ACLS

Question 1

What med should you withhold if ST elevation in 2,3,AVF

Answer 1

nitroglycerin

Question 2

What causes heart relaxation (depol or repol)

Answer 2

repolarization

Question 3

What causes heart contraction (depol or repol)

Answer 3

depolarization

Question 4

for what kind of rhythm do you never give electricity?

Answer 4

sinus

Question 5

what’s the MC hypoxia?

Answer 5

PVC

Question 6

hypoxia definition

Answer 6

tissues not getting oxygenated

Question 7

hypoxemia definition

Answer 7

low oxygen content in blood

Question 8

what rhythm has no p-wave?

Answer 8

afib

Question 9

what rhythm never has a pulse?

Answer 9

vfib

Question 10

what rhythm has a buried p-wave?

Answer 10

v-tach

Question 11

leads for LA, LL, RA, RL

Answer 11

gray, red, white, green

Question 12

3 types of SVT and describe

Answer 12

all always early
PAC- wide QRS w/ P before it
PJC - nl QRS w/ upside down P or no P
PVC - no Ps, wide QRS

Question 13

PEA is

Answer 13

pulseless but not asystole, vfib, vtach

so. ..
- EMD (no wall motion)
- very low BP
- slow heart block

Question 14

when to cardiovert

Answer 14

unstable
have a pulse
fast rhythm

Question 15

when to defib

Answer 15

unconscious
pulseless
(vtach/vfib)

Question 16

when to pace

Answer 16

unstable bradycardia

Question 17

when to give magnesium

Answer 17

tosadesy

Question 18

how to treat all symptomatic bradycardia

Answer 18

atropine 0.5mg IV 
then
any of the following:
- more atropine (0.5mg) IV
- dopamine (2-20 mcg/kg/min) IV
- epi (2-10 mcg/min) IV

Question 19

causes of R on T phenomenom

Answer 19

defib, electrocution
afib
PVC
comotial cordis

Question 20

cause of a huge R wave

Answer 20

LVH

Question 21

cause of lots of ST changes in many leads

Answer 21

pericarditis

Question 22

acute heart failure means

Answer 22

new onset pulmonary symptoms

Question 23

maximal rate to pace a bradycardic person

Answer 23

2x current rate (more MI or rhabdo)

Question 24

how do you know you have to increase the current when transcutaneously pacing someone

Answer 24

no heartbeat after pacer spike, no palpable pulse

electrical and mechanical capture

Question 25

cardioversion tachycardias (charge in joules)

Answer 25

narrow + reg: 50-100 wide + reg: 100 narrow + irreg: 120-200 wide + irreg: 200 (unsynch)

Question 26

treat a reg + wide tachycardia w/ pulse

Answer 26

``` unstable - cardiovert 100 stable - proceed w/o cardiovert ... is it vtach or SVT? .... adenosine 6mg IV helps SVT only; if helps, give 12mg IV .... if that doesn't work, you have amiodarone 150mg/10min IV (have V.tach) ```

Question 27

treat a reg + narrow tachy w/ pulse

Answer 27

``` vagal maneuver (if stable) shock 50-100 (if unstable) then adenosine 6mg IV not working? adenosine 12 mg IV ```

Question 28

adenosine IV must be followed by

Answer 28

saline flush x 2

Question 29

treat narrow, irregular tachy w/ pulse

Answer 29

CCB or BB

Question 30

treat wide, irregular tachy w/ pulse

Answer 30

amiodarone 150 mg/10 min IV

Question 31

treat wide, irreg, tachy WITHOUT pulse

Answer 31

amiodarone 300 mg PUSH followed by 150 mg PUSH **Unless is PEA or asystole**

Question 32

after they become stable, what to do

Answer 32

- mental status ok? (follow commands?) - breathing (ET tube needed?) - BP - 12 lead - CXR - cool (if mental status impaired)

Question 33

ideal CCF (chest compression fraction)

Answer 33

80% (60% = "adequate")

Question 34

ideal tidal volume

Answer 34

500-600 mL (half squeeze of adult bag)

Question 35

what % of normal capnography does CPR give?

Answer 35

25-30%

Question 36

OPA how to size?

Answer 36

corner lip to angle mandible

Question 37

NPA how to size?

Answer 37

corner nare to tragus

Question 38

name advanced airways

Answer 38

supraglottic: king, combitube, laryngotube definitive: ET, trachostomy

Question 39

#1 of confirming and monitoring tube placement

Answer 39

capnography

Question 40

what does epi do?

Answer 40

increase MAP which increases perfusion pressure to heart

Question 41

what does amiodarone do?

Answer 41

blocks a and b stimuli | slows heart, making defibrillation more effective

Question 42

reversible causes of cardiac arrest are (6H + 5T)

Answer 42

``` hypovolemia hypoxia hydrogen ion (acidosis) hypokalemia hyperkalemia hypothermia ``` ``` tension pneumo tamponade toxins thrombosis (PE) thrombosis (coronary) ```

Question 43

PETCO2

Answer 43

10

Question 44

diastolic pressure

Answer 44

20

Question 45

Joules for a monophase defib

Answer 45

360

Question 46

Joules for a biphasic defib

Answer 46

120-200 (do what manufacturer says)

Question 47

Epi dose for cardiac arrest

Answer 47

1 mg/4 min

Question 48

Amiodarone dose for cardiac arrest

Answer 48

300 mg bolus followed by 150 mg bolus

Question 49

Treat cardiac arrest

Answer 49

``` CPR 2 rounds, 2 shocks epi 1mg @ 4 min amiodarone 300mg @ 6 min epi 1 mg @ 8 min amiodarone 150 mg @ 10 min ```