ACLS Flashcards
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Interruptions in compressions should be limited to critical interventions such as:
Rhythm analysis, Shock delivery, intubation, etc.
Interruptions should be minimized to..
10 seconds or less
High survival rate in studies are associated with several common 6 elements
Training of knowledgeable healthcare providers, planned and practiced response, rapid recognition of sudden cardiac arrest, prompt provision of CPR, defibrillation as early as possible with 3-5 minutes of collapse, organized post-cardiac arrest care.
Best way to improve from sudden cardiac arrest is to start with:
quality improvement model and then modify that model according to chain of survival metaphor.
Effective resuscitation requires an integrated response known as a:
system of care
Compressor role task
Assesses the patient, 5 cycles of chest compressions, alternates with Monitor person every 5 cycles or 2 minutes or if fatigue sets in.
Monitor role task
brings and operates the monitor, alternates with compressor, place monitor where can be seen by team leader.
Airway role task
Opens the airway, provides BVM ventilations, inserts airway adjuncts as appropriate.
Team leader role task
Defined leader, assigns roles to team members, provides feedback, assumes responsibility for roles not assigned.
IV/IO/Medications role task
An ACLS provider role, initiates IV/IO access, administers medications.
Timer/Recorder role task
Records the time of interventions and medications, records the frequency and duration of interruptions in compressions, communicates these to team leader and the rest of the team.
agonal gasps are?
not normal breathing
agonal gasps may be present in
the first minutes after sudden cardiac arrest.
Quality compressions
Compress the chest at least 2 inches.
Compress at a rate of 100 to 120/min
Allow complete chest recoil after each compression.
Optimal chest compression depth is
2 to 2.4 inches
High quality CPR steps
Compress chest hard and fast allow complete chest recoil minimize interruptions 10 seconds or less avoid excessive ventilation switch compressors about every 2 mins
H’s
Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-/hyperkalemia, Hypothermia
T’s
Tension pneumothorax, Tamponade (cardiac), Toxins
Thrombosis (pulmonary), Thrombosis (Coronary)
2 most common underlying and potentially reversible causes of PEA
Hypovolemia and Hypoxia
Hypovolemia S/S
Narrow complex QRS tachycardia Normal BP--> Increased BP-->Sys <100--> Sys <70 Delayed/Absent cap refill diaphoresis Becomes altered mental status
Hypovolemia treatment
Consider volume infusion for PEA associated with narrow complex tachycardia
Average respiratory rate for an adult is?
12 to 16 breathes per minute
Normal tidal volume is?
8 to 10 mL/kg
Tachypnea is RR above
20/min
Bradypnea is RR below
12/min
Respiratory distress is
Is a clinical state characterized by abnormal RR or effort. The respiratory effort may be increased or inadequate. Can range from mild to severe.
Respiratory distress S/S
Tachypnea, increased respiratory effort, bradypnea, tachycardia, abnormal breath sounds, pale cool skin, changes in LOC.
Respiratory failure is
Is a clinical state of inadequate oxygenation, ventilation or both, failure is often the end stage of distress.
Respiratory failure S/S
Tachypnea, bradypnea (late), increased/decreased or no respiratory effort, tachycardia, bradycardia (late) cyanosis or coma (late)
Respiratory arrest is
The absence of breathing and is usually caused by drowning or a head injury.
A patient with a pulse but respiratory arrest you should ventilate the patient..
once every 5-6 seconds.
The most reliable method of confirming and monitoring the correct placement of an ET tube is?
Continuous waveform capnography.
Excessive ventilation is
Too many breaths per minute or too large a volume per breath
Excessive ventilation is harmful because?
It increases intrathoracic pressure, decreases venous return to the heart and diminishes cardiac output. Also can cause gastric inflation.
For patients with cardiac symptoms or respiratory distress oxygen saturation should be?
94% or greater
Respiratory of cardiac arrest patients O2 should strive for what percent?
100%
If cervical spine trauma is suspected you should use what basic airway opening movement?
Jaw thrust without head extension
The OPA should only be used with these types of patients?
Unresponsive patient with no cough or gag reflex.
Properly sizing the OPA steps?
Corner of mouth to angle of mandible.
Properly sizing the NPA steps?
patients nose to the earlobe
Suction attempts should not exceed?
10 seconds.
Oxygen should be applied in ACS patients if?
dyspneic, hyperemic, signs of heart failure, SATs <90% or the oxygen saturation is unknown
Aspirin does what to the body?
causes immediate and near-total inhibition of thromboxane A2 production by inhibiting platelets.
Aspirin dose
160 to 325mg.
Aspirin is best absorbed?
Chewed, particularly if morphine has been given
Nitroglycerin does?
effectively reduces ischemic chest discomfort, and it has beneficial hemodynamic effects.
Physiologic effects of nitroglycerin?
Reduction in LV and right ventricular preload through peripheral arterial and venous dilation
