What can capnography define in resuscitation?
Can define if you are going to achieve ROSC
ROSC stands for Return of Spontaneous Circulation.
What does the wave form of capnography resemble?
Looks like an elephant
Where should needle decompression be performed?
Top of the second intercostal space above the 3rd rib on the mid clavicular line
How should needle decompression be performed?
Needs to be reversed very fast
What is the difference in mediastinal structures between a simple pneumothorax and a tension pneumothorax?
A simple pneumothorax does not shift the mediastinal structures, while a tension pneumothorax does
When should an orogastric tube (OGT) be used?
Only used with i-gel
What is important to do during ROSC care?
Primary survey and keep the same airway in if you can
What is the purpose of IV and IO access?
To maintain blood pressure and radial pulse
What happens if a cannula is not inserted correctly?
Will display a lump of fluid/medication build up very close to the injection site
What are the sizes of needles and their designations?
14 gauge = big needle, 24 gauge = small needle
What is a general rule for IV access?
General rule being distal (hand) and then go proximal (elbow)
What should be done after 2 failed IV attempts?
Move to IO
What are the IO access points?
- Proximal Tibia
- Proximal humerus
- Distal tibia
What are the contraindications for IO access?
- Knee replacements
- Pelvic trauma
What are the considerations for asthmatic cardiac arrest?
- Bronchospasm and mucous plugging
- Gas trapping
- Hyperinflation
How can treatment be altered for asthmatic patients?
- Chest decompression
- Focus on ventilations and allow air to expel 30:2 resus
- Take off bag valve when compressing
- Slow ventilations to allow for exhale
- Reverse hypoxia
- Give adrenaline through IV
- Set up inline neb for salbutamol
- Give IV fluids to increase intrathoracic pressure
What is required to set up a T piece for salbutamol?
- 2 oxygen kits
- T piece
- Capnography
What characterizes anaphylaxis arrest?
Immunological response
What is the focus during an anaphylaxis arrest?
NEEDS fluids – hypovolemic cardiac arrest
What is essential to consider in drowning cardiac arrest?
- Dry drowning vs wet drowning
- Success related to submersion time
- Focus on airway
What should you consider in hypothermic cardiac arrest?
- Low temperature saves brain
- Drugs may not work – adjust dosage
- Hold off defibrillation after first attempt below 30 degrees
What is the management for a pregnant patient in cardiac arrest?
C section if > 20 weeks and mother is unstable
What are the factors to consider in pregnancy-related emergencies?
- Bleeding
- Embolism
- Cardiac risks
- Placental abruption
- Sepsis
What is the effect of a gravid uterus on venous return?
Roll to the left to relieve pressure on IVC
