Cardiac Arrest Flashcard 2

B. Rationale: The utilization of extracorporeal CPR is recommended for experienced, well-trained, and fully equipped institutions. Extracorporeal CPR utilizes a membrane oxygenation device as an adjunct for CPR that allows for oxygenation of the patient’s blood through this machine.

A. Rationale: Amiodarone and lidocaine are used to convert shockable cardiac arrest rhythms that do not respond to defibrillation therapies. Amiodarone is given intravenously with a dose of 5 mg/kg, while lidocaine is also given intravenously at a dose of 1 mg/kg. Amiodarone can be considered after a second shock. Epinepherine should always be given after the first shock once CPR is resumed and continued every 3 to 5 minutes while the patient remains in cardiac arrest.

C. Rationale: Epinephrine is given intravenously at a dose of 1 mg in a dilution of 1:10,000. It is administered every 3 to 5 minutes, with no total dose limit.

D. Rationale: Pediatric patient survival depends on where the arrest has taken place (in-hospital vs. out-of-hospital) and the presenting rhythm of the arrested patient. Higher survival rates to hospital discharge occur for in-hospital pediatric cardiac arrest patients presenting with shockable cardiac arrest rhythms such as ventricular fibrillation and pulseless electrical activity. Survival rates are higher in patients after in-hospital cardiac arrest at 43%, compared with out-of-hospital cardiac arrest at 8%. The highest survival rates occur when CPR is performed in patients with significant bradycardia and poor perfusion before pulseless arrest develops.

D. Rationale: Sudden cardiac arrest is observed in patients with cardiac conditions that potentially cause arrhythmias and ventricular dysfunction such as congenital heart disease, conduction defects, and acquired heart disease such as viral myocarditis.

C. Rationale: Torsade’s de pointes is a polymorphic ventricular tachycardia with changes in the amplitude of the QRS complex that seems to “twist” about the isoelectric line.

C. Rationale: When an organized rhythm is diagnosed after a successful shock or rhythm check, the healthcare provider palpates for a central pulse. The carotid sinus is recommended location to check the central pulse. The presence of a palpable central pulse begins the post-cardiac arrest care.

B. Rationale: The most common causes of post-arrest cardiac morbidity are hemodynamic instability and respiratory problems, which lead to a myriad of complications, such as pulmonary congestion leading to pneumonia, or hemodynamic instability leading to stroke, cardiac arrest, or shock.

D. Rationale: Cardiac arrest is the absence of blood circulation and mechanical activity of the heart. Pediatric patients will become unresponsive with abnormal or absent breathing and have absent pulses. The resulting multiorgan ischemia leads to death without immediate intervention.

D. Rationale: There are four rhythms of cardiac arrest: ventricular fibrillation, pulseless ventricular tachycardia, asystole, and pulseless electrical activity. Shockable cardiac arrest patients are those presenting with ventricular fibrillation and pulseless ventricular tachycardia. Atrial fibrillation and unstable supraventricular tachycardia are converted with synchronized cardioversion.