CPR Flashcards by Boikhutso Sekgobela

The first 3H for CPR

Hazards
Hello
Help

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What is the first step in the Advanced Cardiac Arrest Algorithm?

Ensure scene safety (Hazards)

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What does HELLO assess?

Responsiveness

Breathing (absent or gasping)

Pulse

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What should you do if the patient is unresponsive, not breathing normally, and pulseless?

Call for help and bring AED/defibrillator

Start CPR immediately

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What do you do if the patient has a pulse and is breathing?

Place in recovery position

Monitor continuously

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What do you do if the patient has a pulse but is not breathing effectively?

Provide rescue breathing

Adult: 1 breath every 5 seconds

Child: 1 breath every 3 seconds

Infant: 1 breath every 3 seconds

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When do you start chest compressions?

No pulse

Pulse rate <60/min in children/infants with poor perfusion

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What is the correct compression rate?

100–120 compressions per minute

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What is the correct compression depth?

Adults: at least 5 cm

Children: ⅓ chest depth

Infants: ⅓ chest depth

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What are key principles of high-quality CPR?

Push hard and fast

Full chest recoil

Minimise interruptions

Change compressors every 2 minutes

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What is the compression-to-ventilation ratio without an advanced airway?

Adults: 30:2

Children & infants (2 rescuers): 15:2

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How do breaths change once an advanced airway is in place?

Continuous compressions

1 breath every 6 seconds (10/min)

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When should the AED/defibrillator be attached?

Immediately when available

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Which rhythms are shockable?

Ventricular fibrillation (VF)

Pulseless ventricular tachycardia (VT)

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What should you do after a shock?

Resume CPR immediately

Continue for 2 minutes before rhythm check

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What rhythms are non-shockable?

Asystole

Pulseless electrical activity (PEA)

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When should adrenaline be given in cardiac arrest?

As soon as IV/IO access is obtained

Every 3–5 minutes

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When is amiodarone indicated?

Refractory VF/VT after multiple shocks

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What advanced airway options are used during arrest?

Endotracheal tube

Extraglottic airway (LMA)

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Why is capnography important during CPR?

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Confirms tube placement

Assesses CPR quality

Sudden rise suggests ROSC

What are the 4 Hs in cardiac arrest?

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Hypoxia

Hypovolaemia

Hydrogen ion (acidosis)

Hypo/Hyperkalaemia

What are the 4 Ts in cardiac arrest?

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Tension pneumothorax

Tamponade (cardiac)

Toxins

Thrombosis (coronary or pulmonary)

What indicates return of spontaneous circulation (ROSC)?

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Palpable pulse

Rise in ETCO₂

Improving blood pressure

What are priorities after ROSC?

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Maintain oxygenation and ventilation

Treat hypotension

Identify and treat underlying cause

A 54-year-old man collapses in the ER. He is unresponsive, gasping, and has no palpable pulse. What is the most appropriate immediate action? A. Intubate the patient B. Give adrenaline C. Start chest compressions D. Attach cardiac monitor E. Give oxygen via mask

C Explanation: In cardiac arrest, CPR takes priority. Defibrillation and drugs follow, but high-quality chest compressions must start immediately.

What is the recommended chest compression rate in adult CPR? A. 80–100/min B. 90–110/min C. 100–120/min D. 120–140/min E. As fast as possible

C Explanation: Guidelines recommend 100–120 compressions per minute for effective perfusion

Which rhythm is shockable during cardiac arrest? A. Asystole B. Pulseless electrical activity C. Sinus tachycardia D. Ventricular fibrillation E. Complete heart block

D Explanation: Only VF and pulseless VT are shockable rhythms.

After defibrillation for ventricular fibrillation, what is the next step? A. Check pulse B. Re-analyse rhythm C. Resume CPR immediately D. Give adrenaline E. Intubate

C Explanation: After shock → immediate CPR for 2 minutes. Do not pause to check pulse or rhythm.

Which of the following indicates high-quality CPR? A. Frequent pauses for pulse checks B. Shallow compressions C. Full chest recoil D. Compression rate of 80/min E. Ventilation after every compression

C Explanation: Full recoil allows venous return and improves cardiac output.

In a child with a pulse rate of 50/min and signs of poor perfusion, what should be done? A. Observe only B. Give oxygen C. Start chest compressions D. Give atropine E. Defibrillate

C Explanation: In children/infants, HR <60/min with poor perfusion = start CPR.

What is the correct compression-to-ventilation ratio for two-rescuer CPR in children? A. 30:2 B. 20:2 C. 15:2 D. 10:2 E. Continuous compressions

C Explanation: Children and infants with two rescuers → 15:2.

Adrenaline during CPR should be given: A. Once only B. Every 1 minute C. Every 3–5 minutes D. Only after ROSC E. Only for shockable rhythms

C Explanation: Adrenaline is given every 3–5 minutes in all cardiac arrests.

A sudden rise in end-tidal CO₂ during CPR most likely indicates: A. Hyperventilation B. Equipment malfunction C. Return of spontaneous circulation D. Worsening acidosis E. Poor CPR quality

C Explanation: A sudden increase in ETCO₂ suggests ROSC.

Which of the following is part of the 4 Hs of cardiac arrest? A. Hypoglycaemia B. Hypothermia C. Hypernatremia D. Hypertension E. Hypocalcaemia

B Explanation: 4 Hs: Hypoxia, Hypovolaemia, Hydrogen ion (acidosis), Hypo/Hyperkalaemia, Hypothermia (some lists include it).

Which condition is a T cause of cardiac arrest? A. Tension pneumothorax B. Thyrotoxicosis C. Trauma to limb D. Thrombocytopenia E. Tachycardia

A Explanation: 4 Ts: Tension pneumothorax, Tamponade, Toxins, Thrombosis.

List four components of high-quality CPR.

Compression rate 100–120/min Adequate depth Full chest recoil Minimal interruptions

State two differences between adult and paediatric CPR.

Compression-ventilation ratio differs (adult 30:2, child 15:2 with two rescuers) Paediatric arrests are usually hypoxic, adults usually cardiac

Why should interruptions in CPR be minimised?

Interruptions reduce coronary and cerebral perfusion Takes time to rebuild perfusion pressure

During CPR, a patient has an ETCO₂ of 8 mmHg despite a correct airway and oxygenation. What is the most appropriate interpretation? A. Normal CPR quality B. Equipment malfunction C. Inadequate chest compressions D. Early ROSC E. Hyperventilation

C Explanation: ETCO₂ <10 mmHg suggests poor cardiac output from ineffective compressions. Improve depth/rate and change compressor

A patient in VF is shocked appropriately. CPR is resumed. After 90 seconds, the monitor shows organised electrical activity at 70 bpm. What should you do? A. Stop CPR and check pulse B. Continue CPR until 2 minutes completed C. Deliver another shock D. Give amiodarone E. Intubate immediately

B Explanation: Never interrupt CPR early. Rhythm checks are only done every 2 minutes unless ROSC is obvious.

During intubation in cardiac arrest, ETCO₂ waveform is present but oxygen saturation continues to fall. What is the most likely cause? A. Esophageal intubation B. Hyperventilation C. Poor pulmonary blood flow D. Tube displacement E. Pneumothorax

C Explanation: In arrest, SpO₂ depends on perfusion, not ventilation. Falling saturation with ETCO₂ present suggests low cardiac output from CPR.

A child in cardiac arrest has persistent bradycardia at 50/min despite oxygenation and ventilation. What is the most appropriate action? A. Atropine B. Defibrillation C. Adrenaline infusion D. Chest compressions E. Observe

D Explanation: In paediatrics, HR <60/min with poor perfusion = CPR, even if a pulse exists.

After 20 minutes of high-quality CPR, ETCO₂ remains consistently at 5–7 mmHg. What does this most strongly suggest? A. Incorrect ET tube placement B. Need for sodium bicarbonate C. Very poor prognosis without ROSC D. Hyperventilation E. Shockable rhythm

C Explanation: Persistently low ETCO₂ despite good CPR is associated with low likelihood of ROSC.

A patient in PEA arrest suddenly develops a narrow-complex tachycardia at 110 bpm on the monitor. There is no palpable pulse. What is the correct interpretation? A. ROSC achieved B. Sinus tachycardia C. PEA continues D. VF converted E. Monitor artifact

C Explanation: Electrical activity without a pulse = PEA, regardless of how “normal” the rhythm appears.

You notice frequent pauses in CPR for airway suctioning. ETCO₂ drops after each pause. Why does this occur? A. Loss of oxygen reserves B. Increased airway resistance C. Loss of coronary perfusion pressure D. Hypoventilation E. Adrenaline washout

C Explanation: Stopping compressions causes immediate loss of coronary perfusion pressure, reducing cardiac output and ETCO₂

During CPR, a patient becomes increasingly difficult to ventilate with rising airway pressures. Which reversible cause should be prioritised? A. Hypovolaemia B. Tension pneumothorax C. Metabolic acidosis D. Hyperkalaemia E. Coronary thrombosis

B Explanation: Sudden ventilation difficulty + high pressures → tension pneumothorax until proven otherwise.

A patient arrests immediately after induction for intubation. What is the most likely physiological explanation? A. Hypoxia from apnea B. Vagal stimulation C. Loss of sympathetic tone D. Drug allergy E. Aspiration

C Explanation: Sedative induction removes “fight or flight” sympathetic compensation, leading to collapse in critically ill patients.

A patient achieves ROSC but remains hypotensive and acidotic. What is the most important next step? A. Stop all oxygen B. Treat reversible cause C. Give amiodarone D. Immediate extubation E. Repeat defibrillation

B Explanation: Post-ROSC care focuses on fixing the cause of arrest, not the arrest itself.

CPR Flashcards

(48 cards)