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ER > ACLS > Flashcards

ACLS Flashcards

0
Q

How many compressions per minute should be being provided?

A

100-120

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1
Q

What is the first step for V fib?

A

Shock

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2
Q

When should ventilation be started in V fib protocol?

A

After the second shock and during the second round of chest compressions

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3
Q

When is cardiac epi given in the v fib protocol?

A

After the second shock

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4
Q

What is the dosage of cardiac epi?

A

10 cc of 1:10,000

Each cc has 100 mcg

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5
Q

What drug is given after epi and how much?

A

300 mg of amiodarone

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6
Q

What must you do after giving amiodarone?

A

Flush the line - amiodarone eats veins!

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7
Q

What is the next med and dose given after the first dose of amiodarone?

A

150 mg of amiodarone

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8
Q

What can be given after amiodarone?

A

Lidocaine (100) or magnesium (1-2 grams over 60 minutes)

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9
Q

What is the maintenance dose of magnesium?

A

0.5-1 gram q hour

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10
Q

What is the first step in the treatment of anaphylaxis?

A

0.3 mg epi IM

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11
Q

What are the subsequent steps of treating anaphylaxis?

A

Steroids
Benadryl
H2 blockers
Fluids

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12
Q

What is the IV drip formula for epi in a patient in anaphylactic shock?

A

1 liter of normal saline + 1 amp or 1 mg of epi hooked into a fast running bag at 1 cc/min increasing by 1 cc every minute

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13
Q

What is PSVT?

A

Narrow, 180, regular

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14
Q

What is the first thing you say for PSVT?

A

Stable or unstable

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15
Q

What is the second thing you ask about PSVT?

A

Old or young?

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16
Q

What is the first step in treating PSVT?

A

Vagal maneuvers:

  1. Valsalva
  2. Carotid massage
  3. 1+2
  4. Ice
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17
Q

What is the medicine you give for PSVT?

A

6 mg of adenosine IV push or 12

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18
Q

What is the PSVT protocol for older people?

A
  1. Valsalva

2. Adenosine

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19
Q

What is the PSVT protocol for stable young people?

A
  1. Valsalva
  2. Carotid massage
  3. 1+2
  4. Ice
  5. Adenosine 6 mg IV push then flush
20
Q

What do you do for unstable PSVT?

A

Synchronized cardioversion

21
Q

What are the contraindications to adenosine?

A
  1. Sinus tachycardia
  2. Atrial flutter or fib
  3. Irregular rhythm
  4. Rate of over 220 (=bypass tract)
  5. History of a fib, a flutter, or MAT
  6. COPD, ACS, or HF
22
Q

What is a clean kill if you give adenosine?

A

Wide, irregular rhythm = a fib with WPW

23
Q

What is the first thing you say with PEA?

A

Reversible!

24
Q

What are the reversible causes of PEA?

A

A: hypoxia
B: PTX
C: hypovolemic, hypervolemia (tamponade)
D: toxic (drug OD: TCA, BB, CAB) , metabolic (hyper K)

25
Q

What is the first step in treating PEA?

A
  1. Oxygenate and ventilate
26
Q

What is the second step in PEA protocol?

A
  1. Get open IV access
27
Q

What is the third step in PEA protocol?

A

Look at 3:

  1. EKG
  2. Temperature
  3. Volume status
28
Q

What drug can you give in PEA?

A

1 mg of epi q 3 min

29
Q

What is the PEA protocol?

A
  1. Oxygenate and ventilate
  2. IV access
  3. Look at EKG, temp, volume status
  4. Give 1 mg of epi q 3 min
30
Q

Wide complex, rate = 25-40, no p waves

A

Idioventricular rhythm

31
Q

What is the first step in the BLS protocol?

A
  1. Check for responsiveness
32
Q

What is the second step on BLS.

A

Activate the emergency response system/get an AED

33
Q

What is the third step in BLS?

A

Check for carotid pulse

34
Q

What do you do if there is no pulse?

A

Start chest compressions

35
Q

What do you do next if there is a pulse?

A

Start rescue breathing at 1 breath every 5-6 seconds

36
Q

How often should you check a pulse?

A

Every 2 minutes

37
Q

How often should you switch CPR givers?

A

Every 2 minutes

38
Q

What does a end tidal CO2 less than 10 tell you?

A

The chest compressions are of poor quality

39
Q

Which patients should have induced hypothermia?

A

ROSC patients after out of hospital Vfib

Comatose patients with ROSC with cardiac arrest in the hospital or out of hospital with PEA or asystole

40
Q

What temperature is induced hypothermia?

A

32 to 34 degrees Celsius

41
Q

What should oxygen supply be titrated to?

A

The lowest level that can keep sats above 94%

42
Q

What should ventilation rates be titrated to?

A

35-40 ETCO2 or PaCO2 of 40-45

43
Q

What is the MAP goal?

A

65

44
Q

Where should the glucose be kept in a patient with ROSC after cardiac arrest?

A

144-180

45
Q

How frequent do you give breath during a cardiac arrest with BMV?

A

2 ventilation after every 30 compressions

46
Q

How frequently do you give breaths with an advanced airway in cardiac arrest?

A

1 every 6-8 seconds

47
Q

Why so we resume chest compressions after successful defibrillation?

A

Because the rhythm the heart comes back with is usually slow and does not create a pulse or give adequate perfusion

48
Q

What does defibrillation do to the heart?

A

Briefly terminates all electrical activity

ER (4 decks)

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