between ScvO2, oxygen delivery, and oxygen consumption in the context of CPR, and how this informs the interpretation of ScvO2 values.

ScvO2 reflects the balance between oxygen delivery and consumption. Low values indicate inadequate delivery, while high values may suggest impaired utilization. Signup and view all the answers

Explain why ECPR is considered as having increased risk of major bleeding, limb ischemia, vascular injury, stroke, and renal failure.

ECPR involves invasive procedures, higher doses of anticoagulation, and potential compromise of the circulatory system. Any one of can lead to potentially serious complicatoins. Signup and view all the answers

How do IVC ultrasound and passive leg raise tests help assess volume responsiveness post-ROSC, and what are the limitations of these assessments?

IVC collapse and increased stroke volume with leg raise suggest fluid responsiveness, but their accuracy is limited by factors like intrathoracic pressure and cardiac function. Signup and view all the answers

Given the lack of demonstrated survival benefit, in what specific clinical scenarios might vasopressin be considered as an alternative to epinephrine during cardiac arrest?

Vasopressin may be considered as an alternative in refractory VF, especially if there is reason to suspect that epinephrine is ineffective or detrimental. Signup and view all the answers

In the context of effective CPR, beyond rate and depth, explain the importance of full chest recoil and its impact on coronary perfusion pressure.

Full chest recoil allows for complete ventricular filling, which promotes higher coronary perfusion pressures during the compression phase. Signup and view all the answers

How would the management of hyperkalemia differ in a patient with known chronic kidney disease compared to a patient with previously normal renal function?

Patients with CKD may require more aggressive and prolonged management, including dialysis. Regardless, use calcium, insulin, and dextrose. Signup and view all the answers

What are some of the logistical challenges associated with implementing ECPR in smaller hospitals or rural settings, and how can these challenges be addressed?

Smaller hospitals may lack resources and expertise available. Regional centers and mobile ECMO teams can help bridge this gap. Signup and view all the answers

In addition to lorazepam and midazolam, what other second-line or adjunctive medications might be considered for refractory seizures during HTTM, and what are their mechanisms of action?

Levetiracetam, phenytoin, or phenobarbital might be considered. They act through various mechanisms, including GABA enhancement and sodium channel blockade. Signup and view all the answers

What patient characteristics or transport conditions would make mechanical CPR particularly advantageous compared to manual CPR?

Obese patients and during long transports. However, it is critical to monitor the patient during transport. Signup and view all the answers

How can arterial blood gas analysis help differentiate between different causes of hypoxemia post-ROSC?

ABGs assess oxygenation (PaO2), ventilation (PaCO2), and acid-base status. This is for targeted intervention. Signup and view all the answers

What are the potential risks and benefits of using hypertonic saline in TCA overdose during arrest?

Hypertonic saline can help overcome sodium channel blockade, but may worse volume overload or hypernatremia. Signup and view all the answers

Explain the physiological mechanisms by which hypovolemia can lead to pseudo-EMD, and how rapid fluid resuscitation can improve cardiac output.

Reduced preload impairs ventricular filling, reducing cardiac output. Volume administration restores preload, improving contractility. Signup and view all the answers

How does hypothermia affect platelet function, and why does this make ticagrelor a more attractive option than alternatives?

Hypothermia inhibits platelet function and impairs clopidogrel's activation. Ticagrelor's direct action bypasses this impairment. Signup and view all the answers

Beyond simply achieving a target ScvO2, what other clinical markers should be monitored to assess the adequacy of tissue oxygenation post-ROSC?

Lactate levels, urine output, mental status, and end-organ function should also be monitored to assess tissue oxygenation. Signup and view all the answers

What specific strategies can be implemented to minimize the risk of limb ischemia during ECPR?

Careful cannulation techniques, distal perfusion catheters, and vigilant monitoring can reduce ischemia. Signup and view all the answers

In patients with elevated intrathoracic pressure, how would you determine whether they are fluid responsive?

Volume responsiveness is difficult to gauge. One technique includes a passive leg raise. Signup and view all the answers

How might the underlying cause of cardiac arrest influence the choice between vasopressin and epinephrine?

The cause of some cardiac arrests may respond better to a certain catecholamine. However, this is mostly speculation. Signup and view all the answers

What are some possible ways to improve perfusion during CPR if you cannot perform compressions?

There are no possible ways to improve perfusion during active cardiac arrest. At that point, CPR is critical. Signup and view all the answers

What is unique about the presentation of hyperkalemia in patients with ESRD?

The only unique aspect is that they might be on chronic dialysis. The process and treatment is the exact same. Signup and view all the answers

Besides ECPR, name any other interventions that might improve a patient with cardiac arrest?

Other than excellent CPR and early defibrillation, the reversible H's & T's can influence patient cardiac status. Signup and view all the answers

Which benzodiazepine might you prefer in a patient with liver issues?

LOT (lorazepam, oxazepam, temazepam). These benzodiazepines are not metabolized in the liver. Signup and view all the answers

Is it possible to rely on mechanical CPR for too long?

Yes, mechanical CPR should be used at maximum for one hour. At that point, it might cause more harm than good. Signup and view all the answers

Name some unique challenges a bariatric patient post-ROSC might have versus a normal BMI patient?

Positioning. It might be hard to get a good airway or perform chest compressions on a bariatric patient. Furthermore, ultrasound might be difficult due to fat deposition. Signup and view all the answers

How might a succinylcholine drip complicate the interpretation of hyperkalemia post-ROSC?

Succinylcholine can lead to severe hyperkalemia. If it is run as a drip, it will be difficult to determine if the underlying hyperkalemia is ongoing. Signup and view all the answers

During cardiac arrest, what modifications to standard ACLS should be made if the patient is suspected to have a tension pneumothorax, and how would this impact the '4 H's and 4 T's' approach?

Needle decompression should be performed promptly. This addresses the 'T' for tension pneumothorax in the reversible causes of PEA. Signup and view all the answers

A patient remains in refractory VF/pVT despite multiple defibrillation attempts and amiodarone. What other antiarrhythmic agent could be considered, under what circumstances, and what are the weight-based dosing considerations?

Lidocaine is an alternative antiarrhythmic. Initial dose: 1-1.5 mg/kg, then 0.5-0.75 mg/kg. Magnesium sulfate may be given for torsades de pointes: 2–4 g IV. Signup and view all the answers

Post-ROSC, a patient's ScvO2 remains suboptimal at 55% despite achieving a MAP of 70 mmHg with norepinephrine. What additional interventions should be considered to optimize oxygen delivery and what are the specific target values for ScvO2 post-ROSC?

Consider dobutamine or further fluid resuscitation, while reassessing for the underlying cause of persistent hypoperfusion. The target ScvO2 should be ≥65%. Signup and view all the answers

After achieving ROSC following a prolonged cardiac arrest, a patient develops signs of severe hyperkalemia (e.g., peaked T waves, widened QRS). Describe the step-wise approach to managing hyperkalemia in this setting, including specific medications and their dosages.

Administer calcium chloride 1 g IV (or calcium gluconate 3 g IV) to stabilize the myocardium. Follow with insulin (10 units IV + 25g dextrose) and/or dialysis. Signup and view all the answers

Following successful resuscitation and PCI, a patient is being managed with HTTM. The patient requires placement of an arterial line. Considering the impact of hypothermia on coagulation, what strategies should be implemented to mitigate the risk of bleeding complications?

Use dual antiplatelet therapy with aspirin 325 mg + ticagrelor 180 mg loading dose. Monitor for signs of bleeding complications vigilantly, and weigh the risks and benefits of anticoagulation carefully. Signup and view all the answers

Explain how a compression fraction below 60% during CPR might affect the patient's chances of survival and neurological outcomes.

A compression fraction below 60% reduces effective blood flow, leading to decreased oxygen delivery to vital organs, potentially worsening survival rates and neurological outcomes due to prolonged ischemia. Signup and view all the answers

Describe the physiological consequences of inconsistent chest compression depth during CPR, focusing on its impact on cardiac output.

Inconsistent chest compression depth leads to variable cardiac output, compromising blood flow and oxygen delivery, and reducing the likelihood of achieving ROSC (Return of Spontaneous Circulation). Signup and view all the answers

Apart from survival rates, what are some other crucial, longer-term outcomes that are significantly influenced by the maintenance of a high compression fraction during CPR?

Longer-term outcomes influenced by compression fraction include neurological function, cognitive abilities, and overall quality of life post-resuscitation. Signup and view all the answers

Discuss the interrelation between compression rate, compression depth, and compression fraction in optimizing outcomes for adult CPR. How do these factors collectively contribute to the effectiveness of resuscitation efforts?

Optimal adult CPR requires balancing compression rate (100-120/min) and depth (at least 2 inches) while maximizing compression fraction. This balance ensures adequate blood flow and oxygen delivery for successful resuscitation. Signup and view all the answers

How does the definition of compression fraction relate to the practical challenges faced by healthcare providers in real-world CPR scenarios, particularly in chaotic or resource-limited environments?

In chaotic environments, maintaining optimal CPR parameters is challenging. High compression fraction demands careful coordination and training to minimize interruptions and ensure effective chest compressions amidst distractions. Signup and view all the answers

Explain how the use of mechanical CPR devices can specifically address and improve the compression fraction during prolonged resuscitation attempts.

Mechanical CPR devices maintain consistent and uninterrupted chest compressions, improving compression fraction by reducing fatigue-related inconsistencies that occur during manual CPR. Signup and view all the answers

Describe the necessary modifications to CPR techniques when performing CPR on an obese individual to achieve effective chest compressions.

On an obese individual, more force may be needed to compress the chest deeply enough. Ensure correct hand placement and consider using two hands interlocked for increased compression force. Signup and view all the answers

Detail how performing CPR on a pregnant woman differs from standard CPR, particularly in terms of chest compression placement and potential need for manual uterine displacement.

CPR on a pregnant woman includes higher hand placement on the sternum and manual left uterine displacement to relieve aortocaval compression, enhancing venous return and CPR effectiveness. Signup and view all the answers

Explain the criteria by which you would determine the effectiveness of CPR being administered, including both primary and secondary signs.

Effectiveness is determined by chest rise with ventilation, palpable pulse during compressions, and secondary signs like improved skin color or spontaneous breathing efforts. Signup and view all the answers

Describe how the rescuer should adapt CPR techniques based on different patient body types (e.g., elderly, frail) to avoid injury while maintaining effective compressions.

Adjustments include using less force on frail individuals to prevent rib fractures and ensuring proper hand placement to maximize compression effectiveness without causing injury. Signup and view all the answers

Discuss the physiological basis for maintaining a consistent rhythm during CPR and its direct effects on myocardial perfusion.

Consistent rhythm ensures steady blood flow and myocardial perfusion, increasing the chance of successful defibrillation and ROSC by preventing fluctuations in coronary artery pressure. Signup and view all the answers

How does the rescuer's fatigue impact the rhythm of chest compressions, and what strategies can be employed to mitigate this effect and maintain consistent rhythm?

Fatigue causes inconsistent rhythm, decreased compression depth, and rate. Mitigation strategies include switching rescuers every 2 minutes, using mechanical devices, and real-time feedback devices. Signup and view all the answers

Describe the advantages and limitations of incorporating a metronome or real-time feedback device to guide compression rhythm during CPR, including potential drawbacks.

Metronomes and feedback devices improve rhythm consistency and adherence to recommended rates. Limitations include over-reliance on the device and potential neglect of other critical CPR components. Signup and view all the answers

Explain how a dysrhythmia that is not shockable impacts the compression rate and the importance of uninterrupted rhythm in CPR.

In non-shockable rhythms, uninterrupted chest compressions are vital for maintaining any chance of perfusion since defibrillation is not indicated, emphasizing rate and consistent rhythm. Signup and view all the answers

Discuss the effects of varying compression-to-ventilation ratios on the consistency of chest compression rhythm, and explain how these ratios are optimized to ensure minimal interruption.

High compression-to-ventilation ratios reduce rhythm interruptions. The 30:2 ratio is designed to minimize pauses for ventilation, preserving compression rhythm. Signup and view all the answers

What specific physiological parameters can be monitored during CPR to provide immediate feedback on the effectiveness of chest compressions and ventilation?

End-tidal CO2, arterial blood pressure during compressions, and central venous oxygen saturation provide immediate feedback on CPR effectiveness. Signup and view all the answers

Explain the role of capnography (measuring end-tidal CO2) in assessing the quality of chest compressions during CPR and how changes in EtCO2 levels correlate with cardiac output.

Capnography tracks end-tidal CO2, reflecting cardiac output; an increase indicates improved perfusion from effective compressions, while a decrease suggests inadequate compressions or fatigue. Signup and view all the answers

Describe how you would differentiate between effective and ineffective chest rise during rescue breaths, focusing on how each affects oxygenation and ventilation efficacy.

Effective chest rise involves visible expansion, indicating sufficient air delivery and oxygenation. Ineffective chest rise suggests inadequate volume, airway obstruction, or poor seal, compromising ventilation. Signup and view all the answers

Discuss the limitations of relying solely on feeling for a pulse to assess CPR effectiveness, particularly in situations involving poor perfusion or rescuer fatigue.

Palpating for a pulse is unreliable due to poor perfusion, rescuer fatigue, or inexperience, which can lead to inaccurate assessments. Objective measures like EtCO2 are more reliable. Signup and view all the answers

Detail various advanced monitoring techniques, such as arterial blood pressure monitoring and echocardiography, and their specific contributions to guiding CPR adjustments in complex cases.

Arterial blood pressure monitoring and echocardiography offer detailed real-time data on perfusion and cardiac function, guiding CPR adjustments in complex cases to optimize hemodynamic support. Signup and view all the answers

Provide a rationale for why compression depth is shallower in pediatric CPR compared to adult CPR.

Compression depth is shallower in pediatric CPR due to smaller chest size, which helps prevent injuries while still creating adequate circulation. Signup and view all the answers

Explain the key anatomical and physiological differences that necessitate variations in CPR techniques between infants and adults.

Infants have smaller airways, different causes of cardiac arrest (often respiratory), and require different hand placement and compression depths than adults, necessitating modified CPR techniques. Signup and view all the answers

Detail the age and developmental distinctions between infant, child, and adolescent CPR guidelines, explicitly addressing compression rate, depth, and hand placement.

Infants (under 1 year) need two-finger or thumb-encircling compressions; children (1 year to puberty) need one or two-hand compressions; adolescents follow adult guidelines, with adjusted compression depths and rates accordingly. Signup and view all the answers

Describe how the primary causes of cardiac arrest in children (e.g., respiratory issues) influence the initial steps and priorities of pediatric CPR compared to adult CPR.

Respiratory issues are common in pediatric cardiac arrest, making ventilation a higher initial priority. This contrasts with adults, where primary cardiac causes prioritize compressions. Signup and view all the answers

Discuss the differences in the compression-to-ventilation ratios recommended for pediatric CPR depending on whether the rescuer is a trained healthcare provider or a layperson.

Trained providers often use a 15:2 ratio in pediatric CPR, while laypersons may use a 30:2 ratio to simplify the process and ensure adequate compressions. Signup and view all the answers

Describe the rationale behind limiting compression interruptions to less than 10 seconds during CPR and the implications of prolonged interruptions on patient outcomes.

Limiting interruptions to <10 seconds maintains coronary and cerebral perfusion; prolonged interruptions lead to decreased blood flow and poorer outcomes. Signup and view all the answers

Explain the concept of 'perfusion pressure' during CPR and describe how it is affected by compression depth, rate, and interruptions.

Perfusion pressure, the driving force for blood flow during CPR, increases with adequate compression depth and rate and decreases with interruptions, affecting organ perfusion. Signup and view all the answers

Discuss how incorporating 'active compression-decompression' techniques might influence both the venous return and overall myocardial perfusion during CPR.

Active compression-decompression enhances venous return and myocardial perfusion by creating negative intrathoracic pressure during the recoil phase, improving cardiac filling. Signup and view all the answers

Describe the effects of hyperventilation during CPR on intrathoracic pressure and venous return, and explain how it impacts the overall effectiveness of resuscitation efforts.

Hyperventilation increases intrathoracic pressure, reducing venous return and cardiac output, hindering effective resuscitation efforts. Signup and view all the answers

Explain the compensatory mechanisms that the body activates during CPR in response to reduced cardiac output, and describe how these mechanisms influence the monitoring of CPR effectiveness.

During CPR, the body activates vasoconstriction to prioritize blood flow to vital organs. Monitoring for improved skin color or rising EtCO2 can indicate these compensatory mechanisms are occurring effectively. Signup and view all the answers

What are the ethical considerations when deciding to continue or terminate CPR, based on monitoring parameters and the patient's overall condition and prognosis?

Ethical considerations involve balancing the potential for successful resuscitation with the futility of prolonged CPR, based on factors such as persistent asystole, patient comorbidities, and duration of arrest. Signup and view all the answers

How does the 'load distribution' across the chest during compressions impact the effectiveness of CPR, and what strategies can be used to optimize load distribution?

Uneven load distribution reduces compression effectiveness. Strategies include using correct hand placement and ensuring the patient is on a firm surface to optimize load distribution. Signup and view all the answers

Explain the 'rebound' or 'recoil' phase during chest compressions and its importance for effective CPR. What factors might impede effective chest recoil?

Complete chest recoil allows the heart to refill with blood, enhancing venous return. Factors that impede recoil include leaning on the chest between compressions and a non-yielding surface. Signup and view all the answers

Describe the impact of different body positions (e.g., supine, semi-prone) on the effectiveness of chest compressions and ventilation during CPR.

The supine position is optimal for CPR as it allows for effective compressions and ventilation. Semi-prone positions may compromise these efforts due to altered chest mechanics. Signup and view all the answers

Discuss the physiological effects of rescue breaths delivered too forcefully or at too high a volume, and explain how these effects can compromise the effectiveness of CPR.

Overly forceful or voluminous breaths cause gastric inflation, increasing the risk of aspiration and reducing lung compliance, ultimately compromising ventilation and CPR effectiveness. Signup and view all the answers

Explain how the timing of rescue breaths in relation to chest compressions (e.g., pauses for breaths versus asynchronous delivery) influences overall CPR efficacy.

Pauses for rescue breaths interrupt compressions, reducing cardiac output. Asynchronous delivery minimizes interruptions and can improve blood flow and overall CPR efficacy. Signup and view all the answers

Describe the advantages of using a bag-valve-mask (BVM) versus mouth-to-mouth ventilation during CPR, and discuss the challenges associated with effective BVM ventilation.

BVM provides higher oxygen concentrations but requires proper seal and technique; mouth-to-mouth may be simpler but delivers lower oxygen and poses infection risks. BVM challenges include maintaining a tight seal and preventing air leaks. Signup and view all the answers

Discuss how environmental factors, such as extreme temperatures or confined spaces, might affect the delivery and effectiveness of CPR, and what adaptations are necessary.

Extreme temperatures can affect rescuer performance and patient condition, and confined spaces limit movement. Adaptations include temperature regulation and modified positioning for effective CPR. Signup and view all the answers

Explain how the presence of specific medical conditions (e.g., severe asthma, COPD) might alter the standard approach to airway management during CPR.

Severe asthma or COPD may require lower tidal volumes and slower ventilation rates to prevent barotrauma, necessitating careful airway management during CPR. Signup and view all the answers

Explain the rationale for using cricoid pressure (Sellick maneuver) during CPR, and discuss the current evidence supporting or refuting its effectiveness and safety.

Cricoid pressure was thought to prevent aspiration by occluding the esophagus, but current evidence questions its effectiveness and safety due to potential airway compromise. Its use is now controversial. Signup and view all the answers

Explain how a compression fraction below 60% might impact the likelihood of successful resuscitation during CPR, and suggest two strategies to improve this metric in real-time during an ongoing resuscitation effort.

A compression fraction below 60% reduces blood flow, diminishing oxygen delivery to the heart and brain, thereby lowering resuscitation success. Strategies include using real-time feedback devices to monitor compression quality and minimizing pauses with efficient team coordination. Signup and view all the answers

Describe the physiological rationale behind the emphasis on consistent rhythm in CPR. How does maintaining a steady compression rate contribute to better patient outcomes during cardiac arrest?

Consistent rhythm in CPR ensures steady blood flow, which enhances oxygen delivery to vital organs, improving the chances of successful resuscitation. It also prevents pressure fluctuations that could harm the patient. Signup and view all the answers

Outline a tiered approach to monitoring CPR effectiveness, integrating both immediate physical signs and technological feedback. Detail how each assessment informs adjustments to CPR technique.

A tiered approach includes observing chest rise for adequate ventilation, palpating for a pulse to check circulation, and using capnography to measure exhaled CO2, which indicates blood flow. Each informs adjustments to compression depth, rate, and ventilation volume. Signup and view all the answers

In the context of pediatric CPR, explain why compression depth is adjusted relative to adult CPR, and describe the potential risks associated with applying adult compression depths to a child.

Compression depth is reduced in pediatric CPR due to smaller chest dimensions. Applying adult compression depths could cause injury, such as rib fractures or lung contusions, without improving effectiveness. Signup and view all the answers

During adult CPR, if you notice the patient's chest is not fully recoiling between compressions, how should you modify your technique and why is allowing full chest recoil important?

Ensure complete release of pressure after each compression to allow full chest recoil. Without it, the heart cannot fully refill with blood, reducing the effectiveness of subsequent compressions and overall cardiac output. Signup and view all the answers

Flashcards

Effective CPR benchmarks?

Compression rate: 100-120/min, depth: 5-6 cm, compression fraction ≥80%, full chest recoil, ventilation rate: 10 breaths/min.

Reversible PEA causes?

Hypoxia, Hypovolemia, Hypo/Hyperkalemia, Hypothermia; Thrombosis (PE), Tamponade, Toxins, Tension pneumothorax.

Epinephrine dosing during arrest?

1 mg IV/IO every 3–5 minutes. Give immediately for non-shockable rhythms (PEA/asystole); give after first defibrillation attempt for shockable rhythms (VF/pVT).

HTTM parameters post-ROSC?

Target temperature: 32°C–36°C (89.6°F−96.8°F) for 24 hours. Rewarm at 0.5°C/hour, then maintain normothermia (<37.5°C) for 72 hours.