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Hospital > ACLS > Flashcards

ACLS Flashcards

1
Q

What are the ACLS H’s and T’s?

A
  1. Hypovolemia
  2. Hypoxia
  3. Hydrogen ion (acidosis)
  4. Hypo/hyperkalemia
  5. Hypothermia
  6. Tension pneumothorax
  7. Tamponade, cardiac
  8. Toxins
  9. Thrombosis, pulmonary
  10. Thrombosis, coronary
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2
Q

What is the dosing and frequency for atropine in symptomatic bradycardia?

A

0.5 mg bolus q3-5 min. Max: 3 mg

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3
Q

What is the dosing for adenosine?

A

First dose: 6 mg IV rapid push followed by NS flush. Second dose: 12 mg if required.

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4
Q

What is the dosing and frequency for epinephrine?

A

1 mg IV/IO q3-5 min

(q4 min is easiest: for asystole/PEA just give epi every other round of CPR)

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5
Q

What is the rate of rescue breaths WITH an advanced airway in place?

A

1 breath q6 seconds

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6
Q

What is the rate of rescue breaths WITHOUT an advanced airway in place?

A

2 breaths every 30 compressions

(2 breaths q15 seconds)

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7
Q

What are the 7 absolute contraindications to fibrinolytic therapy for STEMI?

A
  1. Prior intracranial hemorrhage
  2. Known structure cerebral vascular lesion
  3. Known malignant intracranial neoplasm
  4. Ischemic stroke within 3 months (except 3 hours)
  5. Suspected aortic dissection
  6. Active bleeding or bleeding diathesis
  7. Significant closed head trauma or facial trauma within 3 months
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8
Q

What is the goal time for PCI?

A

90 minutes

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9
Q

What is the goal time for fibrinolysis?

A

30 minutes

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10
Q

How long do you hold anticoagulants/anti-platelets after tPA?

A

24-48 hours

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11
Q

What is the dosing of tPA (alteplase) for suspected PE induced cardiac arrest?

A

50 mg IV bolus over 2 min and continue CPR. After 15 min, if no ROSC, repeat 50 mg IV bolus.

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12
Q

What is the dosing of tPA (alteplase) for PE with suspected, impending cardiac arrest?

A

50 mg IV bolus over 2 min, then 50 mg IV over 2 hours.

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13
Q

What is the dosing of tPA (alteplase) for STEMI?

A

> 67 kg: Infuse 15 mg IV bolus over 1 to 2 minutes, followed by infusions of 50 mg over 30 minutes, then 35 mg over 1 hour; maximum total dose: 100 mg.

<67 kg: Infuse 15 mg IV bolus over 1 to 2 minutes, followed by infusions of 0.75 mg/kg (not to exceed 50 mg) over 30 minutes, then 0.5 mg/kg (not to exceed 35 mg) over 1 hour; maximum total dose: 100 mg.

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14
Q

What is the dosing of tPA (alteplase) for acute ischemic stroke?

A

0.9 mg/kg (maximum total dose: 90 mg).

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15
Q

How long do you have to administer tPA for acute ischemic stroke?

A

4.5 hours

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16
Q

What is refractory VF/pVT?

A

persistent VF/pVT despite at least one shock

17
Q

What are some therapies that you can do during a code that will treat potential H’s and T’s empirically?

A

1g calcium gluconate (5 min)
1 amp bicarb (5 min)
1L NS bolus (30 min)

18
Q

What are the first and second bolus doses of amiodarone during ACLS?

What is the dosing for starting an amiodarone infusion?

A

300 mg then 150 mg

150 mg then 1 mg/min for six hours

19
Q

What is the shock energy for biphasic defibrillation?

A

200 J

20
Q

Without an advanced airway in place, do you pause compressions to give rescue breaths?

A

Yes, two breaths every thirty compressions

21
Q

What do you need to order after ACLS?

A
  1. CBC
  2. CMP
  3. PT, PTT, INR
  4. Lactate
  5. Troponin
  6. BNP
  7. EKG
  8. CXR
  9. CT Head, CTA chest, +/- EEG
  10. TTM if newly unresponsive off sedation
22
Q

Treatment for unstable bradycardia with a pulse?

A

First line: atropine

Second line: dopamine or epinephrine infusions (target heart rate 60-80)

Third line: transvenous pacing, cardiology consultation

23
Q

Treatment for any unstable tachycardia?

A

Synchronized cardioversion

Narrow regular: 100 J (consider adenosine)

Narrow irregular: 200 J

Wide regular: 100 J

Defibrillate

Wide irregular: 200 J

24
Q

Treatment for a stable wide complex tachycardia?

A
  1. Adenosine if regular, monomorphic
  2. Amiodarone infusion
25
Q

Treatment for a stable narrow complex tachycardia?

A
  1. Vagal maneuvers
  2. Adenosine (if regular)
  3. Beta blocker
  4. Calcium channel blocker
26
Q

What is the treatment for asystole?

A

CPR
1 mg epi q3-5 min

27
Q

What is the treatment for PEA?

A

CPR
1 mg epi q3-5 min

28
Q

What do you do after seeing sinus rhythm on the monitor during ACLS?

A

Check for a pulse

(PEA vs. sinus rhythm)

29
Q

What do you need after identifying a stroke?

A
  1. Establish last known normal
  2. Check glucose
  3. Stat CT head w/o CTA head/neck
  4. NIH score
  5. EKG
30
Q

If one of these three is present, chance of a stroke is 72%

A

Facial droop
Arm drift
Abnormal speech

31
Q

BP goal during stroke if no tPA?

BP goal during stroke if given tPA?

A

no tPA: 220/120

tPA: 180/110

Hospital (56 decks)

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