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ACLS > ACLS > Flashcards

ACLS Flashcards

1
Q

What are the 6 Hs? (Reversible causes of cardiac arrest)

A
  1. Hypovolemia
  2. Hypoxia
  3. Hydrogen ions (acidosis)
  4. Hyperkalemia
  5. Hypokalemia
  6. Hypothermia
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2
Q

What are the 5 Ts? (reversible causes of cardiac arrest)

A
  1. Tension pneumothorax
  2. Cardiac Tamponade
  3. Toxins
  4. Pulmonary Thrombosis
  5. Coronary Thrombosis
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3
Q

Cardiac Arrest Algorithm - V fib or pulseless v tach when rhythm remains shockable. When rhythm is not shockable? Steps 1-8

A
  1. Start CPR, Give 02, and attach monitor/defibrillator
    RHYTHM SHOCKABLE?
    YES
  2. V fib or pulseless V tach
  3. Shock
  4. CPR 2 min, IV/IO access

RHYTHM SHOCKABLE?
YES

  1. Shock
  2. CPR 2 min
    1 mg Epi q3-5 min
    Consider Advanced airway/capnography

RHYTHM SHOCKABLE?
YES

  1. Shock
  2. CPR 2 min
    Amiodarone
    Treat Reversible causes

Back to Step 5

At steps 4 and 6 if the rhythm is not shockable?
No ROSC - Go to Asystole alogrithm
ROSC - Go to Post-cardiac Care

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4
Q

Cardiac Arrest Algorithm - Asystole/ pulseless electrical activity

A
  1. Start CPR, Give 02, and attach monitor/defibrillator
    RHYTHM SHOCKABLE?
    NO
  2. Asystole/PEA
  3. CPR 2 min
    IV/IO access
    1 mg Epi q3-5 min
    Consider advanced airway/capnography

RHYTHM SHOCKABLE?
YES - Steps 5-7 in V fib/V tach

NO
11. CPR 2 min
Treat Reversible Causes

RHYTHM SHOCKABLE?
YES- Steps 5-7 in V fib/V tach

NO
12. No ROSC - to step 10 or 11

ROSC - Post-cardiac care

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5
Q

Cardiac Arrest 1st step (3)

A

Start CPR
Give Oxygen
Attach Monitor/defibrillator

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6
Q

1 round of CPR completed. RHYTHM is SHOCKABLE.

What is it? Next Step?

A

It’s V fib or pulseless V Tach

Shock

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7
Q

1 round of CPR completed.
1 Shock given
Next step (2)?

A

CPR 2 min

IV/IO access

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8
Q

2 rounds of CPR completed.
1 Shock given
RHYTHM SHOCKABLE
Next Steps (4)?

A

Shock

CPR 2 min
1 mg Epi q3-5 min
Consider advanced airway/capnography

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9
Q 
3 rounds of CPR completed.
2 Shocks given
1 mg Epi
RHYTHM SHOCKABLE
Next Steps (3)?
A

CPR 2 min
Amiodarone
Treat Reversible Causes (Hs and Ts)

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10
Q

Along V fib Vtach pathway:
When can Epi be given?
When can Amiodarone be given?

A

After 2 rounds of CPR and 1 shock. During 3rd round of CPR

After 3 rounds of CPR and 2 shocks. During 4th round of CPR

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11
Q

1 round of CPR completed. RHYTHM is NOT SHOCKABLE.

What is it? Next Step (4)?

A

Asystole/PEA

CPR 2 min
1 mg Epi q3-5 min
Consider advanced airway/capnography

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12
Q

2 rounds of CPR completed. RHYTHM was NOT SHOCKABLE.

a) RHYTHM is NOW SHOCKABLE 
Next Steps (4)?
b) RHYTHM is NOW NOT SHOCKABLE
Next Step (2)?
A

a) Shock
CPR 2 min
1 mg EPi q3-5 min
Consider advanced airway/capnography

b) CPR 2 min
Treat reversible causes (Hs and Ts)

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13
Q

3 rounds of CPR completed. RHYTHM was NOT SHOCKABLE. x3. Next step if +/- ROSC?

A

ROSC - Go to Post-Cardiac Arrest Care

No ROSC -
CPR 2 min
1 mg Epi q3-5 min
Rhythm Check

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14
Q

In what ACLS situation would you use Atropine? General MOA?

A

Used for bradycardia. Speeds up the heart rate

Anti-cholinergic blocks vagus nerve from slowing the heart rate.

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15
Q

1st line medication for bradycardia?

A

Atropine
1st dose -
0.5 mg bolus q 3-5 min. 3 mg MAX.

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16
Q

3 options after ineffective treatment of bradycardia with atropine?

A
  1. Transcutaneous pacing
  2. Dopamine 2-20 mcg/kg/min. Titrate to response. Taper slowly
  3. Epi 2-10 mcg/min infusion. Titrate to patient response
17
Q

Algorithm for symptomatic tachycardia with pulse. HR>= 150.

A
  • Synchronized cardioversion
  • Consider sedation
  • If Regular, narrow consider Adenosine ( 6mg rapid IV push followed by NS flush
18
Q

Adenosine dosing for tachycardia with a pulse.

A

1st dose: 6 mg rapid IV push. Follow w/ NS flush.

2nd dose: 12 mg

19
Q

Algorithm for asymptomatic tachycardia with pulse. HR>= 150. Wide QRS >= 0.12 sec (4)

A
  • IV access and 12 lead ECG
  • Adenosine if regular and monomorphic
  • Consider antiarrythmic infusion
  • Consider expert consultation
20
Q

Algorithm for asymptomatic tachycardia with pulse. HR>= 150. Regular QRS (5)

A
  • IV access and 12 lead ECG
  • Vagal maneuvers
  • Adenosine (if regular)
  • B-blocker or CCB
  • Consider expert consultation
21
Q

Asymptomatic tachycardia with pulse and wide QRS. Procainamide dosing and when to stop.

A 
Procainamide IV
20-50 mg/min until
-arrhythmia suppressed
-hypotension
-QRS increases 50%
-Max dose 17 mg/kg
22
Q

Maintenance infusion of procainamide and when to avoid.

A

1 - 4 mg/min.

Avoid if prolonged QT or CHF

23
Q

Asymptomatic tachycardia with pulse and wide QRS. Amiodarone IV dosing.

A

1st dose - 150 mg over 10 min

Repeat as needed if VT recurs.

24
Q

Maintenance infusion of amiodarone

A

1 mg/min for 1st 6 hrs

25
Q

Asymptomatic tachycardia with pulse and wide QRS. Sotalol IV dose. When to avoid.

A

100 mg (1.5 mg/kg) over 5 min.

Avoid if prolonged QT

26
Q

ROSC algorithm

A
  • O2 94%, advanced airway
  • Treat hypotension (SBP < 90)
  • -IV/IO bolus
  • -Vasopressor infusion
    • Treatable causes
  • If STEMI - coronary reperfusion
  • No STEMI or after coronary reperfusion. Can they follow commands?
  • Follows commands
  • -Advanced critical care
  • Doesn’t follow commands
  • -Initiate targeted temp management
27
Q

Treating hypotension in post-cardiac arrest

A

IV bolus 1-2L NS or LR

28
Q

Epi IV dosing post-cardiac

A

0.1-0.5 mcg/kg/min

70 kg - 7-35 mcg/min

29
Q

Dopamine IV dosing post-cardiac

A

5-10 mcg/kg/min

30
Q

NE IV infusion post-cardiac

A

0.1-0.5 mcg/kg/min

70 kg - 7-35 mcg/min

ACLS (1 decks)

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