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Dentistry > ACLS > Flashcards

ACLS Flashcards

Advanced life support

1
Q

What are agonal gasps an indication of

A

Cardiac arrest

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2
Q

What does ACLS stand for

A

Advanced cardiac life support

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3
Q

Airway

A

Airway is adequate and protected, insert advanced airway

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4
Q

Breathing

A

Give O2, Confirm placement of Endotracheal toube, Monitor waveform capnography, Don’t over ventilate

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5
Q

Circulation

A

IV/IO access, treat hr/rythm, monitor CPR quality, defibrillate, vitals

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6
Q

Differential diagnosis and disability

A

Determine problem, h and t, mental status, Glasgow coma scale

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7
Q

ACE

A

Angiotensin-converting enzyme

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8
Q

ACS

A

Acute Coronary syndromes

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9
Q

AED

A

Automated external defibrillator

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10
Q

AHF

A

Acute heart failure

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11
Q

AIVR

A

Accelerated idioventricular rhythm

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12
Q

AMI

A

Acute myocardial infarction

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13
Q

aPTT

A

Activated partial thromboplastin time

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14
Q

AV

A

Atrioventricular

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15
Q

CARES

A

Cardiac arrest registry to enhance survival

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16
Q

CCF

A

Chest compression fraction

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17
Q

CPR

A

Cardiopulmonary resuscitation

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18
Q

CPSS

A

Cincinnati prehospital stroke scale

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19
Q

CQI

A

Continuous quality improvement

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20
Q

CT

A

Computed tomography

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21
Q

DNAR

A

Do not attempt resuscitation

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22
Q

ECG

A

Electrocardiogram

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23
Q

ED

A

Emergency department

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24
Q

EMS

A

Emergency medical services

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25
Q

ET

A

Endotracheal

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26
Q

FDA

A

Food and drug administration

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27
Q

FIO2

A

Fraction of inspired oxygen

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28
Q

GI

A

Gastrointestinal

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29
Q

ICU

A

Intensive care unit

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30
Q

INR

A

International normalized ratio

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31
Q

IO

A

Intraosseous

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32
Q

IV

A

Intravenous

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33
Q

LV

A

Left ventricle/ventricular

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34
Q

mA

A

Milliamperes

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35
Q

MACE

A

Major adverse cardiac events

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36
Q

MET

A

Medical emergency team

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37
Q

MI

A

Myocardial infarction

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38
Q

mm Hg

A

Millimeters of Mercury

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39
Q

NIH

A

National institutes of health

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40
Q

NIHSS

A

National institutes of health stroke scale

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41
Q

NINDS

A

National institute of neurological disorders and stroke

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42
Q

NPA

A

Nasopharyngeal airway

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43
Q

NSAID

A

Nonsteroidal anti-inflammatory drug

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44
Q

NSTE-ACS

A

Non-ST-segment elevation acute coronary syndromes

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45
Q

NSTEMI

A

Non-ST-segment elevation myocardial infarction

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46
Q

OPA

A

Oropharyngeal airway

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47
Q

Paco2

A

Partial pressure of carbon dioxide in arterial blood

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48
Q

PCI

A

Percutaneous coronary intervention

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49
Q

PE

A

Pulmonary embolism

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50
Q

PEA

A

Pulses electrical activity

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51
Q

PETCO2

A

Partial pressure of end-tidal carbon dioxide

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52
Q

PT

A

Prothrombin time

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53
Q

pVT

A

Pulseless ventricular tachycardia

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54
Q

ROSC

A

Return of spontaneous circulation

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55
Q

RRT

A

Rapid response team

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56
Q

rtPA

A

Recombinant tissue plasminogen activator

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57
Q

RV

A

Right ventricle/ventricular

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58
Q

SBP

A

Systolic blood pressure

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59
Q

STEMI

A

ST-segment elevation myocardial infarction

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60
Q

SVT

A

Supraventricular tachycardia

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61
Q

TCP

A

Transcutaneous pacing

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62
Q

TTM

A

Targeted temperature management

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63
Q

UA

A

Unstable angina

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64
Q

VF

A

Ventricular fibrillation

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65
Q

VT

A

Ventricular tachycardia

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66
Q

How do you optimize ACLS

A

A team leader effectively integrates high-quality CPR w/minimal interruptions of compressions/advanced life support strategies (defibrillation, meds, advance airway)

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67
Q

What should intervals be between compressions and shock delivery for increased predicted shock success

A

10 seconds or less

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68
Q

BLS survey is for people who are

A

Unconscious

69
Q

ACLS survey is for people who are

A

Conscious

70
Q

BLS survey

A

Check responsiveness, call for help, check carotid/ chest rise, assess pulse/breathing 5-10 sec, pulse present but no breath assist ventilation, no pulse no breathing CPR, defibrillate

71
Q

Where do narrow QRS complexes originate

A

Syria near av node

72
Q

Where do wide complexes originate

A

Ventricles

73
Q

What is the most common rhythm to occur immediately after cardiac arrest

A

Ventricular fibrillation

74
Q

What is happening during vfib

A

Ventricles quiver and cant pump blood

75
Q

What are the 2 types of vfib

A

Coarse and fine

76
Q

Which type of vfib is more easily corrected with defibrillation

A

Coarse

77
Q

What type of vfib is seen more in a pt with cardiac arrest

A

Fine vf

78
Q

What is vtach

A

Ventricular focus takes over control of heart and fires at tachy rate

79
Q

In vtach what does the QRS complex look like and why

A

Wide because it originates in the ventricles

80
Q

What is treatment for vfib and pulseless vtach

A

Defibrillate, Cpr for 2 minutes, check rhythm/pulse, shock again if needed, repeat until rhythm not shockable, meds admin with CPR/defibrillation

81
Q

**Medication sequence for vfib and pulselss vtach

A

Epi 1mg 1:10,000 IV/IO every 3-5 min, **(persistent vf) amiodarone 300mg IV/IO 1st dose amiodarone 150mg last dose

82
Q

Asystole

A

No detectable activity on EKG

83
Q

***Pulseless electrical activity

A

Heart not beating and no pulse but rhythm still present on EKG

84
Q

Treatment for asystole

A

CPR, epinephrine 1mg 1:10,000 IV/IO 3-5 min, consider H and T

85
Q

Hypovolemia

A

Volume depletion: excessive loss of body water/blood

86
Q

Hypoxia

A

Oxygen depletion

87
Q

Hydrogen ion

A

Excess of acid in blood/alkali. drop in ph

88
Q

Hypo/hyperkalamia

A

Low/high potassium

89
Q

Hypoglycemia

A

Low blood sugar

90
Q

Tamponade, cardiac

A

Fluid build-up around heart

91
Q

Tension pneumothorax

A

Air in the pleural space

92
Q

Thrombus, coronary

A

Clot in coronary artery causing block of blood flow

93
Q

Thrombus, pulmonary

A

Clot/material in artery of lungs

94
Q

What are the h’s and t’s to consider for asystole and PEA

A

Hypovolemia, hypoxia, hydrogen ion, hypo/hyperkalemia, hypoglycemia, toxins, Tamponade cardiac, tension pneumothorax, thrombosis coronary, thrombosis pulmonary

95
Q

What are the bradycardic rhythms

A

Sinus Bradycardia, 1st degree AV block, 2nd degree block type 1, 2nd degree block type two, 3rd degree block

96
Q

1st degree AV block

A

Conduction through AV node slowed ( long PR wave inteval) Less than 5 boxes no treatment needed but may indicate higher degree in future

97
Q

2nd degree block type one

A

Increase delay AV node conduction until failure of P wave

98
Q

2nd degree block type 2 mobitz

A

Occurs below AV node. P waves regular but QRS drops. Atrial contractions not followed by ventricular contractions. Pacing recommended

99
Q

3rd degree block

A

Complete heart block. No communication between SA and AV

100
Q

Treatment for symptomatic blocks

A

O2, atropine .5mg 3-5min till 3mg***, transcutaneous pacing for high degree, airway maneuvers and ventilation for airway/breathing complications

101
Q

TCP alternative

A

Dopamine IV infusion 2-20mcg/kg/min, epinephrine IV infusion 2-20 mcg/min

102
Q

Tachycardic rhythms

A

Sinus tachycardia, supraventricular tach, monomorphic ventricular tach, polymorphic ventricular tach, torsades de pointes

103
Q

How many beats per min would be considered tachycardic

A

101-150

104
Q

SVT

A

Indistinguishable P wave due to HR greater than 150. Narrow QRS, P runs into T.

105
Q

SVT rhythms

A

Atrial tach, junctional tach, atrial flutter, a-fib, and sinus tach

106
Q

Treatment for stable supraventricular tach

A

Vagal maneuvers, adenosine 6mg rapid IVP, adenosine 12mg IVP 2nd dose, beta blocker or calcium channel blocker

107
Q

Treatment for unstable supraventricular tach

A

Sedate, cardioversion (6mg adenosine if have IV at beginning of signs if meds are ready)

108
Q

Monomorphic ventricular tach with pulses

A

ORS complex same size and shape

109
Q

Treatment for stable monomorphic v-tach

A

Expert consult, adenosine 6mg rapid IVP, adenosine 12mg, amiodarone infusion 150mg over 10 min

110
Q

Treatment for unstable monomorphic v-tach

A

Sedate, cardioversion

111
Q

Polymorphic v-tach with pulse

A

QRS complex different size and shapes

112
Q

Treatment for polymorphic v-tach

A

Defibrillate and CPR

113
Q

Torsades de pointes

A

Twisting pattern. QRS diff size and shapes, treat with magnesium

114
Q

Types of electrical therapy

A

Defibrillation, cardioversion, transcutaneous pacing

115
Q

What shouldn’t be happening during shock for safety

A

Oxygen should not be blowing over pt chest

116
Q

Do you have to move a pt when defibrilating if they are on water or snow

A

No only if water is on chest

117
Q

High quality compressions immediatly before and after shock increase chance of what

A

Conversion from vf

118
Q

Difference between defibrillation and cardioversion

A

Defibrillation: random shocks during cardiac cycle Cardioversion: delivery of energy that is synchronized to QRS complex

119
Q

Recommended initial cardio version dosages

A

Narrow regular: 50 - 100 J biphasic
Narrow irregular: 120 - 200 J biphasic/200 J monophasic Wide regular: 100 J biphasic Wide irregular: defibrillation dose (do not sync)

120
Q

How to perform transcutaneous pacing

A

Consider sedation, place electrodes on patient, turn on pacer, set the pace rate, slowly increase MA until capture achieved with corresponding pulse.

121
Q

What are airway adjuncts

A

Nasopharyngeal airway, oropharyngeal airway

122
Q

When can you use a nasopharyngeal airway

A

Semi conscious patient

123
Q

When is a nasopharyngeal airway contraindicated

A

In head injuries

124
Q

When is an oropharyngeal airway used

A

In unconscious patients with no gag reflex

125
Q

What are the advanced airways

A

Endotracheal tube, Laryngeal mask Airway

126
Q

Which airway is the most ideal

A

Endotracheal

127
Q

Things to watch out for using an Endotracheal tube

A

Suction during with draw 10 seconds or less, No tube ties obstructing veins in neck, Monitor capnography to confirm ET tube placement

128
Q

Why is a laryngeal mask airway used

A

Used by providers not familiar with ET tube intubation

129
Q

After advanced airway is placed what happens

A

A 100 compressions per minute Do not stop for breaths, ventilate Once every 6 seconds

130
Q

If oxygen is delivered through a BVM what should O2 be set at

A

10 - 15LPM

131
Q

Where should oxygen be kept post cardiac arrest

A

Between 94 and 99%

132
Q

What can be caused by excess ventillation

A

Increased chest pressure and decrease cardiac output

133
Q

What does Capnography measure

A

Partial pressure of end-tidal CO2

134
Q

Where does normal capnography range

A

35 - 40MMHG

135
Q

What allows for monitoring of CPR quality

A

Quantitative capnography

136
Q

What will indicate that chest compressions may not be effective

A

PETCO2 readings of less than 10MMHG

137
Q

What are signs and symptoms of a stroke

A

Loss/difficulty speaking, loss of vision, sudden severe headache, difficulty standing/walking, Weakness/numbness of face extremities or one side of body

138
Q

How to treat stroke

A

Support ABC’s, eval using Cincinnati pre-hospital stroke scale, check blood sugar, establish stoke time, transport to stroke center, CT scan Priority

139
Q

What is the Cincinnati pre hospital stroke scale

A

Facial droop, arm drift, slurred speech

140
Q

What will a CT scan possibly show in a stroke victim

A

Intracranial hemorrhaging

141
Q

After a CT If there are no signs of hemorrhaging what do you do

A

Begin fibrinolytic therapy ASAP

142
Q

What are the 3 groups of ACS

A

Unstable angina, ST segment elevation MI cama non-ST-segment elevation MI

143
Q

What are signs and symptoms of ACS

A

Chest pain to jaw/left arm

144
Q

Signs of ACS are typically more subtler in who

A

Women and diabetic patients

145
Q

What should you do if you are unsure a patient is having ACS

A

Perform 12 lead ECG

146
Q

Treatment for ACS stable

A

ABC’s, 12 lead, O2, aspirin, nitroglycerin, morphine, labs, chest X-ray

147
Q

Treatment of ACS unconscious and not breathing

A

CPR and defibrillate

148
Q

After how long in a systole should you stop CPR and medication

A

25 minutes or more

149
Q

How quickly should CPR be performed on victims they have no pulse and no normal breathing

A

Within 10 seconds

150
Q

What is a common mistake in cardiac arrest management

A

Prolonged interruptions in chest compressions

151
Q

It’s there is no suspected neck injury what is the best way to open the airway

A

Head tilt chin lift

152
Q

When an infant’s pulse rate reaches less than ___ beats per minute you should start CPR

A

60

153
Q

What is hand placement for adult CPR

A

2 hands on the lower half of the breastbone

154
Q

What is hand placement for infant CPR

A

One rescuer - 2 fingers on center of chest, Two rescuer - encircleing thumbs technique

155
Q

How many breaths a minute Should you give someone with a pulse but poor breathing

A

Adults - 1 every 5-6 seconds, children- 1 every 3-5 seconds

156
Q

Best place to check infants pulse

A

Brachial artery

157
Q

How many compressions do you deliver per minute

A

100 - 120

158
Q

How often should you switch compressors

A

Every 2 minutes or 5 cycles of CPR

159
Q

Compression depth for adults

A

At least 2”

160
Q

Compression depth for children and infants

A

At least 1/3 the depth of the chest

161
Q

Compression and breath rates after advanced airway placed

A

Compressions - 100 per minute continuous, breaths - 1 every 6 seconds

162
Q

What is the best way to relieve severe choking in responsive infants

A

5 back slaps followed by 5 Chest thrusts

163
Q

What is the highest priority for patients in respiratory failure with rapidly dropping heart beats

A

Assist with ventillation and simple airway maneuvers

164
Q

Airway for those who have achieved ROSC

A

Optimize ventillation and oxygenation

165
Q

Breathing for those who have achieved ROSC

A

A PETCO2 range of 35-40MMHG

166
Q

Circulation for those who have achieved ROSC

A

For hypotensive A122L Bullis of IV fluid, Systolic BP of 90MMHG, Epinephrine drip .1 - .5 mcg/kg/min, Differential diagnosis

167
Q

At what temperature would be considered therapeutic hypothermia

A

32 to 36ﾟC

168
Q

When is their pubic hypothermia not indicated

A

When the patient is responding to verbal command

169
Q

What might be beneficial to a patient Who are comatose

A

Therapeutic hypothermia for at least 24 hours

Dentistry (63 decks)

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