Cardiac Arrest Scenario (ECA)

What is your immediate priority and first action as you approach the patient and nurse?

During your assessment to confirm cardiac arrest, the patient is unresponsive, has no pulse, but is very occasionally gasping. What does this indicate?

You attach the AED and it states “analysing”. Can you continue CPR during this time to minimise pauses?

The AED advises “Shock advised” and starts charging. What is the most appropriate next step?

A shock is delivered and CPR resumes. What rhythm would the AED have just shocked?

According to UK resuscitation guidelines, pauses in CPR should ideally take no longer than…?

What is the clinical significance of full chest recoil between compressions?

How often should compressors swap during CPR if more than one rescuer is available?

Why is minimising interruptions in chest compressions so critical during BLS?

After 2 minutes, the AED delivers another shock. You swap roles and move to the airway. An OPA is in place with BVM ventilation ongoing. You note that it is difficult to ventilate the patient, and you seem to only get one or two good inflations every few. You try positioning but it’s no good, should you upgrade to an I-gel?

You upgrade to an I-gel and ventilation is now much better. Thinking ahead for the Paramedic’s arrival, what are the 4 H’s of reversible causes?

What are the 4 T’s of reversible causes?

Based on the information you know so far, which reversible cause is most likely in this case?

The Paramedic arrives, praises your good BLS work, and begins ALS procedures. They keep your airway in place but add capnography. What information does this provide?

A cannula is inserted for drug therapy. You report that 2 shocks have already been given. When would the Paramedic look to start drug administration?

After switching the AED to manual mode, VF is confirmed. Another shock is delivered but the rhythm does not change. Assuming all 3 shocks failed to terminate VF, is this referred to as refractory or recurrent VF?

If the patient is in refractory VF and ALS does not achieve ROSC, what is the best management plan?