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Cardiac arrest (Management (Cardiac arrest
management (Airway
management…
Cardiac arrest
Management
Team leader
Controls, coordinates and organises
Makes treatment decisions
4-6 members, each know role
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Cardiac arrest
management
Defibrillation
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One pad to R upper sternum below clavicle,
Other to L mid-axilla where V6 electrode
Re-assess rhythm, resume compressions
Airway
management
LMA is readily available,
easy to insert alternative to ETT
Ventilate 100% O2, inspiration 1s,
sufficient to see chest rise, rate 10/min
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Monitor end-tidal CO2
(correct tracheal tube placement,
indirect measure of CO)
Precordial thump
If non-shockable rhythm
(PEA, asystole)
Tight clenched fist from 20cm height,
single blow to lower half of sternum
Drugs
Adrenaline
(after 3 shocks in VT/VF,
ASAP in PEA/asystole)
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Length of resus
Depends on event,
time since onset, prognosis etc.
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Post resus
care
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Circulation
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CXR
(check ETT position,
central lines, pneumothorax)
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Bloods
(FBC, U+E, glucose, etc.)
Diagnosis
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History
Ambulance crew, relatives
Patient details
(age, PMH, DH, symptoms before event)
Timings
(collapse, 999 call, ambulance arrival,
start of CPR, first defib, other intervention,
restore of spontaneous circulation)
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Pathophysiology
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Non-shockable
rhythms
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PEA
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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)
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Epidemiology
Most patients have a sudden,
unexpected out of hospital event