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ACLS > ACLS > Flashcards

ACLS Flashcards

1
Q

What is PCI?

A

Percutanious Cardiac Intervention

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2
Q

What are the first 2 interventions for a suspected stroke? When must they be done?

A

Glucose and head CT. Within 45 minutes.

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3
Q

How deep are chest compressions for an adult?

A

At least 2”, or compress the chest 1/3/

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4
Q

What is the longest you should interrupt compressions?

A

10 seconds.

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5
Q

What is ROSC?

A

Return of spontaneous circulation.

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6
Q

What capnography reading would suggest that your CPR performance is unsuitable? What level would indicate a return of ROSC?

A

<10…. 35-40

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7
Q

What part of the ABCD algorithym changes from BLS to ACLS?

A

The “D” stands for defib in BLS and differential diagnosis in ACLS.

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8
Q

Why are stick on pads better than hand held pads?

A

Faster. More compressions are allowed.

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9
Q

How many breaths are given for respiratory arrest?

A

1 every 5-6 seconds, or 10-12 per minute.

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10
Q

How much O2 is used with a bag-valve mask?

A

100% at high rate 10-15L +

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11
Q

What does hyper-oxygenation cause?

A

Increase intrathoracic pressure, decreased venous return to the heart, and diminished cardiac output.

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12
Q

What is an “OP”, and how is it measured?

A

Oropharyngeal airway. It is measured from the corner of the mouth to the mandibular angle.

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13
Q

What is an “NP”, and how is it measured?

A

A nasopharyngeal airway. It is measured from the edge of a nostril to the tragus.

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14
Q

What nare is normally used for an NP?

A

The right nare.

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15
Q

What O2 level is considered within optimal limits? Why not 100%?

A

94-99%. with 100% you may cause oxygen toxicity.

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16
Q

What is ACS?

A

Acute coronary syndrome.

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17
Q

What are the first 3 treatments for ACS?

A

O2 at 4L until SAT is at least 94%. Aspirin-160-325 mg. Nitro Q 5 mins X 3

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18
Q

What are the indicators for a STEMI?

A

ST elevation or LBBB

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19
Q

What are the treatment goals for a STEMI?

A

Door to balloon < 90 minutes. Door to TPI , 30 minutes.

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20
Q

What are the indicators for a UA/NSTEMI?

A

ST depression or dynamic T wave inversion.

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21
Q

What are the treatments for a UA/NSTEMI?

A

Nitro/LMW heparin/betas/clopidrogel(Plavix).

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22
Q

What are some possible contraindications for nitro use?

A

Low BP-<90, bradycardia, tachycardia. Possibly RV infarct.

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23
Q

When is morphine used in ACLS?

A

Stemi.

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24
Q

What is the ACLS Bradycardia algorithm?

A

Symptomatic? (Hypotensive/altered mental state/shock/CHF/chest pain), Atropine (0.5mg up to 3 mg), Dopamine (2-10)mcg/kg/min, Epi (2-10) mcg/min, pacing.

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25
Q

What is it important to remember to do when administering EPI?

A

Flush with 20 ml after and elevate the extremity for 10-20 seconds.

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26
Q

When is therapeutic hypothermia used?

A

With return of ROSC, but the patient is still unresponsive.

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27
Q

What rhythms are shock-able?

A

VF/Pulseless VT

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28
Q

Which rhythms are unshockable?

A

Asystole/PEA

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29
Q

What is the ACLS algorithm for VT/VF?

A

CPR/Shock/2 min CPR/shock/2 min CPR/Epi 1 mg q 3-5 or vasopressin 40 mg/shock/amiodarone 300/150

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30
Q

What do you ask the patient BEFORE giving nitrates?

A

Do you take Viagra or other phosphodiesterase inhibitors.

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31
Q

When stroke is suspected, when must a CT scan be completed? Read?

A

Completed within 25 minutes and read within 45 minutes.

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32
Q

How are drugs given to a heart attack patient?

A

Slow if alive, fast if dead.

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33
Q

What is done for SVT?

A

It comes from the atria, so shock at 50-100 Joules.

34
Q

What is done for VT with a pulse?

A

Ask, “are they stable”?

35
Q

What is done if SVT is stable?

A

Slow them down. Vagel them, then adenosine 6/12. Must be fast.

36
Q

What is done for sinus tachycardia?

A

If stable, find underlying cause. If unstable,

37
Q

What does a shift to the left in the oxy-hemoglobin disassociation curve suggest?

A

Elevated PH, hypothermia…. Oxygen’s affinity for hemoglobin is greater.

38
Q

What does a shift to the right in the oxy-hemoglobin disassociation curve suggest?

A

Acidosis, elevated temp……. Oxygen’s affinity for hemoglobin is decreased.

39
Q

What is the mnemonic for ETT placement evaluation?

A

D.O.P.E. Displaced tube, Obstructed tube, Pneumothorax, Equipment failure.

40
Q

What are the 2 main examples of obstructive shock?

A

Cardiac tampanade and tension pneumothorax.

41
Q

What are the 3 types of distributive shock?

A

Anaphylactic, Septic, and Neurogenic shock.

42
Q

What are the S/S of the compensatory stage of shock, ?

A

Systolic remains WNL. Diastolic rises, pulse pressure narrows, decreased urine output, tachycardia, increased RR.

43
Q

What are the S/S of decompensated shock?

A

LOC decreases, normal to slightly decreased systolic BP, narrowing pulse pressure, Tachycardia > 100 BPM, rapis/shallow resperations, cool clammy skin, serum lactate increases to 2-4 mmol.

44
Q

What are the 3 layers of the meninges?

A

P.A.D. Pia mater(innermost-attaches to the brain), arachnoid mater(thin/transparent), Dura mater (outermost-tough/fibrous-attaches to skull)

45
Q

What is Cushings response?

A

It is a triad of responses to brainstem ischemia that includes - reflex bradycardia, widening pulse pressure, and diminished respiratory effort.

46
Q

What are fixed/dilated pupils an indication of?

A

Occulomotor nerve compression/increased ICP.

47
Q

What are fixed/pinpoint pupils a S/S of?

A

Injury to the PONS or the effects of opioids.

48
Q

What are moderately dilated pupils with sluggish response an indication of?

A

It may be an early sign of herniation syndrome.

49
Q

What GCS score indicates a need for intubation?

A
50
Q

What are the 3 components of the GCS?

A

BEST eye opening, BEST verbal response, BEST motor response.

51
Q

What are the components of the four score coma scale?

A

Eye response, motor response, brainstem reflexes, respiration.

52
Q

What does the Medial Rectus muscle do and what nerve is involved?

A

Moves the eye toward the nose. CN III (oculomotor)

53
Q

What does the Lateral Rectus muscle do, and what nerve is involved?

A

It moves the eye away from the nose. CN VI (Abducent)

54
Q

What does the Superior Rectus muscle do and what nerve is involved?

A

It moves the eye upward. CN III (oculomotor)

55
Q

What does the Inferior Rectus muscle do and what nerve is involved?

A

It moves the eye downward. CN III (Abducent)

56
Q

What does the Superior oblique muscle do and what nerve is involved?

A

It provides medial eye rotation. CN IV. (trochlear)

57
Q

What doe the Inferior oblique muscle do and what nerve is involved?

A

It provides lateral eye rotation. CN III (oculomotor)

58
Q

What is Cullen’s sign?

A

Bruising around the umbilicus, a sign of Hepatic injury.

59
Q

What serum level will rise if the pancreas is damaged?

A

Serum Amylase.

60
Q

What is Turners sign?

A

Echymosis over the flank at the level of the 11th and 12th ribs, a sign of Renal injury.

61
Q

What do the dorsal and ventral roots do?

A

Each of the 31 pairs of spinal nerves has a dorsal and ventral root. The dorsal root transmits sensory impulses and the ventral root transmits motor impulses.

62
Q

What is a “plexus”? How many main plexus are there?

A

A plexus is a nerve cluster connecting the peripheral and central nervous systems. There are 4 main ones, Cervical, brachial; lumbar, and sacral.

63
Q

What area of the spinal cord, when damaged, can cause neurogenic shock?

A

Any injury at T6 or higher.

64
Q

What are some S/S of neurogenic shock?

A

Bradycardia, hypotension, warn normal skin color, core temp instability.

65
Q

What is an inotrope?

A

A medicine the alters the force of muscular contractions, either positive or negative.

66
Q

What serum level will rise following muscle trauma? How long until it peaks?

A

Potassium. 12 hours.

67
Q

What are the classic triad of assessment findings with Rhabdomyolysis?

A

Muscle pain/numbness, muscle weakness/paralysis, dark brown/red urine.

68
Q

What is the Tx for Rhabdomyolysis?

A

Aggressive fluid resuscitation. Maintain urine output at 100 ml/hour.

69
Q

What are the 6 P’s?

A

Pain, Pallor, pulse, pressure, paralysis, paresthesia.

70
Q

What are the 3 zones of injury to skin?

A

Zone of coagulation (Center of the burn), Zone of stasis (surrounds zone of coagulation), Zone of hyperemia (outermost area).

71
Q

What is the immediate fluid resuscitation protocol for burns?

A

If burn is 20% or more of TBSA, start lactated ringer at 2mL/Kg/percentage of TBSA. Give half in the first 8 hours (starting from when the burn occured) and half over the next 16 hours.

72
Q

What is the fluid resuscitation formula for burns in Pt’s under the age of 14 or weighing

A

3 mL/kg/%TBSA

73
Q

What should urine output be in a burn Pt?

A

0.5 mL/kg in an adult. 1 mL/kg in children weighing

74
Q

What is the first thing you do for a burn Pt?

A

Remove all clothing and jewelry.

75
Q

If a Pt has superficial burns that are

A

Cool the skin with room temp. cloths and sterile water.

76
Q

If a burn Pt weighs

A

D5 in ringers solution.

77
Q

What is considered a normal carboxyhemoglobin level? A toxic level?

A

Non-smoker=0%-3%. Smoker=0%-15%. toxic+25%-35%. Lethal=>60%.

78
Q

Name the 5 levels of burns.

A

Superficial, superficial partial thickness, deep partial thickness, Full thickness, Fourth degree.

79
Q

What does the mnemonic RESPOND stand for?

A

It represents interventions used as psychosocial support of the Pt and family. Reassure, Establish rapport, Support Pt, Plan care and manage Pain, Offer hope, Never deliver news of death alone, Determine the Pt’s needs.

80
Q

What are the 4 dimensions of grief?

A

Somatic response=physical response. Cognitive expression= overeating, etc. Affective expression=depression, guilt, despair. behavioral=agitation, fatigue, crying, etc.

81
Q

During adult disaster triage, what criteria show the need for immediate care?

A

unable to walk and::::: airway placed with spontaneous breathing, RR>30, radial pulse absent/cap refill>2 sec, doesn’t obey commands.

82
Q

During pediatric triage, what criteria lead to immediate care?

A

unable to walk and::::::airway positioned with breathing, RR 45, no palpable pulse, an AVPU of “P” or “U”.

ACLS (3 decks)

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