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Cardiac arrest (Management (Cardiac arrest management (Airway management…

- - - - Airway and
        ventilation
        
        Head tilt chin lift
        Jaw thrust (if suspected head injury)
        
        Remove visible obstructions
        from the mouth
        
        Breath 1s,
        watch chest rise and fall
      - Chest compression
        
        Heel of one hand over middle lower part of sternum,
        other hand on top, interlock fingers and lift up
        
        Position self above patients chest
        with straight arms
        
        Compress 5-6cm deep
        
        Release and repeat at
        100-120/min
        
        Use 30:2 ratio of
        compressions to ventilation
        
        Change person doing CPR every 2min
  - - - If a shockable rhythm
        (VF/VT)
      - One pad to R upper sternum below clavicle,
        Other to L mid-axilla where V6 electrode
      - Re-assess rhythm, resume compressions
    - - LMA is readily available,
        easy to insert alternative to ETT
      - Ventilate 100% O2, inspiration 1s,
        sufficient to see chest rise, rate 10/min
      - Ventilate while CPR ongoing
      - Monitor end-tidal CO2
        (correct tracheal tube placement,
        indirect measure of CO)
    - - If non-shockable rhythm
        (PEA, asystole)
      - Tight clenched fist from 20cm height,
        single blow to lower half of sternum
    - - Adrenaline
        (after 3 shocks in VT/VF,
        ASAP in PEA/asystole)
      - Oxygen!
    - - Depends on event,
        time since onset, prognosis etc.
      - Continue while VF/VT persists
      - Unresponsive or asystole >1h
        rarely associated with good outcome
- - - - Hypoxia
      - Hypovolemia
      - Hyper/hypokalemia,
        metabolic disorders
      - Hypothermia
    - - Tension pneumothorax
      - Tamponade (cardiac)
      - Toxins
      - Thromboembolism
  - - - Absent ventricular activity
    - - Cardiac arrest with an
        ECG compatible with CO
      - Causes
        
        Mechanical pump failure
        (MI, drugs e.g. CCBs or B-blockers,
        electrolyte disturbances)
        
        Obstruction to filling/output
        (tension pneumothorax, cardiac tamponade,
        myocardial rupture, PE, hypovolemia)