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Assessment Test 1 > ACLS > Flashcards

ACLS Flashcards

1
Q

The best indicator that a patient has stopped perfusing is to check _____ because they do not have to have a ______ to have cardiac arrest

A

Pulses
Bad rhythm

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2
Q

What will be the first indicator your pt is arresting?

A

End tidal CO2

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3
Q

ACLS algorithm

A
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4
Q

First vital sign to get after a code?

A

BP

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5
Q

What can you use an ultrasound for post arrest?

A

To see if the heart is squeezing or if an artery is pulsing

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6
Q

Who is someone you can ask to do CPR during surgery?

A

The surgeon!

We have to delegate compressions/ventilations to lead the code

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7
Q

What rhythms do we shock?

A

Vfib
Pulseless vtach

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8
Q

Treatment for stable vs unstable SVT

A

Stable: adenosine
Unstable: Cardiovert

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9
Q

If you have biphasic equipment, how many joules do you start with to defibrillate?

A

200 J

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10
Q

If you have monophasic equipment, how many joules do you start with to defibrillate?

A

360 J

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11
Q

After defibrillation, what should you immediately do?

A

Restart CPR

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12
Q

After a pulse check, normal etCO2 could be due to:

A

Amazing compressions
Return of perfusion

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13
Q

What is an alternative route to give meds if you didn’t have an IV? What meds can you give this way?

A

ET tube
Lido, epi, narcan, atropine (LEAN)

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14
Q

First med we give for pulseless rhythm?

A

Epi 1 mg

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15
Q

How often do you repeat Epi 1mg during ACLS?

A

3-5 minutes

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16
Q

After epi, what would your next medication be for ventricular arrhythmias?

A

Lido or amio

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17
Q

What is the dose for amio during ACLS?

A

300 mg initally
Second dose: 150 mg

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18
Q

What is the dose for lido during ACLS?

A

1-1.5 mg/kg

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19
Q

What are the H&Ts?

A

Hypoxia
Hypovolemia
Hypothermic
Hydrogen ions (acidosis)
Hyper/hypokalemia
Toxins
Tamponade (cardiac)
Tension pneumo
Thrombosis

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20
Q

What are the 2 most common causes of cardiac arrest?

A

Hypoxia and hypovolemia

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21
Q

If pt is hypovolemic, how do you treat?

A

Crystalloids
Blood

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22
Q

How do you treat acidosis?

A

Bicarb
Good (hyper)ventilation
Replace volume

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23
Q

What are the 2 common rhythms in someone who is hypothermic?

A

Bradycardia or vfib

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24
Q

How to treat hyperkalemia?

A

Stabilize cells (calcium)
Insulin/D50
Bicarb
Volume
Albuterol
HD if needed

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25
Q

How do treat tension pneumothorax?

A

Needle decompression
Chest tube

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26
Q

We will see JVD in tension pneumo due to:

A

Increased thoracic pressure

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27
Q

What is beck’s triad? What do we see this in?

A

Tamponade

Hypotension, JVD, narrowed pulse pressure

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28
Q

What are potential different toxins? How do you treat each?

A

Opiods: narcan; focus on ventilation

Tylenol: hard to treat, kills liver

Benzos: flumazenil

Beta blockers: usually accidental
- glucagon: 3-5mg
- If unstable, may need to pace

Psych meds
- tricyclics: causes acidosis and messes up heart
- treat with bicarb

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29
Q

How do treat PE or cardiac thrombosis?

A

Systemic anti-thrombotic (tPA)
IR (thombectomy)
Catheter directed therapy for localized tPA

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30
Q

Asystole/PEA causes:

A

Hypoxemia: get an airway
Hypovolemia: replace volume

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31
Q

What 2 rhythms have a worse prognosis?

A

Asystole
PEA

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32
Q

Bradycardia algorithm

33
Q

Basic treatment for bradycardia

A

If unstable: start with electrical therapy

If no access to electrical therapy, start with epi gtt; if no epi, use dopamine

34
Q

What is considered as unstable bradycardia?

A

Hypotensive
Decreased LOC

35
Q

What is the dose for an epi gtt?

A

2-10 mcg/min

36
Q

What is the dose for a dopamine gtt?

A

5-20 mcg/kg/min (more like 10-20)

37
Q

Adult tachycardia with a pulse algorithm

38
Q

If you have unstable tachycardia, what is the first treatment?

A

Cardioversion

39
Q

What is the electricity dose for cardioversion?

40
Q

If you have stable and narrow QRS tachycardia, what is the treatment?

A

Adenosine 6 mg

41
Q

What medications can you use for narrow AND wide QRS tachycardia?

A

Amio
Cardizem

42
Q

If you have stable and wide QRS tachycardia, what is the treatment?

A

Lidocaine: 150 mg over 10 min

43
Q

Lido gtt dosing

44
Q

Amio gtt dosing

A

1 mg/min for 6 hours
0.5 mg/min after

45
Q

How to preform vagal stimulation? In kids?

A

Rub on carotid
“bear down”

In kids, put ice on their face

46
Q

What is the risk with vagal stimulation?

A

If they are at risk for plaque, it could break a clot off

47
Q

Pediatric ACLS algorithm

48
Q

What is usually the number one cause of arrest in pediatrics?

What is one exception?

A

Respiratory complications

Unknown heart issues

49
Q

What is different with pediatric dosing from adult dosing?

A

You have to adjust your doses based on weight

50
Q

What are common vfib/vtach causes in kids?

A

Underlying cardiac issue
Electrocution

51
Q

Pediatric dosing of atropine

A

0.02 mg/kg

52
Q

Pediatric dosing of epi

A

0.01 mg/kg

53
Q

Causes of cardiac arrest in kids:

A

Accidental OD
Drowning
Trauma
Choking
“Pill parties” in HS students

54
Q

Pediatric defibrillation is ______ based

55
Q

What is the defibrillation pad placement in kids?

A

Anterior and posterior

56
Q

Pediatric bradycardia algorithm

57
Q

Pediatric bradycardia is usually caused by:

58
Q

In kids, if the heart rate is less than 60, what do you do?

A

Start compressions

59
Q

What is the initial treatment for unstable bradycardia in kids?

60
Q

What other meds can you use for unstable bradycardia in kids?

A

Atropine
Glycopyrrolate (onset 10 min)
Atropine (onset 30 sec - 1 min)

61
Q

What medication that we use in OR has bradycardia has a side effect in kids?

A

Succs

*Have atropine available

62
Q

If you give TOO low of a dose of atropine in adults, what can this cause?

A

Reflex bradycardia

63
Q

Pediatric tachycardia algorithm

64
Q

A normal “cut off” for HR in a 2-8 yr old would be:

65
Q

A normal “cut off” in a child <2 for HR would be:

66
Q

Biggest cause of tachycardia in kids:

A

Volume depletion
Elevated temp

67
Q

Treatment for pediatric tachycardia is more directed at:

A

Treating the underlying issue

68
Q

It is _____ to have to cardiovert a pediatric patient

69
Q

Neonatal resuscitation algorithm

70
Q

Common causes of neonatal arrest:

A

From C-section with complications to baby
Airway issues

71
Q

Post C-section, it’s important to keep baby ___ and ____

72
Q

What 3 questions do we ask if we suspect neonatal code?

A

Are they breathing?
Are they gasping?
What is the HR?

73
Q

One way to stimulate newborn:

A

Push nail bed onto the heal

74
Q

If the heart rate is less than ____ in a newborn, start ventilation

75
Q

What 2 things (if done appropriately) are enough to bring a newborn back if HR <100?

A

Ventilation
Good suction

76
Q

If a newborn HR is <60, what do you do?

77
Q

What is something that can cause volume depletion in babies immediately after birth?

A

If baby is still connected to mom via umbilical cord, and you pick baby up

Volume will leave baby and go to mom!

78
Q

Cardiac arrest in pregnancy algorithm

79
Q

Causes of cardiac arrest in pregnant women?

A

Trauma
Thrombotic events

Assessment Test 1 (6 decks)

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