Download EMD Cardiac Arrest

EMD Cardiac Arrest
22/10/10
SP Notes
DEFINITION
PEA = presence of coordinated electrical activity in myocardium but no detectable cardiac
output
- prognosis far less favourable than VF/VT
- treat cause
CAUSES
Hypovolaemia
Hypoxia
Hyper/hypokalaemia and metabolic disorders
Hyper/hypothermia
Toxicity
Tension pneumothorax
Tamponade (cardiac)
Thromboembolism – MI or PE
MANAGEMENT
ACLS protocol
Supportive care: continuous CPR, intubation + ventilation, IV access, adrenaline 1mg Q3 min
Specific therapy to treat cause:
Hypovolaemia – fluid, blood products, stop bleeding, clamp vessels
Hypoxia – intubation and ventilation (FiO2 1.0)
Hypokalaemia – K+ replacement
Hyperkalaemia – treat cause, Ca2+ gluconate 10mL 10%, insulin-dextrose, salbutamol,
NaHCO3
Metabolic disorders – Mg2+ if low, Ca2+ if low, acidosis -> HCO3
Hyperthermia – cool, dantrolene for MH
Hypothermia– warm
Toxicity – stop absorption, increase elimination, antidote to specific drug
Tension pneumothorax – decompress (needle thoracostomy -> ICC)
Tamponade – pericardiocentesis, open chest
Thromboembolism – thrombolysis (proven or suspected PE) +/- surgical embolectomy
Jeremy Fernando (2011)