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PHM 703- Critical Care > ACLS > Flashcards

ACLS Flashcards

1
Q

Cardiac arrest happens when…

A

unable to generate adequate cardiac output to support oxygen demands of tissue

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2
Q

4 rhythms of cardiac arrest

A

VF, pVT, PEA, asystole

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3
Q

Which rhythms are shockable?

A

VF, pVT

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4
Q

Which rhythms are not shockable?

A

PEA, asystole

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5
Q

Survival in cardiac arrest depends on what?

A

BLS and/or ACLS

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6
Q

Only proven survival benefit

A

Good quality chest compressions and defibrillation

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7
Q

Immediate goal of cardiac arrest

A

ROSC (return of spontaneous circulation)

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8
Q

ACLS algorithm: Step 1

A

Start CPR if the patient has no pulse; give 100% O2 via a mask and hook them up to a monitor and/or defibrillator

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9
Q

ACLS algorithm: Step 2

A

After 2 minutes of CPR, determine if the rhythm is shockable

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10
Q

ACLS algorithm: Step 3a if the patient is in VF or pVT arrest

A

Shock for the first time, then do CPR for another 2 minutes
Get IV/IO access if not already done

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11
Q

ACLS algorithm: Step 4a if the patient is in VF or pVT arrest

A

Assess rhythm after 2 minutes of CPR; if it’s shockable, shock for the second time, then administer epinephrine q2-5 minutes and consider advanced airway, capnography

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12
Q

ACLS algorithm: Step 5a if the patient is in VF or pVT arrest

A

Assess rhythm again; if it’s shockable, shock for the third time, then you can administer lidocaine or amiodarone and treat underlying causes

If at any point the patient goes into PEA/asystole, don’t shock, give epinephrine and continue CPR

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13
Q

ACLS algorithm: Step 3b if the patient is in PEA or asystole

A

DO NOT SHOCK, administer epinephrine as soon as feasible (q3-5 mins) and get IV/IO access

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14
Q

ACLS algorithm: Step 4b if the patient is in PEA or asystole

A

After 2 minutes of CPR, determine if the rhythm is shockable

No: CPR x2 minutes, treat reversible causes
Yes: shock, administer epinephrine q3-5 minutes or amiodarone or lidocaine

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15
Q

Epinephrine MoA

A

Vasoactive agent: enhances organ perfusion by increasing arterial and aortic diastolic pressures resulting in increases in coronary and cerebral perfusion pressures

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16
Q

Epinephrine indications for ACLS

A

All 4 rhythms: VF, pVT, asystole, PEA

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17
Q

Epinephrine dosing

A

1mg/kg IV/IO

18
Q

Antiarrhythmics used in ACLS

A

Amiodarone, lidocaine, magnesium

19
Q

Antiarrhythmics MoA

A

Potentially normalizes abnormally depolarizing and conduction myocardial cells

20
Q

Amiodarone indications

A

VF, pulseless VT, stable VT with pulse

21
Q

Amiodarone: caution in…

A

Bradycardia and hypotension

22
Q

Amiodarone has the potential to cause what?

A

QTc prolongation

23
Q

Lidocaine indication

A

Same as amiodarone: VF, pVT, stable VT with pulse

24
Q

When is lidocaine used?

A

Alternate to amiodarone, so use if it’s not available or TdP due to minimal risk of QT prolongation

25
Q

Avoid lidocaine in…

A

History of QT prolongation and TdP

26
Q

Magnesium indications

A

VF/pulseless VT, associated with TdP

27
Q

Magnesium dosing

A

Not established, but usually a 2g IV bolus

28
Q

When to use magnesium

A

TdP; don’t use in VF/pVT with a normal QT interval

29
Q

What is possible with magnesium administration?

A

Hypotension after administration if the patient gets their pulse back

30
Q

Reversible causes: the Hs

A

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hyperkalemia
Hypothermia

Hypoglycemia

31
Q

Reversible causes: hypovolemia treatment

A

IV crystalloids

32
Q

Reversible causes: hypoxia treatment

A

100% O2 by mask

33
Q

Reversible causes: hydrogen ion treatment

A

Treat with sodium bicarb if the pH is <7.1-7.2

34
Q

Reversible causes: hyperkalemia treatment

A
  1. Calcium chloride or calcium gluconate
  2. Sodium bicarb, 10 units of regular insulin, dextrose
  3. Excretion: diuresis, kayexalate, dialysis
35
Q

Reversible causes: hypothermia treatment

A

Warm patient up

36
Q

Reversible causes: hypoglycemia

37
Q

Reversible causes: the Ts

A

Tension pneumothorax
Cardiac tamponade
Toxins
Pulmonary thrombosis
Coronary thrombosis

38
Q

Reversible causes: tension pneumothorax treatment

A

Insert a needle into the lung and let the air escape through the needle

39
Q

Reversible causes: cardiac tamponade treatment

A

Drain the fluid STAT

40
Q

Reversible causes: toxins treatment

A

Opioids: IV naloxone via IV push
Local anesthetics: lipid emulsion
TCAs: sodium bicarb

41
Q

Reversible causes: pulmonary thrombosis treatment

A

Alteplase/tenecteplase

42
Q

Reversible causes: coronary thrombosis treatment

A

Alteplase/teneceteplase

PHM 703- Critical Care (14 decks)

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