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ACLS - Tess's Notes > ACLS > Flashcards

ACLS Flashcards

1
Q

what 2 things are proven to improve survival rate/keep neuro intact

A

chest compressions

early defib

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2
Q

epi dosing

A

1 mg q 3-5 min

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3
Q

chest compressions should be given at a rate of __

at a depth of at least __

A

100-120/min

2 in

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4
Q

what is CCF

A

chest compression fraction = time compressing / overall time

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5
Q

minimum CCF for good quality compressions

A

80%

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6
Q

primary survey consists of

A

Airway

Breathing

Circulation

Disability (neuro)

Exposure/Environmental

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7
Q

circulation in the primary survey includes (2)

A

IV/IO

12 lead EKG

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8
Q

secondary survey includes

A

s/sx

allergies

meds

pmh

last PO

events surrounding

h’s

t’s

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9
Q

what are the h’s

A

hypovolemia

hypoxia

H+ (acidosis)

hyper/hypokalemia

hypothermia

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10
Q

what are the t’s

A

tension pneumo

tamponade

thrombosis → PE/ACS

toxins

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11
Q

goal for O2 if hypoxia w. no cardiac/neuro involvement

A

94-99%

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12
Q

goal for O2 if there is cardiac/neuro involvement

A

90-99%

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13
Q

loss of vascular tone w. cardiac arrest

A

hypovolemia

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14
Q

tx for hypovolemia

A

fluid

pressors → epi

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15
Q

tx for hypothermia (3)

A

cover pt

give warm IVF

turn up thermostat

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16
Q

fastest way to assess for hypo/hyperkalemia

A

EKG:

hyper → peaked T waves

hypo → depressed/inverted T waves

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17
Q

nl range for pH

A

7.35-7.45

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18
Q

most important aspect of treating slightly acidodic pt (ex pH 7.2)

A

ventilation

bicarb ok but will lead to acidosis if not properly venitlated

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19
Q

tx for toxins

A

epi

O2

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20
Q

pneumothorax that causes decreased cardiac output

A

tension pneumo

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21
Q

2 signs of tension pneumo

A

absent lung sounds

decreased BP

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22
Q

becks triad makes you think of

A

tamponade

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23
Q

what is beck’s triad

A

jvd

decreased pulse pressure

muffled heart sounds

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24
Q

electrical alternans on EKG makes you think of

A

tamponade

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25
Q

tx for tamponade (2)

A

pericardiocentesis

lots of fluids

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26
Q

describe pain w. PE

A

pleuritic CP

sharp/pinpoint

does not radiate

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27
Q

describe MI pain

A

crushing

generalized

radiates

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28
Q

decreased perfusion that does not respond to ventilation makes you think of

A

PE

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29
Q

tx for PE

A

anticoag → heparin

thrombolytics → TPA

tons of O2

fluid

PEEP

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30
Q

tx for MI

A

O2 → goal 90-00%

non enteric coated ASA (4 baby ASA)

nitro

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31
Q

med proven to help MI outcomes

A

non enteric coated ASA

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32
Q

3 ASA contraindications

A

true allergy

recent hemorrhagic stroke

active GIB

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33
Q

3 nitro contraindications

A

PDE-5 → viagra

r inferior MI

hypotn

34
Q

when should nitro be given

A

after IV access is established

35
Q

drugs for ACS

A

morphine (fentanyl is better)

o2

nitro

asa

36
Q

door to balloon time

A

90 min

37
Q

door to needle time

A

30 min

38
Q

2 places FDA approved for IO

A

proximal/distal tibia

humeral head

39
Q

benefit of humoral head IO

A

can get 6L/hr vs 1L/hr w. tibia

40
Q

2 indications for IO

A

cardiac arrest

shock (hypovolemia)

41
Q

4 contraindications for IO

A

active infxn

broken bone

any titanium

IO in that area in the last 72 hr

42
Q

what does FAST stand for

A

facial droop

arm drift

speech

time last seen normal

43
Q

optimal time for stoke outcome

A

< 3 hr

44
Q

what does PEA stand for

A

pulseless electrical activity

45
Q

tx for pea

A

push hard and fast

epi

all h & t

46
Q

2 mc h’s

A

hypoxia

hypovolemia

47
Q

can atropine treat high grade heart blocks

A

no!

48
Q

3 causes of high grade heart blocks

A

meds

SSS

heart transplant

49
Q

how do you know when trans pacing is working

A

all pacer spikes will be followed by QRS

50
Q

can adenosine treat aflutter/afib/wpw

A

no!

51
Q

what should you do post trans pacing

A

check for pulse

52
Q

5 sx that indicate unstable pt

A

cp

hypotn

ams

sob

s/s shock

53
Q

tx for unstable brady

A

atropine

pace

epi/dopamine

consider h’s and t’s

54
Q

tachy w. pulse →

adult:

child:

infant:

A

adult: >150
child: >180
infant: > 220

55
Q

tx for stable wide tachy

A

expert opinion

56
Q

tx for unstable wide tachy

A

synchronized cardiovert

57
Q

tx for stable narrow tachy

A

vagal

adenosine

expert opinion

58
Q

when should rescue breathes be given

A

1 breath q 6 sec

59
Q

3 steps if you find unconscious pt

A

check responsiveness

activate ERS/get defibrillator

check breathing/pulse

60
Q

if unresponsive pt does not have a pulse you should

A

give 1 breath q 6 seconds

61
Q

what should you do if an unresponsive pt has no pulse

A

start CPR

check rhythm/shock if indicated

62
Q

how often should rhythm be checked/shock administered

A

q 2 min

63
Q

4 steps for acute stroke management

A

obtain vitals/ABC intervention

interview witnesses

exam and prehospital stroke screen

obtain POC glucos

64
Q

6 initial steps for brady arrhythmias (<50)

A

maintain airway/assist w. breathing

O2 if hypoxemic

cardiac monitor: rhythm, bp, oximetry

IV access

12 lead EKG

consider h’s and t’s

65
Q

first line drug for brady arrhythmias

A

atropine

66
Q

second line drugs for brady arrhythmias

A

dopamine

epi

67
Q

causes of brady arrhythmias

A

MI

toxins

hypoxia

hyperkalemia

68
Q

3 meds that can cause brady arrhythmias

A

CCB

BB

dig

69
Q

5 steps in management of tachy arrhythmias

A

maintain airway/breathing assist

O2 if hypoxemic

cardiac monitor → rhythm, bp, oximetry

IV access

12 lead EKG

70
Q

tx for narrow tachy arrhythmias

A

vagal maneuvers

adenosine

bb/ccb

expert opinion

71
Q

tx for wide tachy arrhythmias

A

adenosine

antiarrhythmics

expert opinion

72
Q

tx if ventricular rate >150/min w. s/sx

A

immediate cardioversion

73
Q

what are the 2 shockable rhythms

A

VF

pVT

74
Q

tx for shockable rhythms (VF/pVT)

A

cpr x 2 min/O2/monitor

shock

cpr x 2 min/IV or IO access

epi q 3-5 min

shock

cpr x 2 min/epi

amiodarone vs lidocaine

75
Q

2 unshockable arrhythmias

A

asystole

PEA

76
Q

tx for PEA/asystole

A

epi asap

cpr x 2 min

IV/IO access

+/- airway w. capnography

77
Q

tx if asystole/PEA persist and there is no sign of return of spontaneous circulation (ROSC)

A

continue CPR /epi

78
Q

tx when ROSC occurs → post-cardiac arrest care

A

monitor bp and O2/pulse

advanced airway → endotracheal tube

manage respiratory parameters

manage hemodynamic parameters

12 lead EKG

79
Q

hemodynamic parameter goals

A

sbp > 90

MAP > 65

80
Q

respiratory parameters

A

SpO2 92-98%

PaCO2 34-45 mmHg

ACLS - Tess's Notes (1 decks)

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