8. ACLS Scenarios Flashcards by Kira Harms

PEA

no pulse
ECG shows organized rhythm

How well did you know this?

Not at all

Perfectly

ACS

pt exhibiting symptoms of MI due to partial or complete block of coronary artery

How well did you know this?

Not at all

Perfectly

ACS symptoms

chest pain
pressure

How well did you know this?

Not at all

Perfectly

drugs for respiratory arrest

narcan
- nasal: 2-4 mg
- IM: 0.4mg

How well did you know this?

Not at all

Perfectly

narcan can be repeated after

4 mins

How well did you know this?

Not at all

Perfectly

drugs for bradycardia

atropine: 1mg
epi: 2-10 mcg/min
dopmine: 5-20 mcg/kg/min

How well did you know this?

Not at all

Perfectly

atropine can be repeated

every 3-5 mins

How well did you know this?

Not at all

Perfectly

max dose of atropine

3mg

How well did you know this?

Not at all

Perfectly

drugs for SVT

adenosine: 6mg/12mg
sotalol: 100mg or 1.5mg/kg

How well did you know this?

Not at all

Perfectly

how many doses of adenosine can be given

1st: 6mg
2nd: 12mg
3rd: 12 mg

How well did you know this?

Not at all

Perfectly

adenosine mechanism

slows conduction through AV node by stopping heart for a few seconds

How well did you know this?

Not at all

Perfectly

sotalol mechanism

beta blocker
antiarrythmic

How well did you know this?

Not at all

Perfectly

sotalol CI

prolonged QT syndrome
(torsades)

How well did you know this?

Not at all

Perfectly

drugs for monomorphic VTACH with pulse

amiodarone: 150 mg over 10 min
lidocaine: 1-1.5 mg/kg
sotalol: 100 mg or 1.5mg/kg
procainamide: 20-50mg/min

How well did you know this?

Not at all

Perfectly

procainamide mx infusion

1-4 mg/min

How well did you know this?

Not at all

Perfectly

drugs for Vfib/pulseless VTACH

epi: 1 mg
lidocaine: 1-1.5 mg/kg
amiodarone: 300mg bolus

How well did you know this?

Not at all

Perfectly

lidocaine Vfib/pulseless VTACH first/second doses

1st: 1-1.5mg/kg
2nd: 0.5-0.75 mg/kg

How well did you know this?

Not at all

Perfectly

how often can lidocaine be redosed

5-10 mins

How well did you know this?

Not at all

Perfectly

amiodarone vfib/pulseless vtach 1st/2nd doses

1st: 300 mg
2nd: 150 mg

How well did you know this?

Not at all

Perfectly

amiodarone post-ROSC doses

1st 6 hrs: 1mg/min
next 18 hrs: 0.5 mg/min

How well did you know this?

Not at all

Perfectly

amiodarone CI

sinus node dysfunction
2nd degree heart block
3rd degree heart block
torsades

How well did you know this?

Not at all

Perfectly

when are amiodarone and lidocaine recommended to be given for vfib/pulseless VTACH

after 3rd shock

How well did you know this?

Not at all

Perfectly

drugs for torsades

epi: 1mg
magnesium: 1-2 g over 10-20 mins
lidocaine: 1-1.5 mg/kg

How well did you know this?

Not at all

Perfectly

drugs for Asystole/PEA

epi; 1 mg

How well did you know this?

Not at all

Perfectly

drugs for ACS

NTG: 3 tablets aspirin: 160-325 mg PO

NTG can be repeated

3-5 mins up to 3 total doses

drugs for post-ROSC hypotension

NE: 0.1-0.5 mcg/kg/min Epi: 2-10 mcg/kg/min Dopa: 5-20 mcg/kg/min

Respiratory Arrest protocol

bradycardia protocol

SVT protocol

Afib/Aflutter protocol

monomorphic VTACH w/Pulse protocol

monomorphic VTACH: pulseless

CPR defibrillation Epi Amiodarone (300mg)

Monomorphic VTACH: Pulse and Stable

antiarrythmics - amiodarone (150mg) - lidocaine (1.5mg/kg)

monomorphic VTACH: pulse and unstable

synchronized cardioversion

Vfib/Pulseless VTACH protocol

Asystole/PEA protocol

polymorphic VTACH (torsades) protocol

ROSC protocol

ACS etiology

plaque in CA plaque becomes unstable plaque ruptures PLTs cover ruptured plaque PLT-rich thrombus

hos is coronary ischemia diagnosed

12 lead ECG

ACS ECG types

normal STEMI NSTE w/T wave inversion NSTE w/ST depression

STEMI diagnosis

ST elevation on ECG

STEMI

completely blocke CA that leads to heart attack

highest risk ECG

STEMI

NSTEMI diagnosis

ST depression or T wave inversion

NSTEMI

partially blocked CA

unstable angina

normal ECG

what should adults do if they have chest pain

chew aspirin

most important step for pt with chest pain

12 lead ECG

only way to ID STEMI

12 lead ECG

ACS treatment

O2 Aspirin NTG Morphine heparin/plavix reperfusion therapy

what pts should not receive morphine

NSTEMI does not get morphine

what pts should not receive fibrinolytics

NSTEMI does not get fibrinolytics

reperfusion therapy includes

PCI fibrinolytics

when do ACS pts need O2

SpO2 < 90%

when should NTG be avoided

SBP < 90 mmHg or 30mmhg less than baseline PDE inhibitors milrinone viagra

if pt becomes hypotensive after NTG, what action should be taken?

administer fluid bolus

aspirin mechanism

plt inhibitor decr coronary reocclusion after fibrinolytics

when should you consider rectal aspirin

N/V PUD upper GI disorders

rectal aspirin dosing

300mg

do you give aspirin to pts with ASA/NSAID allergy

heparin

given early to STEMI pts adjunct to PCI/fibrinolytics

P2Y12 inhibitor mechanism

antiplatelet

most common P2Y12

plavix

PCI

balloon angioplasty and stenting of coronary artery

best treatment for ACS

PCI

when does PCI need to be accomplished?

within 90 mins of first medical contact (120 mins if transfer required)

when are fibrinolytics considered for PCI

if PCI will not be able to be initiated within 90-120 mins

fibrinolytics are considered for what pts

STEMI only

timeline for fibrinolytics for STEMI

30 mins of arrival

fibrinolytics are not given if ACS symptoms have been present for _____ hrs

12 hrs

fibrinolytic CI

NSTEMI HTN (>180/100 mmHg) recent head trauma (3 months) GI bleed blood thinners stroke symptoms > 3 hrs ACS symptoms > 12 hrs

STEMI/NSTEMI protocol

ACS protocol

ischemic stroke

blood clot blocks blood flow to brain

hemorrhagic stroke

weakened vessel ruptures and bleeds into brain

subarachnoid stroke

blood vessel outside brain ruptures

time zero

last time patient was "normal"

ischemic stroke is ____% of strokes

87%

hemorrhagic stroke is ___% of strokes

10%

subarachnoid stroke is ___%

ischemic stroke treatments

IV fibrinolytics aspirin surgical endovascular intra arterial fibrinolytics insulin

preferred treatment for ischemic stroke

fibrinolytics - rtPA (alteplase)

timeline for ischemic stroke fibrinolytics

1 hr of arrival 3 hr of symptoms

when is apirin given for ischemic stroke

if fibrinolytics are CI

timeline for surgical endovascular therapy

90 mins after arrival (up to 6 hrs) (up to 24 hrs if penumbral imaging is required)

when is penumbral imaging required

symptoms > 6 hrs

when are intra arterial fibrinolytics administerd for ischemic stroke

if IV fibrinolytics are CI

timeline for intra arterial fibrinolytics

within 24 hrs of symtoms

can you take aspirin and fibrinolytics

no - delay aspiring for 24 hrs post fibrinolytics

treatment for hemorrhagic/subarachnoid stroke

STAT neurology consult avoid fibrinolytics

stroke recognition

Facial drooping Arm weakness Speech difficulty Time to call 9-1-1

cincinatti prehospital stroke schedule

determines if stroke is occuring

NIHSS

quantifies severity of stroke

one abnormal finding

72% of stroke

3 abnormal findings

85% of stroke

NIHSS higher score

bad

NIHSS timeline

within 10 mins of ED arrivalk

how are stroke diagnosed

CT scan

CT scan timeline

within 20 mins of arrival

acute stroke protocol EMS

acute stroke protocol ED

stroke managment in ICU

treat blood glu > 185 prevent HTN urgent CT if neuro deteriorates

protocol for cardiac arrest in pregnancy

LVADs

chest compression if MAP <50 mmHg or EtCO2 < 2o mmHg

8. ACLS Scenarios Flashcards

(106 cards)