Shock/Ischemia/CPR Flashcards

1
Q

Regarding CPR, how does survival in anesthetized patients compare to overall survival?

A

47% vs. 4-9.6%

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2
Q

From RECOVER, due to decay of skills, refresher training is recommended every?

A

6 months

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3
Q

T/F: veterinarians or technicians may be considered leaders of a CPR team

A

TRUE

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4
Q

From RECOVER, recommended chest compression depth:

A

1/3 to 1/2 the width of the chest

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5
Q

From RECOVER, in large and giant breed dogs, hands should be placed…

A

over the widest portion of the chest

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6
Q

From RECOVER, in keel-chested dogs, hands should be placed…

A

directly over the heart

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7
Q

From RECOVER, in barrel-chested dogs, you should consider chest compression in which position?

A

dorsal recumbency with sternal chest compressions

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8
Q

From RECOVER, recommended chest compression rate

A

100-120 compressions/min

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9
Q

From RECOVER, in nonintubated patients or single-rescuer CPR, what C:V ratio is recommended?

A

30:2

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10
Q

From RECOVER, recommended ventilation rate and tidal volume?

A

10 bpm and 10 ml/kg

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11
Q

From RECOVER, CPR should be performed in cycles of how many minutes?

A

2

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12
Q

From RECOVER, what is the low dose of epi? High dose? How often?

A

0.01 mg/kg (low), 0.1 mg/kg (high), and q 3-5min

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13
Q

From RECOVER, dose of vasopressin? How often?

A

0.8 U/kg q3-5min

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14
Q

From RECOVER, dose of external defibrillation with monophasic vs biphasic?

A

4-6 J/kg (mono), 2-4 J/kg (bi)

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15
Q

From RECOVER, immediate defibrillation is recommended in cases of CPA due to VF of duration of how many minutes or less?

A

4 minutes or less

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16
Q

From RECOVER, T/F: immediate defibrillation may be considered if VF is diagnosed during a rhythm check b/w cycles of CPR

A

TRUE

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17
Q

From RECOVER, T/F: 2-minute cycle of CPR should PREcede defibrillation in cases of CPA due to VF of known or suspected duration of greater than 4 minutes.

A

TRUE

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18
Q

From RECOVER, which drug can be considered in cases of pulseless VT/VF resistant to defibrillation?

A

amiodarone

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19
Q

From RECOVER, what class is amiodarone? (Vaughan Williams classification)

A

Class III

20
Q

From RECOVER, what is the MOA of amiodarone?

A

Classified as class III (potassium channel blocker), but also has Class I, II, and IV activity!

21
Q

From RECOVER, what is the SECOND choice drug for pulseless VT/VF resistant to defibrillation?

A

Lidocaine

22
Q

MgSO4 may be considered for which arrhythmia?

A

Torsades de pointes

23
Q

MOA of impedance threshold device?

A

more negative intrathoracic pressure = more venous return = more cardiac output

24
Q

ITD not recommended in patients weighing less than? Why?

A

10kg. Cannot generate cracking pressure (-12 mmHg)

25
Q

T/F: the use of FIO2 of 21% may be considered

A

TRUE

26
Q

What is the equation for coronary perfusion pressure?

A

CPP = aortic diastolic pressure - right atrial diastolic pressure

27
Q

What is the dose of NaHCO3? After how many minutes of CPA would you consider administration?

A

1 mEq/kg. 10-15 min

28
Q

T/F: Fine VF is associated with a better prognosis

A

FALSE. Coarse is better.

29
Q

T/F: Arterial blood gas is preferred to venous blood gases

A

FALSE.

30
Q

From RECOVER, post-arrest target of PaCO2 in dogs vs cats?

A

Dog: 32-43 mmHg
Cat: 26-36 mmHG

31
Q

From RECOVER, post-arrest targets for PaO2 and SpO2?

A

PaO2 = 80 - 100 mmHg

SpO2 94-98%

32
Q

From RECOVER, hypothermic dogs and cats post-arrest should be rewarmed at what rate?

A

0.25 - 0.5 C/h

fast rewarming at >1C/h is NOT recommended

33
Q

From RECOVER, for comatose patients after ROSC, mild therapeutic hypothermia is recommended for how long? What temps?

A

32-34C for 24-48h

34
Q

From RECOVER, mild hypothermia post-arrest should not be initiated if…

A

mechanical ventilation and advanced critical care infrastructure not available

35
Q

From RECOVER, recommendations regarding corticosteroids?

A

not routinely recommended. can be considered for hemodynamically unstable despite fluids and inotropes/pressors (1 mg/kg followed by either 1 mg/kg q6h or 0.15 mg/kg/h)

36
Q

From RECOVER, ,bundle of care targets post-arrest?

A

34C for 12 hours post, normocapnia 35-40 mmHg for 24 hours, and sustained hypertension 140 mmHg (mean) for 4 hours

37
Q

From RECOVER, dose of INTERNAL defibrillation with monophasic vs biphasic?

A
  1. 5 - 1.0 J/kg (mono)

0. 2 - 0.4 J/kg (bi)

38
Q

What is the low-dose epinephrine dose in ml for a 10kg dog?

A

0.1 ml

39
Q

MOA of dobutamine?

A

beta1 agonist: inotrope

40
Q

MOA of dopamine

A

beta1 agonist: inotrope
alpha1 agonist: vasoconstriction
DA1 agonist: vasodilation

41
Q

MOA of vasopressin

A

V1 agonist: vasoconstriction

42
Q

MOA of norepinephrine

A

alpha1 agonist: vasoconstriction

43
Q

Name of retractor used to spread ribs?

A

Finochietto

44
Q

Structures to avoid when performing open chest CPR

A

Intercostal artery, vein, and nerves
Intrathoracic artery
Phrenic nerve

45
Q

Where does the phrenic nerve originate from?

A

C5-7

46
Q

What is the Pringle Maneuver?

A

clamping of the hepatoduodenal ligament