Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BLS/ACLS > ACLS > Flashcards

ACLS Flashcards

1
Q

When should the primary assessment occur before the BLS assessment?

A

If the pt is conscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How should you maintain an open airway in an unconscious patient?

A
  • Head tilt-chin lift
  • oropharyngeal/nasopharyngeal airway
  • Advanced airway management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the types of advanced airway management?

A
  • Laryngeal mask airway
  • Laryngeal tube
  • Endotracheal tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should you confirm when using advanced airway management?

A
  • Proper integration of CPR and ventilation
  • Confirm proper placement
  • Secure the airway
  • Monitor airway placement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the best way to confirm/monitor airway placement?

A

Continuous waveform capnography

Note: Physical exam should be complimentary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What % supplemental oxygen should be used in pts with cardiac arrest?

A

100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What % supplemental oxygen should be used in pts undergoing a primary assessment and not in cardiac arrest?

A

Adjust oxygen level to achieve O2 saturation of 95% to 98%

Note: In acute coronary syndrome you should target an O2 saturation of 90%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How should you monitor adequacy of ventilation?

A
  • Physical exam (look for chest rise and cyanosis)
  • Quantitative waveform capnography
  • Oxygen saturation

Note: Avoid excessive ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What value indicates adequate CPR quality when using quantitative waveform capnography?

A

10 mm Hg CO2 (at end expiration)

Note: If less than 10 mm Hg, attempt to improve CPR quality (rare to get ROSC in this situation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

While performing CPR, the end expiration CO2 rapidly increases to more than 25 mm Hg…

A

This may indicate ROSC (check for consciousness/pulse at next pulse check)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should the intra-arterial diastolic pressure be during adequate quality CPR?

A

20 mm Hg or more

Note: If less than 20 mm Hg, attempt to improve CPR quality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the components of the primary assessment?

A
  • Airway
  • Breathing
  • Circulation
  • Disability (consciousness, pupil dilation)
  • Exposure (trauma, bleeding, burns, medical alert bracelets)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the primary assessment levels of consciousness?

A

AVPU:

  • Alert
  • Voice
  • Pain
  • Unresponsive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A

1st degree heart block

Note: PR interval is greater than 0.2 seconds (1 big box).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

2nd degree AV block (type 1), AKA Wenkebach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

2nd degree AV block (type 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
A

2:1 block (a subtype of 2nd degree type 2 AV block where every other QRS complex is dropped)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
A

3rd degree AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for stable bradycardia

A
  • Identify and treat underlying cause
  • Monitor and observe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

First line treatment for unstable bradycardia

A

Atropine (1 mg bolus, repeated as needed every 3-5 min to a max of 3 mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Second line treatment for unstable bradycardia

A
  • Transcutaneous pacing
  • Dopamine infusion
  • Epinephrine infusion

Note: Consider expert consultation and/or transvenous pacing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When should bradycardia be considered unstable?

A
  • Hypotension
  • Acutely altered mental status
  • Signs of shock
  • Ischemic chest discomfort
  • Acute heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the adult dopamine dose for unstable bradycardia?

A

5-20 mcg/kg dopamine per minute (titrated to pt response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the adult epinephrine dose for unstable bradycardia?

A

2-10 mcg epinephrine per minute (titrated to pt response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Common causes of unstable bradycardia
- Myocardial ischemia/infarction - Drugs - Hypoxia - Electrolyte abnormalities
26
What drug overdoses should you think about in the setting of unstable bradycardia?
- Calcium-channel blockers - Beta blockers - Digoxin
27
What are examples of calcium channel blockers?
- Amlodipine/nifedipine - Diltiazem - Verapamil
28
What electrolyte abnormality should you think about in the setting of unstable bradycardia?
Hyperkalemia
29
Sinus tachycardia (100-150 bpm)
30
Supraventricular tachycardia (narrow complex and >150 bpm)
31
Wide complex tachycardia (monomorphic V tach)
32
Wide complex tachycardia (monomorphic V-tach)
33
Irregular wide complex tachycardia (polymorphic V-tach)
34
When should tachycardia be considered unstable?
- Hypotension - Acutely altered mental status - Signs of shock - Ischemic chest discomfort - Acute heart failure
35
Treatment for unstable tachyarrhythmia
Synchronized cardioversion Note: If regular, narrow complex, can consider adenosine.
36
If persistent unstable tachyarrhythmia following synchronized cardioversion, whats the next step
- Continue looking for underlying cause - Increase energy level for next cardioversion - Consider adding an anti-arrhythmic drug - Consider expert consultation
37
What is considered a widened QRS complex?
0.12 seconds or greater
38
Treatments to consider for stable wide complex tachyarrhythmia
- Adenosine (ONLY if regular and monomorphic) - Antiarrhythmic infusion - Expert consultation
39
Treatment for stable narrow complex tachyarrhythmia
- Vagal maneuvers (if regular) - Adenosine (if regular) - Beta blocker or calcium-channel blocker - Expert consultation
40
Adult adenosine dose for tachyarrhythmia
6 mg rapid IV push (followed by a normal saline flush) followed by 12 mg IV push + flush (if needed)
41
What are the common antiarrhythmic infusions used for stable wide-QRS complex tachycardia?
- Procainamide - Amiodarone - Sotalol
42
Adult procainamide dose for stable wide-QRS tachycardia
20-50 mg per minute until endpoint is reached then 1-4 mg per minute maintenance
43
What is the maximum dose of procainamide for stable tachyarrhythmia?
17 mg/kg
44
What are the endpoints for procainamide when you should switch to maintenance infusion?
- Hypotension ensues - QRS duration increases by 50% or more - Maximum dose given (17 mg/kg)
45
When should procainamide be avoided?
- Prolonged QT - CHF
46
Adult amiodarone dose for stable wide-QRS tachyarrhythmia
150 mg over 10 minutes (repeated as needed if V-tach recurs) then 1 mg per minute maintenance (for the first 6 hours)
47
Adult sotolol dose for stable wide-QRS tachyarrhythmia
100 mg over 5 minutes
48
When should sotalol be avoided?
Prolonged QT
49
What are the shockable rhythms?
- Ventricular fibrillation - Monomorphic V-tach
50
What are the non-shockable rhythms in the setting of cardiac arrest?
- PEA (pulseless electrical activity) - Asystole
51
Ventricular fibrillation
52
Asystole
53
How far should each compression depress the sternum?
At least 2 inches (5 cm)
54
How frequently should compressors switch?
Every 2 minutes (or sooner, if fatigued)
55
What should the compression:ventilation ratio be during CPR?
30:2 (no advanced airway) Note: 1 breath every 6 seconds if there is an advanced airway (with continuous compressions).
56
What charge strength should the defibrillator adminster?
120-200 J (if biphasic) 360 J (if monophasic)
57
What drugs are routinely administered during ACLS?
- Epinephrine - Amiodarone - Lidocaine
58
Adult epinephrine dose during CPR
1 mg (every 3-5 minutes)
59
Adult amiodarone dose during CPR
300 mg (first dose) then 150 mg (second dose)
60
Adult lidocaine dose during CPR
1-1.5 mg/kg (first dose) then 0.5-0.75 mg/kg (second dose)
61
CPR algorithm for shockable rhythm
1. Start 30:2 CPR 2. Shock as soon as possible 3. CPR (2 min) 4. Shock again (if shockable) 5. Administer epinephrine during next 2 min CPR 6. Shock again (if shockable) 7. Administer amiodarone or lidocaine during next 2 min CPR Note: Repeat steps 4-7 (stop meds when maximum doses reached).
62
Reversible causes for cardiac arrest
- Hypovolemia - Hypoxia - Hydrogen ion (acidosis) - Hypokalemia or hyperkalemia - Hypothermia - Tension pneumothorax - Tamponade, cardiac - Toxins - Thrombosis, pulmonary - Thrombosis, coronary
63
CPR algorithm for nonshockable rhythm
1. Start 30:2 CPR 2. Apply pads as soon as available and check rhythm 3. Administer epinephrine immediately (if not shockable) and do 2 more min CPR
64
What are the components of the initial stabilization phase after ROSC is achieved?
- Manage airway - Manage respiratory parameters - Manage hemodynamic parameters - Get 12-lead ECG
65
How should you manage the airway after ROSC?
Early placement of an endotracheal tube is recommended
66
How should you manage respiratory parameters after ROSC?
- Increase breaths to 10 breaths per minute - Target SpO2 of 92-98% - Target PaCO2 of 35-45 mm Hg
67
How should you manage hemodynamic parameters after ROSC?
- Target systolic BP > 90 mm Hg - Target mean arterial pressure > 65 mm Hg
68
When should you consider emergent cardiac intervention after ROSC?
- STEMI - Unstable cardiogenic shock - Pt requiring mechanical circulatory support
69
Targeted temperature management
Cooling pts to 32-36 degrees celsius for 24 hours after ROSC to preserve brain function
70
What are the main components of continued management following ROSC for pts that are unable to follow commands?
- Targeted temperature management - Head CT - EEG monitoring

BLS/ACLS (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions