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NREMT® Paramedic > EMT-P (2) Cardiology and Resuscitation > ACLS > Flashcards

ACLS Flashcards

Practice Advanced Cardiac Life Support

1
Q

Which four therapies are managed during post-cardiac arrest treatment?

A
  • Target Temperature Management: Maintain between 32-36°C for at least 24 hours.
  • Oxygen: Aim for SpO2 94% or greater.
  • Ventilation: Start VR at 10 breaths/min; ETCO2 35-45mmHg
  • Pressure: Keep MAP at 65 mmHg or greater.
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2
Q

What are the tasks of the team leader?

A
  • Clearly define roles for each person.
  • Ask that a new intervention be performed if it is a greater priority.
  • Seek input for diagnoses.
  • Confirm actions and be provide clear instructions.
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3
Q

List the key roles involved in cardiac arrest.

A
  • Airway manager
  • Chest compressor
  • Defibrillator operator
  • Team leader
  • Medication administrator
  • Time/recorder
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4
Q

What is the role of a team member.

A
  • Ask for a new task or role if unable to perform assigned task.
  • Suggest an alternative drug dose in a confident manner.
  • Question a colleague who is about to make a mistake.
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5
Q

What should you do if you are unsure about detecting a pulse?

A

start CPR

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6
Q

What is coronary perfusion pressure?

A

Aortic relaxation
diastolic

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7
Q

What is a quality chest compression?

A

Includes:

  • at least 2 inches in depeth
  • full chest recoil
  • 100-120 compressions/min
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8
Q

Fill in the blank.

If ETCO2 is <10 mmHg, you should reassess _____ of CPR.

A

quality

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9
Q

List the H’s

A
  • Hypovolemia
  • Hypoxia
  • Hydrogen ion
  • Hypo-/Hyperkalemia
  • Hypothermia
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10
Q

What is the normal tidal volume of an adult?

A

8-10 ml/kg

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11
Q

Define:

Respiratory Failure

A

Inadequate oxygenation

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12
Q

Define:

Respiratory Arrest

A

Absent breathing

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13
Q

What is bad about excessive ventilation?

A
  • Increases thoracic pressure
  • Decreases venous return to the heart
  • Decreases cardiac output
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14
Q

What is the tidal volume you give for a patient not breathing?

A

6-7 ml/kg

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15
Q

What is a common airway obstruction?

A

tongue

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16
Q

Treatment

Unresponsive airway obstruction

A
  • Begin CPR immediately.
  • Every two minutes, check the mouth before giving ventilations.
  • Remove visible obstructions with fingers.
  • Use direct laryngoscopy with Magill forceps if trained.
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17
Q

How much pressure should be applied when squeezing a BVM during ventilations?

A

Until you see the chest rise.

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18
Q

What suctioning pressure (mmHg) should be used?

A

80-120 mmHg

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19
Q

What are the reperfusion goals?

Hint: duration in minutes

A
  • door to balloon: 90 minutes
  • door to needle: 30 minutes
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20
Q

Fill in the blank.

  1. A rigid suction should be measured the same as an ____.
  2. Suctioning should not exceed ____ seconds.
A
  1. OPA
  2. 15
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21
Q

List the ACS algorithm.

A
  • Assess ABCs and obtain a 12-lead ECG.
  • Administer O2 if saturation is below 90% and give aspirin.
  • Provide nitroglycerin.
  • Administer morphine if pain persists despite nitroglycerin.
22
Q

What is the dosage for aspirin?

Acute myocardial infarction

A

160-325 mg

23
Q

What is the dosage for Nitroglycerine

A

400 mcg Q 3-5 minutes

24
Q

What medication should be avoided in patients who have recently used Phosphodiesterase Inhibitors?

A

nitroglycerine

25
Q

Why is morphine given for chest discomfort?

A

It decreases pain which also decreases myocardial oxygen demand.

26
Q

What is an NSTEMI?

A

It is characterized by:

  • ST depression indicating injury; or
  • Dynamic T wave inversion
27
Q

Why is heparin given?

A

It is given as an adjunct to PCI therapy.

28
Q

What type of medication is streptokinase?

A

fibrinolytic

29
Q

Fill in the blank.

Fibrinolytic therapy should be initiated within ____ of hospital arrival time.

A

30 - 60 minutes

30
Q

List the types of strokes.

A
  • Ischemic 87%
  • Hemorrhagic 23%
31
Q

What are the signs/symptoms of stroke?

A
  • confusion
  • trouble speaking
  • sudden weakness
  • dizziness
  • trouble walking
  • severe headache
32
Q

What are the three components of the Cincinnati Stroke Scale?

A
  • facial droop
  • arm drift
  • abnormal speech

If one of these signs is identified, there is a 72% chance the patient is having a stroke.

33
Q

When should you provide oxygen to a stroke patient?

A

< 94% SPO2

34
Q

What type of medication is rTPA?

recombinant tissue plasminogen activator

A

alteplase

A clot buster used for stroke patients.

35
Q

What is the defibrillation shock dosage?

A

200j-300j-360j

36
Q

What is the rate of decline in survival chances for patients without CPR?

A

For every minute without CPR, survival chances decrease by 7-10%.

37
Q

Mechanism of action.

Amiodarone

A

It blocks sodium and potassium channels.

38
Q

What is the dosage for Lidocaine?

Cardiac arrhythmias

A
  • 1 - 1.5mg/kg bolus
  • 0.5 - 0.75mg/kg, MAX of 3mg/kg
39
Q

Indication:

Magnesium Sulfate

A

Torsades in patients with long QT interval.

40
Q

Termination of CPR

A
  • If ETCO2 <10 mmHg after 20 minutes
  • No bystander during CPR
  • No defibrillations
41
Q

What conditions are considered indicative of symptomatic unstable bradycardia?

A
  • hypotension
  • AMS
  • ischemic chest pain
  • shock
42
Q

What are the signs/symptoms of symptomatic bradycardia?

A
  • dizziness
  • weakness
  • datigue
  • light headed
  • syncope
43
Q

Indication:

Transcutaneous Pacing

A
  • hypotension
  • AMS
  • shock
  • ischemic chest discomfort
44
Q

What rhythms are commonly treated with cardioversion?

A
  • Atrial fibrillation/flutter with RVR
  • V-tachycardia
  • SVT
45
Q

Treatment

Symptomatic/Stable SVT

A
  • Vagal maneuvers
  • Adenosine
  • Amiodarone

make sure pathological

46
Q

At what point does the monitor synchronize a rhythm?

A

Highest point of the R wave.

47
Q

Treatment

symptomatic but stable A-fib with RVR

A
  • Vagal maneuvers
  • Diltiazem (Cardiazem):
    Initial dose: 0.25 mg/kg
    If needed, a subsequent dose: 0.35 mg/kg
  • Maintenance infusion: 5-15 mg/hr
48
Q

List some key components of post-cardiac arrest care.

A
  • Avoid excessive ventilation: 10 breaths/min, maintain PaCO2 at 35-40 mmHg.
  • Keep oxygen saturation >94%.
  • Consider advanced airway and capnography.
  • Treat hypotension (SBP < 90 mmHg):
    IV/IO fluid bolus (1-2 liters).
    Vasopressor infusion.
  • Address reversible causes.
  • Perform a 12-lead ECG.
  • Implement temperature management (32-36°C).
49
Q

What is the dosage for post-arrest vasopressor infusion?

A
  • Epinephrine: .1-.5 mcg/kg/min
  • Dopamine: 5-10 mcg/kg/min
50
Q

What is the dosage for epinephrine infusion in unstable bradycardia?

A

2-10 mcg/min

51
Q

What is the dosage for epinephrine infusion in persistent hypotension?

A

.1 - .5 mcg/kg/min

52
Q

What are the T’s of reversible causes for cardiac arrest?

A
  • Tension pneumothorax
  • Cardiac tamponade
  • Toxins
  • Thrombosis (coronary and pulmonary embolism)

EMT-P (2) Cardiology and Resuscitation (8 decks)

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