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ACLS > ACLS > Flashcards

ACLS Flashcards

1
Q

CPR depth and rate

A

at least 2 inches

100-120 bpm

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2
Q

if no advanced airway, what is the

compression : ventilation ratio

A

30 : 2

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3
Q

what does the ETCO2 value during CPR need to be?

if it’s abnormal, what do you do?

A

above 10 mmHg

if it’s too low then improve CPR quality

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4
Q

what does the intra-arterial pressure need to be during CPR?

if it’s abnormal, what do you do?

A

above 20 mmHg in the relaxation (diastolic) phase

if it’s too low, improve CPR quality

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5
Q

biphasic defibrillator-

how many joules do you use to shock someone in cardiac arrest

A

120- 200 J for the first shock (if unknown use max)

subsequent shocks should be equivalent, maybe higher

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6
Q

monophasic defibrillator-

how many joules do you use to shock someone in cardiac arrest

A

360 J

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7
Q

VF

what’s the treatment?

A

(shockable rhythm)

  • Epi- 1 mg
    • begins after 2nd shock
    • then Q 3-5 mins
  • Amiodarone
    • 1st dose- 300 mg bolus
      • begins after 3rd shock
    • 2nd dose- 150 mg
      • begins after 5th shock
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8
Q

asystole

what’s the treatment?

A

(not shockable)

Epi- 1 mg Q 3-5 mins

+ CPR

+ evaluating Q 2 mins to see if rhythm becomes shockable

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9
Q

pVT (pulseless)

what’s the treatment?

A

(shockable rhythm)

  • Epi- 1 mg
    • begins after 2nd shock
    • then Q 3-5 mins
  • Amiodarone
    • 1st dose- 300 mg bolus
      • begins after 3rd shock
    • 2nd dose- 150 mg
      • begins after 5th shock
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10
Q

Cardiac Arrest: shockable rhythm

what’s the treatment?

A
  1. Epi- 1 mg
    • begins after 2nd shock
    • then Q 3-5 mins
  2. Amiodarone
    • 1st dose- 300 mg bolus
      • begins after 3rd shock
    • 2nd dose- 150 mg
      • begins after 5th shock
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11
Q

Cardiac Arrest: not shockable

what’s the treatment?

A

(not shockable)

Epi- 1 mg Q 3-5 mins

+ CPR

+ evaluating Q 2 mins to see if rhythm becomes shockable

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12
Q

PEA

what’s the treatment?

A

(not shockable)

Epi- 1 mg Q 3-5 mins

+ CPR

+ evaluating Q 2 mins to see if rhythm becomes shockable

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13
Q

Cardiac Arrest- who is shockable?

A

VF

pulseless VT

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14
Q

Cardiac Arrest- who is NOT shockable

A

asystole

PEA

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15
Q

what are the reversible causes of cardiac arrest

A
  • 5 H’s
    • Hypovolemia
    • Hypoxia
    • Hydrogen
    • Hypo/hyperkalemia
    • Hypothermia
  • 4 T’s
    • Tension pneumo
    • Tamponade
    • Toxins
    • Thrombosis (pulm/ cardiac)
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16
Q

5 things that will qualify a patient as

UNSTABLE

A

hypotension

AMS (acute)

signs of shock

chest pain

acute heart failure (rales/ ronchi)

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17
Q

what does the HR need to be for a bradycardic pt to initiate workup?

A

< 50

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18
Q

bradycardic pt who’s stable

what’s the treatment?

A

none

just monitor and observe

(order EKG)

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19
Q

bradycardic pt who’s UNSTABLE

what’s the treatment?

A

First Drug:

  • Atropine 0.5 mg bolus
    • then every 3-5 mins
    • maximum of 3 mg (6 doses)

If 1st dose doesn’t work then move on to:

  1. transcutaneous pacing
  2. dopamine 2-20 mcg/kg/ min (titrated)
  3. epinephrine 2-10 mcg/ min (titrated)
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20
Q

tachycardic pt who’s UNSTABLE with a narrow RRR QRS

what’s the treatment?

A
  • synchronized cardioversion- 50-100 J
  • Adenosine
    • ​first dose- 6 mg IV push + NS flush
    • second dose (PRN)- 12 mg
  • give sedation if possible
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21
Q

tachycardic pt who’s UNSTABLE with a RRR and you can’t tell if the QRS is wide or narrow

what’s the treatment?

A
  • synchronized cardioversion- 100 J
  • Adenosine
    • ​first dose- 6 mg IV push + NS flush
    • second dose (PRN)- 12 mg
  • give sedation if possible
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22
Q

tachycardic pt who’s UNSTABLE with a narrow irregular QRS

what’s the treatment?

A
  • synchronized cardioversion
    • biphasic- 120 to 200 J
    • monophasic- 200 J
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23
Q

tachycardic pt who’s UNSTABLE with a wide RRR QRS

what’s the treatment?

A

synchronized cardioversion- 100 J

24
Q

tachycardic pt who’s UNSTABLE with a wide irregular QRS

what’s the treatment?

A

defibrillation dose cardioversion

NOT synchronized

25
Q

tachycardic pt who’s stable with a wide QRS

what are the drug options?

A
  • adenosine (consider)
    • 1st dose- 6 mg IV rapid push then NS flush
    • 2nd dose (PRN)- 12 mg
  • procainamide (consider)
    • 20-50 mg/ min
  • amiodarone (consider)
    • 1st dose 150 mg over 10 minutes
  • sotalol (consider)
    • 100 mg over 5 minutes
26
Q

tachycardic pt who’s stable with a wide QRS, RRR, monomorphic

what is this?

A

VT with a pulse

27
Q

when can you give adenosine to a pt with stable tachycardia and a wide QRS

A

only when they are

REGULAR

and

MONOMORPHIC

28
Q

when should you AVOID giving procainamide to a pt with stable tachycardia and a wide QRS

A

if they have

prolonged QT

or

CHF

29
Q

when should you AVOID giving sotalol to a pt with stable tachycardia and a wide QRS

A

if they have a

prolonged QT

30
Q

when giving procainamide to a pt with stable wide-QRS tachycardia, how do you dose them

A
  • 20-50 mg/min until
    • arrhthmia stops
    • hypotension ensues
    • QRS duration increases by more than 50%
    • you reach the max dose of 17 mg/ kg
  • maintenance infusion
    • 1-4 mg/min
31
Q

when giving amiodarone to a pt with stable wide-QRS tachycardia, how do you dose them

A
  • 1st dose- 150 mg over 10 minutes
    • repeat as needed if VT recurs
  • maintenance infusion
    • 1 mg/ min for 6 hours
32
Q

when giving sotalol to a pt with stable wide-QRS tachycardia, how do you dose them

A

100 mg (1.5 mg/kg) over 5 minutes

33
Q

tachycardic pt who’s stable with a narrow QRS

what’s the treatment?

A
  1. vagal maneuvers
  2. adenosine (if RRR)
  3. BB or CCB
  4. consider expert consultation
34
Q

what are you doing 1st on EVERY pt who is stable with tachy/brady-arrhythmia

A

IV/IO access

EKG

35
Q

post cardiac arrest, what O2 sat do you need to maintain

A

94+ %

36
Q

post MI, what O2 sat do you need to maintain

A

90+ %

37
Q

in post cardiac arrest care, how do you treat hypotension

A
  • FIRST
    • IV bolus- 1-2 L NS or LR (don’t jump to pressors!!)
  • then
    • vasopressor infusion
      • Epi
      • Dopamine
      • Norepi
    • consider treatable causes
38
Q

in post cardiac arrest care, what do you do if the pt has a STEMI or you have high suspicion of AMI

A

coronary reperfusion

39
Q

in post cardiac arrest care, what do you do if the pt can’t follow commands

A

initiate (TTM)

Targeted Temperature Management

40
Q

in post cardiac arrest care, what do you need to keep a pt’s temperature between

A

32- 36 for at least 24 hours to improve neuro recovery

41
Q

Epinephrine infusion dose

(post cardiac arrest care tx of hypotension)

A

0.1 to 0.5 mcg/kg/min

(in a 70 kg adult, this is 7-35 mcg/min)

42
Q

Dopamine infusion dose

(post cardiac arrest care tx of hypotension)

A

5-10 mcg/kg/min

43
Q

Norepinephrine infusion dose

(post cardiac arrest care tx of hypotension)

A

0.1 to 0.5 mcg/kg/min

(in a 70 kg adult, this is 7-35 mcg/min)

44
Q

atropine dose

A

0.5 mg bolus

repeat Q 3-5 mins

max dose 3 mg

for bradycardia w/ a pulse

45
Q

dopamine dose for bradycardia with a pulse

A

2-20 mcg/kg/min

IV infusion

titrated to pt response

46
Q

epinephrine dose for bradycardia w/ a pulse

A

2-10 mcg/min

IV infusion

titrate to pt response

47
Q

epinephrine cardiac arrest dose

A

1 mg Q 3-5 mins

48
Q

amiodarone cardiac arrest dose

A

1st dose- 300 mg bolus

2nd dose- 150 mg

49
Q

adenosine dose

A

1st dose: 6 mg IV push then NS flush

2nd dose: 12 mg (if required)

for narrow QRS RRR tachycardia

50
Q

procainaimide dose

A
  • 20-5- mg/ min IV
    • until
      • arrhythmia stops
      • QRS duration increases by more than half
      • max dose of 17 mg/kg is given
  • maintenance: 1-4 mg

anti-arrhythmic for tachycardia w/ a pulse

51
Q

amiodarone tachycardia w/ a pulse dose

A

150 mg/ 10 mins

repeat if VT reoccurs

maintenance infusion 1mg/min for first 6 hours

52
Q

sotalol dose

A

100 mg/ 5 minutes

(or 1.5 mg/kg/ 5 minutes)

anti-arrhythmic for tachycardia w/ a pulse

53
Q

epinephrine post cardiac arrest dose

A

0.1 to 0.5 mcg/kg/min IV infusion

(7-35 mcg/min in 70 kg adult)

54
Q

dopamine post cardiac arrest dose

A

5-10 mcg/kg/min IV infusion

55
Q

norepinephrine dose

A

0.1 to 0.5 mcg/kg/min IV infusion

(7-35 mcg/min in 70 kg adult)

for post cardiac arrest

56
Q

ASA MI dose

A

160-325 mg

ACLS (1 decks)

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