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ACLS > ACLS > Flashcards

ACLS Flashcards

0
Q

Actions performed for an unconscious apneic patient who you are uncertain has a pulse

A

Begin cycles of compressions and ventilations

Of 30-2

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1
Q

Advantage of using hands free defibrillation pads

A
  • Reduces transthoracic impedance, or resistance that chest structures have on electrical current
  • Reduce the risk of arching, allowing monitoring of underlying rhythm and rapid defib
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2
Q

Problem associated with delivering high concentrations of O2 during ROSC

A

Avoid complications associated with oxygen toxicity
Avoid hyperventilation may lead to adverse hemodynamic effects when intra-thoracic pressures are increased because of potential decreases in cerebral blood flow when PaCO2 decreases

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3
Q

During post cardiac arrest the lowest level required to achieve an arterial oxygen saturation of

A

> _ 94%

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4
Q

In hospital Resuscitative efforts can be terminated if

A 
Cannot identify reversible cause
Patient fails to respond to BLS and ACLS surveys 
Time from collapse to CPR 
Time from collapse to defib
Comorbid disease 
Perarrest state 
Initial arrest rhythm 
Response to resuscitative measures
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5
Q

Most reliable method of confirming and monitoring placement of Endotracheal tube

A

Continuous waveform capnography

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6
Q

What is the role of quantitative waveform in an intubated patient

A

Insures correct tube placement and monitoring
Monitors CPR quality, optimize chest compressions, and detect ROSC during compressions
Displays PETCO2 in mm of Hg on the vertical axis

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7
Q

Pharmacologic treatment for patient with stable SVT

A

6mg Adenosine rapid IV
20-50 mg of Procainamide IV
150 mg Amiodarone over 10 min
100mg Sotalol IV over 5 min

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8
Q

Significance of a PETCO2 level of 8 mmHg

A
  • Need to improve CPR if less than 10

- In intubated patient it suggests that ROSC is unlikely normal value is 35-40

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9
Q

What is the desired post cardiac arrest PETCO2 range for a patient is ROSC

A

35-40 mmHg

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10
Q

What is the second dose of adenosine for a patient in refractory, but stable narrow complex tachycardia

A

12mg rapid IV push

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11
Q

Best strategy for performing high quality CPR on a patient with advanced airway

A

8-10 breaths per minute with continuous chest compressions

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12
Q

An organized rhythm without a pulse is defined as

A

PEA

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13
Q

PEA rhythms can include

A

IVR
Ventricular escape
Post defib IVR
Sinus rhythm

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14
Q

Rhythms which require synchronized cardioversion

A

Unstable SVT
Unstable atrial fib
Unstable atrial flutter
Unstable regular monomorphic tachycardia with pulses

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15
Q

Desired minimum systolic blood pressure in hypotensive post-cardiac arrest who has ROSC

A

> 90 mm Hg

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16
Q

Emergency departments priority for a patient with a positive prehospital stroke assessment

A

Door (appropriate triage to stroke center)
Data (rapid triage, evaluation, and management with ED)
Decision (stroke expertise and therapy selection)
Drug (fibrinolytic therapy, intra-arterial strategies)
Disposition (rapid admission to the stroke unit)

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17
Q

Out of hospital resuscitative efforts can be terminated when

A

Restoration of effective, spontaneous circulation and ventilation
Transfer of care to senior medical
Presence of reliable criteria indicating irreversible death
Unable to continue due to exhaustion or dangerous environment
Valid DNR
Online authorization from medical control

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18
Q

Identify the condition which is contraindication to hypothermia during the post cardiac arrest period for patient with ROSC

A

Patient must be responsive/conscious

19
Q

Continued electrical rhythmicity of the heart in the absence of mechanical function

A

PEA

20
Q

The actions in which increase the chance of successful conversion of ventricular fibrillation

A

Restoring a perfusing rhythm is optimized with early defibrillation and CPR

21
Q

Treatment for patient for a patient with unstable wide complex tachycardia

A 
Treat as V tachycardia until proven other
Synchronized cardioversion 100 J 
CPR 5 cycles 
1mg Epinephrine 
Analyze rhythm if same 
Cardioversion at 150 J
22
Q

Actions of high quality chest compressions

A 
Compress chest hard and fast  >100 per min
Allow complete chest recoil 
Minimize interruptions 10sec or less 
Switch providers every 2minutes 
Avoid excessive ventilation
23
Q

List common mistakes in cardiac arrest management

A

Stopping CPR for more than 10sec
Over ventilation
Fatigue
Inadequate depth and rate

24
Q

Treatment for PEA

A 
CPR 
O2
Epinephrine 
Advanced airway 
Treat reversible causes
25
Q

What do you do when AED doesn’t analyze heart rhythm

A

Resume compressions and ventilations

Check all connections between AED and patient

26
Q

Identify second degree type 1 heart block

A

The electrical signals are delayed more and more with each heart beat until the heart skips a beat

27
Q

Identify treatment for a patient in unstable second degree type 1 heart block

A

Atropine .5 mg
Transcutaneous pacing
Dopamine infusion 2-10 mcg/kg/min
Epinephrine infusion 2-10 mcg/min

28
Q

Describe procedure for endotracheal tube suctioning

A

Use sterile technique to reduce contamination
Insert catheter into ET tube
Not deeper than the end of the ET tube
Apply suctioning by occluding the side opening only while withdrawing catheter with rotating motion
Suction attempts to not exceed 10sec

29
Q

What is the preferred method of medication delivery during cardiac arrest

A

IV/IO

30
Q

When a 12 lead EKG should be obtained for a patient with acute coronary syndrome

A

As soon as possible when signs and symptoms suggest ischemia or infarction
Analyze rhythm within 10 minutes of arrival of ED

31
Q

Initial BLS treatment for patient in cardiac arrest

A 
Tap shout are you alright 
Analyze breathing
Activate emergency response get AED 
Check pulse 
CPR 
Check for shockable rhythm 
Defibrillate
32
Q

Treatment for patient with unstable bradycardia

A

0.5 mg Atropine
Transcutaneous pacing
Dopamine infusion 2-10mcg/kg/min
Epinephrine infusion 2-10 mcg/min

33
Q

Recommended action to help minimize interruptions in chest compressions during CPR

A

The team leader assigns roles and responsibilities and organizes interventions to minimize interruptions in chest compressions

34
Q

What to do if a hospital does not have a CT scan available for the stroke patient you’re transporting

A

Stabilize and promptly transfer the patient to a facility with CT capability
Do not give aspirin, heparin, or rtPA until ruled out hemorrhage

35
Q

Treatment for a patient with stable SVT

A 
IV
12 lead
Vagal maneuvers 
Adenosine 6mg 
Beta blocker or calcium channel blocker 
Consider expert consultation
36
Q

List components of BLS survey

A 
Check responsiveness 
Activate EMS 
Get AED
Circulation 
Defibrillation
37
Q

Pharmacologic agents/doses for patient in refractory V Fib

A

1mg epinephrine 3-5 min
300mg Amiodarone
40 U vasopressin

38
Q

Appropriate interval for interrupting chest compressions during CPR

A

No more than 10 sec during defib
Advanced airway
Only in dangerous environments is more than 10 acceptable

39
Q

Identify the lab values consistent with effective CPR

A

-End-tidal CO2 (PETCO2 35-40)

<30 improve compressions

40
Q

Action that improves the quality of chest compressions

A 
Compress chest hard and fast
Allow complete recoil
Minimize interruptions 
Switch providers 
Avoid excessive ventilation 
Monitor CPR on quantitative capnography
41
Q

Primary purpose of medical emergency team or rapid response team

A

Improve patient outcomes by identifying and treating early clinical deterioration

42
Q

Appropriate ventilation strategy for patient in respiratory arrest with a pulse

A

1 breath every 5-6 seconds (10-12 per min) check pulse every 2min

43
Q

Pharmacologic treatment for patient in unstable bradycardia

A 
0.5 Atropine 
Transcutaneous pacing 
Dopamine infusion 2-10 mcg/kg/min 
Epinephrine 2-10 mcg/min 
Expert consultation
44
Q

Dopamine dose for unstable bradycardia

A

2-10 mcg/kg/min

45
Q

Treatment for patient with suspected stroke if no hemorrhage

A

may be candidate for
Fibrinolytic therapy
not candidate for therapy
Administer aspirin

46
Q

Drugs for non hemorrhage stroke

A

Fibrinolytic therapy
rtPA
Aspirin

ACLS (2 decks)

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