Reversible Causes of Cardiac Arrest
Mar 18, 2024![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/370f7c1-1eaa-8fbf-2d40-f0e33d131f86_2.png)
Identification of reversible causes of cardiac arrest and subsequent treatment is shown to have a significant impact on survival and rearrest rates post return of spontaneous circulation. πβ
At PC, we love cognitive aids, and the ALS algorithm recommends using the 4 Hs and 4 Ts to help us identify or exclude reversible causes of cardiac arrest to increase our chances of successful resuscitation. π«‘
Here they are in a nutshell:
4 Hs
π HYPOXIA: aspiration, asthma, COPD, was CICO declared?
π HYPOVOLAEMIA: blood loss, anaphylaxis, sepsis, and dehydration.
π HYPER/HYPOKALAEMIA & METABOLIC DISORDERS: diagnose with a blood gas!
π HYPER/HYPOTHERMIA: exposure, malignant hyperthermia, failure of intraoperative warming and monitoring.
4 Ts
π TENSION PNEUMOTHORAX: trauma, lung disease, central line insertion.
π TAMPONADE: trauma, current or recent cardiac surgery, laparoscopic surgery, central line insertion, aortic dissection, pericarditis.
π TOXINS: preoperative exposure, overdose, local anaesthetic toxicity.
π THROMBUS: coronary artery disease, DVT, PE, myocardial infarction or stroke.
Remember: there can sometimes be more than one reversible cause of arrest occurring concurrently, so your team should keep an open mind! π€―
Thankfully for us (and our patients!), perioperative cardiac arrests have a 60% chance of being discharged home alive, 37% higher than other in-hospital arrests.π«Άπ
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Ref: https://www.anzcor.org/home/adult-advanced-life-support/guideline-11-2-protocols-for-adult-advanced-life-support/
https://rcoa.ac.uk/news/nap7-report-perioperative-cardiac-arrest