Diagnostic Tools In

Emergency Unit
Dr. Indra Maulana Sulaeka
Reversible Causes Of Cardiac Arrest

• The 5H:
1. Hypovolemia,
2. Hypoxia,
3. Hydrogen ions (acidosis)
4. Hypo/HyperKalemia
5. Hypothermia,
• The 5T:
1. Tension pneumothorax
2. Tamponade, Cardiac
3. Toxins
4. Thrombosis, Pulmonary
5. Thrombosis, Cardiac
Diagnostic Tools

• Laboratory
• ECG
• Imaging
• Others
Laboratory

• Hematology
• BGA
• Electrolytes
• Glucose
• Renal Function Test
ECG

• Identify arrhythmia
• Diagnose and localize myocardial infarctions ( i.e. areas of muscle
damage)
• Diagnose heart disease
Pulseless Rhythm

• Asystole
• Pulseless Electrical Activity
• Ventricular Fibrilation
• Ventricular Tachycardia
Asystole

• Asystole is not actually a true rhythm but rather is a state of no

cardiac electrical activity
PEA

• PEA occurs when any heart rhythm that is observed on the

electrocardiogram (ECG) does not produce a pulse
• PEA can come in many different forms
• Sinus Rhythm, tachycardia, and bradycardia can all be seen with
PEA
Ventricular Fibrilaton

• Occurs when there are uncoordinated contractions within the

ventricles of the heart
• The primary cause of VF is hypoxia (lack of oxygen) to the heart
muscle which causes hyperirritability in the cardiac muscle tissue
Ventricular Tachycardia

• Occurs because the ventricles are not effectively moving blood out
of the heart and there is therefor no cardiac output
• Many tachyarrhythmias of a rate >150 will deteriorate into
pulselessness if timely treatment is not given
Non-Arrest Rhythms

• Tachyarrhythmias
• Supraventricular Tachycardia
• Atrial Flutter
• Atrial Fibrilation
• Others
• Bradyarrhythmias
• AV Block
SVT
Atrial Flutter
Atrial Fibrilation
Monomorphic Ventricular Tachycardia
Polymorphic Ventricular Tachycardia
Torsades de Pointes
1st Degree AV Block
2nd Degree AV Block: Mobitz type I
(Wenckebach)
2nd Degree Block: Mobitz type II
3rd Degree AV Block
Infarct Position
Imaging

• X Ray
• USG
• CT Scan
• MRI
X Ray

• Cervical
• Chest
• Pelvic
Chest X Ray

• Bony Framework
• Soft Tissues
• Lung Fields and Hila
• Diaphragm and Pleural Spaces
• Mediastinum and Heart
• Abdomen and Neck
Bony Fragments

• Ribs
• Sternum
• Spine
• Shoulder girdle
• Clavicles
Soft Tissues

• Breast shadows
• Supraclavicular areas
• Axillae
• Tissues along side of breasts
Lung Fields and Hila

• Hilum
• Pulmonary arteries
• Pulmonary veins

• Lungs
• Linear and fine nodular shadows of pulmonary vessels
Diaphragm and Pleural Surfaces

• Diaphragm
• Dome-shaped
• Costophrenic angles
• Normal pleural is not visible
Mediastinum and Heart

• Right side
• Inferior vena cava
• Right atrium
• Ascending aorta
• Superior vena cava
• Left side
• Left ventricle
• Left atrium
• Pulmonary artery
• Aortic arch
• Subclavian artery and vein
Abdomen and Neck

• Abdomen
• Gastric bubble
• Air under diaphragm
• Neck
• Soft tissue
• Air bronchogram
CT Scan

• Head
• Cervical
• Abdominal
Head CT Scan

• SCALP
• Bone
• Meninges
• Hemisphere cerebri
• Midline shift
• Ventricle system
• Maxillo-facial structure