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ACLS > ACLS > Flashcards

ACLS Flashcards

1
Q

When to call rapid response

A

airway compromise, RR less than 6 or more than 30, HR less than 40 or more than 140, systolic less than 90, symptomatic hypertension, decrease in level of consciousness, unexplained agitation, seizure, significant decrease in urine, concern

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2
Q

high preformance teams need to focus on

A

timing, quality, coordination, administration

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3
Q

compressors should be switched every

A

2 minutes

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4
Q

acute coronary syndrome algorithm is for patients whose symptoms suggest

A

ischemia or infarction

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5
Q

acute coronary syndrome algorithm preperation

A

assess ABCs, administer aspirin, consider O2, nitroglycerin, and morphine, 12 lead ECG

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6
Q

acute coronary syndrome algorithm cath lab assessment

A

activate STEMI team, assess ABCs, establish IV access, physical exam, fibrinolytic checklist, cardiac marker levels and other labs, chest x ray

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7
Q

acute coronary syndrome algorithm cath lab treatment

A

if O2 sat less than 90% then start at 4 L/min, aspirin 162 to 325 mg, nitroglycerin, morphine IV, consider P2Y12 inhibitors

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8
Q

most common symptom of myocardial ischemia and infarction is

A

retrosternal chest discomfort - tightness or pressure

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9
Q

assessing ABCs includes

A

monitoring vital signs and cardiac rhythm, CPR, using a defibrillator if needed.

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10
Q

type of aspirin for ACS

A

162 mg - 325 mg of non-enteric-coated or chewed aspirin as long as there Is no evidence of GI bleed or apirin allergy

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11
Q

use rectal aspirin for

A

pts with nausea, vomiting, active peptic ulcer disease

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12
Q

nitroglycerin

A

reduces left ventricular and right ventricular preload through venous and arterial dilation. reduces chest discomfort.

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13
Q

how much nitroglycerin?

A

1 sublingual tab every 3-5 minutes for a total of 3 doses if needed. watch vitals

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14
Q

nitroglycerin can not be used in pts with

A

inadequate ventricular preload such as inferior wall MI and RV infarction, hypotension, bradycardia, or tachy, recent phosphodiesterase inhibitor use

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15
Q

what should you consider using if chest pain does not go away with the use of nitroglycerin

A

morphine

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16
Q

a patient’s response to nitrate therapy is not

A

diognostic of ACS

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17
Q

what drugs should not be used during hospitalization with STEMI because of the increased risk of morality, reinfarction, hypertension, HF, or myocardial rupture?

A

dont use anti-inflammatory drugs (except fo aspirin)

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18
Q

12 lead ECG is the only way to identify

A

STEMI

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19
Q

Reperfursion goals in pts with STEMI

A

Percutaneous Coronary Intervention (PCI) should begin within 90 minutes from door to balloon.
Firbrinolytics should begin within 30 minutes of the arrival to the ED

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20
Q

STEMI is charaxterized by

A

ST segment elevation in 2 or more contiguous or a new left bundle branch block

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21
Q

Non ST-elevation acute coronary syndrome (NSTE-ACS) is characterized by

A

ischemic ST-segment depression or dynamic T- wave inversion with pain

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22
Q

treat STEMI by providing

A

early reperfusion therapy achieved with primary PCI or fibrinolytic

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23
Q

potential delays in hospital evaluation of ACS (the 4 Ds)

A

delays may occur in evaluation from door to data (ECG), data to decision, and decision to drug.

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24
Q

most common form of PCI is

A

coronary angioplasty with stent placement

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25
Q

fribrinolytics are generally not recommended for patients who are

A

presenting more than 12 hours after onset of symptoms

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26
Q

do not give fibrinolytics to patients who

A

present more than 24 hours after onset of symptoms or those with ST segment depression unless a true posterior MI is suspected

27
Q

iv nitroglycerin is used in patients with

A

ischemic syndrome and not that often in STEMI

28
Q

goal door to needle time in stroke patients

A

60 minutes

29
Q

goal door to device time in stroke patients

A

90 minutes

30
Q

fibrinolytic therapy for stroke should be provided

A

as early as possible but should be within 3 hours of onset of symptoms

31
Q

Stroke chain of survival

A

rapid recognition and reaction to stroke warning signs, rapid use of 911, Rapid EMS recognition and transport, rapid diagnosis and treatment in the hospital

32
Q

8 D’s of stroke care (where delays can occur)

A

detection, dispatch, delivery, door, data, decision, drug/device, disposition

33
Q

upon arrival to the hospital of a stroke patient what needs to be done

A

assessment within 10 minutes, stroke team activation, prepare for CT, assess ABCs, give O2 if needed, IV access, lab assessment and glucose check, onset of symptoms and history

34
Q

time period for immediate general assessment for stroke pts

A

10 minutes

35
Q

time period for immediate neurologic assessment for stroke pts

A

within 20 minutes

36
Q

time period to get CT or MRI of head in stroke pts

A

within 20 minutes

37
Q

time period to get interpretation of CT or MRI of head in stroke pts

A

within 45 minutes

38
Q

time period to administer fibrinolytic therapy in stroke pts after arriving to the ED

A

within 60 minutes

39
Q

time period to administer fibrinolytic therapy in stroke pts from time of onset

A

within 3 hours

40
Q

time period to administer EVT therapy in stroke pts

A

up to 24 hours with patients who have large vessel occlusion

41
Q

time period from admission to bed in stroke pts

A

3 hours

42
Q

major complication of IV alteplace for stroke is

A

intracranial hemorrhage

43
Q

do not administer what after administration of alteplase

A

do not give anticoagulants or antiplatelet treatment for 24 hours after alteplase

44
Q

main steps in life support

A

check for responsiveness
shout for help, activate emergency response system, find defibrilator
check for breathing and pulse no more than 10 seconds!
begin CPR if no pulse is detected
if pulse present - begin rescue breathing

45
Q

how many compressions per minute

A

100-120 per minute

46
Q

1 respiration every

A

5-6 seconds

47
Q

consider giving ________ to ischemic stroke patients if glucose level is greater than 180

A

IV or sub q insulin

48
Q

if pt is eleigable for fibrinolytic therapy BP must be

A

185 mm Hg of less systolic and 110 mmHg or less diastolic

49
Q

Mobitz type I AV block also known as wenckebach phenomenon

A

characterized by successive prologation of the PR interval. P wave is not followed by a QRS

50
Q

Mobitz type II second degree AV block

A

characterized by 2 P waves to 1 QRS complex

51
Q

heart block that is mostly likely to cause cardiovascular collapse

A

complete (third degree) AV block

52
Q

an unstable bradycardia exists clinically when

A
  1. HR is slow
  2. patient has symptoms
  3. symptoms are due to the slow HR
53
Q

s/s of bradycardia

A

hypotension, altered mental status, signs of shock, ischemic chest discomfort, acute heart failure

54
Q

primary assessment (ABCDE)

A

A: maintain patent airway
B: assist breathing as necessary/give O2
C: monitor blood pressure, O2, HR, IV access, 12 lead
D and E: conduct focused history and physical

55
Q

bradycardia associated with hypertension can be a sign of

A

life threatening intracranial pressure

56
Q

s/s of tachycardia

A

hypotension, acutely altered mental status, signs of shock, ischemic chest discomfort, acute HF

57
Q

if patient has unstable tachycardia should you wait to cardiovert until the 12 lead EKG

A

NO

58
Q

a RR below what requires assisted ventilation

A

below 6

59
Q

excessive ventilation can cause

A

gastric inflation and complications such as aspiration

60
Q

during CPR you check pulse every

A

2 minutes

61
Q

techniques for opening airway

A

tilt the head and lift the chin or jaw thrust technique in neck injury pts

62
Q

depth of compressions should be

A

at least 2 inches and let the chest recoil

63
Q

CCF

A

actual chest compression time / total code time

ACLS (1 decks)

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