(A&E) (Peri-Op & Anaesthesia)

Overview

• Sudden state of circulatory failure due to a loss of cardiac systolic function
• Result of 4 specific cardiac arrhythmias → ventricular fibrillation (VF), pulseless ventricular tachycardia (VT), pulseless electrical activity (PEA), and asystole
  • PEA ⇒ ECG shows normal sinus rhythm, but patient has no pulse
• VT & VF are most often the result of IHD and acute myocardial ischaemia

Reversible Causes of Cardiac Arrest:

• 4 H’s ⇒ hypoxia (give oxygen), hypothermia, hyperkalaemia/hypokalaemia, hypovolaemia (correct with IV fluids)
• 4 T’s ⇒ thrombosis, tension pneumothorax (may cause PEA), tamponade (esp. in trauma), toxins

Making Diagnosis

Clinical Features:

• Unresponsive Patient
• Not Breathing
• Absence of Circulation → doesn’t have a pulse

Investigations:

• Conitunous Cardiac Monitoring → identify rhythm, may be shockable rhythm (VT/VF) or non-shockable rhythm (asystole/PEA)