ACLS

Question 1

Initial Assessment (ABC)

Answer 1

Appearance
Breathing (work of)
Color

Question 2

Primary Assessment (ABCDE)

Answer 2

Airway
Breathing
Circulation
Disability (LoC)
Exposure (expose the pt, full HTT)

Question 3

Secondary Assessment (SAMPLE)

Answer 3

S/S
Allergies
Medications (& why?)
PMH
Last PO Intake
Events (leading up to)

Question 4

7 Megacode ROLES

Answer 4

Lead
CPR
CPR Monitor
Bag (Valve mask, Intubation, RT)
AED
Medications
Scribe/Timer

Question 5

Reversible Causes (5H5T)

Answer 5

HypoVOLEMIA
HypOXIA
Hydrogen (acidosis)
HypoKALEMIA
HypoTHERMIA
Tension Pneumo
Tamponade (Cardiac)
Toxins
Thrombosis Pulmonary
Thrombosis Coronary

Question 6

Brady Algorithm

Answer 6

HR < 50
VOMIT
If(symptomatic)
Atropine 1mg q3-5min up to 3mg
if ↑ not effective…
Transcutaneous Pacing OR…
Dopamine gtt @ 5-20 mcg/kg/min OR…
Epi gtt @ 2-10 mcg/min

Consider Expert consultation & Transvenous pacing

Question 7

Tachy (w/ pulse) Algorithm

Answer 7

HR > 159
VOMIT
if(symptomatic)
Consider sedation…
Synchronized Cardioversion OR..
Adenosine 6mg IVP, 12mg for second dose

Proocainamide @ 20-50 mg/min until WDL, then 1-4mg/min gtt (avoid if prolonged QT or CHF)
Amiodarone 150mg until WDL, then 1-4 mg/min gtt
Sotalol 100mg/5minutes (avoid if prolonged QT)

No S/S, wide QRS (>0.12)
Vagals, Adenosin, BBlocker/CaChnlBlockers

Question 8

CPR Algorithm

Answer 8

BLS (Start CPR, O2, get AED)
Shockable? Yes…
Shock
CPR
Shock
Epi 1mg q3-5min
CPR
shock
Amio 300mg 1st dose, 150mg 2nd dose

Consider reversible causes…

NOT shockable?
CPR / Epi 1mg q3–5min
Consider reversible causes

Question 9

ROSC Algorithm

Answer 9

Maintain O2/Airway
BP >90/MAP>65
Monitor (ECG)

Comatose?
Temp 32-36° (Targetted Temp Management/Induced Hypo)
CT
EEG

Then… (or if Ø comatose skip to…)
if STEMI → Cardiac Reperfusion Center
if ØSTEMI → ICU

Question 10

ROSC Meds

Answer 10

Epi or Norepi 0.1-0.5mcg/kg/min gtt
Dopa 5-10mcg/kg/min gtt
cold 4° bolus (LR or NSS) 1-2L to induce hypothermia