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An effective system of care comprises all of these elements: -
ANSWER ✔✔Structure, process, system, and patient outcomes.
Taxonomy of Systems of Care: - ANSWER ✔✔SPSO: Structure,
Process, System, Patient Outcome.
Post-Cardiac Arrest Syndrome: - ANSWER ✔✔Includes post-arrest
brain injury, post-arrest myocardial dysfunction, systemic ischemia or
reperfusion response, and persistent acute and chronic pathology that
may have precipitated the cardiac arrest.
,Providers should titrate post-arrest phase inspired O2 to the lowest
possible level to achieve an arterial SPO2 of: - ANSWER ✔✔94% or
greater
Normocarbia - ANSWER ✔✔Partial pressure of end-tidal carbon
dioxide [PETCO2] of 30-40 mmHg or PaCO2 of 35-45 mmHg) may be a
reasonable goal unless patient factors prompt more individualized
treatment.
Mild hypocapnia might be useful as a temporary measure when treating:
- ANSWER ✔✔cerebral edema
The optimal post-cardiac arrest blood pressure remains unknown;
however a mean arterial pressure of what is a reasonable goal? -
ANSWER ✔✔65 mmHg
Average survival rate of IHCA: - ANSWER ✔✔24%
In a recent study, nearly 80% of hospitalized patients with
cardiorespiratory arrest had abnormal vital signs documented for up to
how many hours prior to the actual arrest? - ANSWER ✔✔8 hours
More than half of IHCA are the result of: - ANSWER ✔✔respiratory
failure or hypovolemic shock
,The majority of IHCA are foreshadowed by changes in physiology, such
as: - ANSWER ✔✔tachypnea, tachycardia, and hypotension.
Components of a rapid response system: - ANSWER ✔✔-Event
detection and response triggering arm.
-A planned response arm, such as the RRT.
-Quality monitoring.
-Administrative support
Examples of physiologic criteria to determine when to call a RRT: -
ANSWER ✔✔-Threatened airway
-Respiratory rate less than 6/min or more than 30/min
-Heart rate less than 40/min or greater than 140/min.
-Systolic BP < 90 mmHg
-Symptomatic hypertension
-Unexpected decrease in LOC
-Unexplained agitation
-Seizure
-Significant fall in urine output
-Subjective concern about the pt
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, Term to define team leaders who may become trapped in a specific
treatment or diagnostic approach- - ANSWER ✔✔Fixation error
In one human study, ROSC did not occur unless a CPP of what was
obtained during CPR? - ANSWER ✔✔15 mmHg or greater
If hypoxia is presumed the cause of the cardiac arrest (such as in a
drowning patient): - ANSWER ✔✔2 minutes of CPR prior to activating
the emergency response team should be delivered.
H's: - ANSWER ✔✔Hypovolemia, Hypoxia, Hydrogen Ion (acidosis),
Hypo-/hyperkalemia, Hypothermia
T's: - ANSWER ✔✔Tension pneumothorax, Tamponade (cardiac),
Toxins, Thrombosis (pulmonary), Thrombosis (coronary).
Common cause of PEA: - ANSWER ✔✔Hypovolemia
Hypovolemia, a common cause of PEA, produces classic physiologic
response of: - ANSWER ✔✔a rapid, narrow-complex tachycardia
(sinus tachycardia), and typically produces increased diastolic and
decreased systolic pressures.
Common non-traumatic causes of hypovolemia include: - ANSWER
✔✔occult hemorrhage and severe dehydration