Notes by Tom Rustom 2009

www.askdoctorclarke.com 1

Notes on Cardiac Arrest

Anyone with chest pain

Morphine
Oxygen
Nitrates
Aspirin

Potential reversible causes:

Hypoxia
Hypothermia
Hypovolaemia
Hypo/hyperkalaemia and other metabolic disorders
Tamponade, cardiac
Toxicity
Thromboembolism
Tension pneumothorax

Drugs which should be available to give during an arrest:

Adrenaline
Atropine (for symptomatic bradycardia)
Amiodarone (antiarrhythmic drug/ K
+
channel blocker)
Magnesium
Thrombolytic drugs (can take up to 60 mins to work)
Sodium bicarbonate


Defibrillation

Used for: Ventricular Fibrillation (VF)
Pulseless Ventricular Tachycardia (PVT)

Leads:
Used to get a trace of the heart (i.e. like an ECG). Place on bony prominences.

RED Right top
YELLOW Left top
GREEN Bottom left


Procedure:

Assess situation. Is patient breathing? Do they have a pulse? Has CPR been
started? If so how long?

Attach leads. Is the patient in a shockable rhythm?

Apply electrodes

Set energy level. 360J for monophasic. 150J for biphasic.

Tell people to stand clear


Notes by Tom Rustom 2009
www.askdoctorclarke.com 2

Charge up. Make sure pads are on patient before doing so. Keep an eye on the
cardiac trace in case patient spontaneously comes out of arrest.

Shock the patient. Then return pads to machine and check rhythm.

If in sinus rhythm then do ABCDE.

If still in VF or PVT then continue CPR for 2 mins and then re-shock.

Adrenaline can be given every 3 5 mins.

If shocking doesnt work then try Amiodarone.

See also: www.resus.org.uk for latest information



Please Note
These notes were written by Tom Rustom as a medical student in 2009. They are presented in good faith and every
effort has been taken to ensure their accuracy. Nevertheless, medical practice changes over time and it is always
important to check the information with your clinical teachers and with other reliable sources. Disclaimer: no
responsibility can be taken by either the author or publisher for any loss, damage or injury occasioned to any person
acting or refraining from action as a result of this information. Please let us know of any errors.