ACLS

Question 1

Dose of epinephrine

Answer 1

1mg q3-5min

Question 2

Dose of amiodarone and lidocaine

Answer 2

300mgx1 then 150mgx1 (amiodarone)

1-1.5mg/kh x1 then 0.5 - 0.75 mg/kg x 1 afterwards (lidocaine)

Question 3

What is the rate of chest compressions

Answer 3

100-200/min with adult depth of at least 2 inches

Question 4

If no airway is available, use a rate of _____ compression-ventilation ratio

Answer 4

30:2

Question 5

What do you do if you see PEA or asystole?

Answer 5

Give epinephrine 1mg q3-5min

Question 6

What medication do you give if someone is bradycardic?

Answer 6

atropine 0.5 mg IV q 3-5min (max 3mg)

Question 7

What do you do if someone is tachycardic?

Answer 7

cardioversion

Question 8

What meds do you give in a narrow complex tachycardia PSVT that does not respond to vagal maneuvers?

Answer 8

adenosine 6mg IV push, wait 2 min and repeat 12mg IV 
Consider CCB (verapamil 2.5-5mg or diltiazem 15-20mg)  or beta-blocker

Question 9

What do you give in a wide complex tachycardia?

Answer 9

amiodarone

Question 10

If an ______1._ _______ is placed, perform continuous compressiosn w/ positive pressure ventilation w/o pausing chest compressions or 1 breath ____2.____

Answer 10

1. advanced airway

2. q6s or 10 breaths/min

Question 11

What is the compression to ventilation ratio for children?

Answer 11

30: 2 with 1 rescuer
15: 2 2 or more rescuers

Question 12

in pediatric patients, what is the appropriate compression depth?

Answer 12

at least 1 third on AP diameter of the chest

Question 13

How long is a CPR round?

Answer 13

2 min

Question 14

What are the 5 H’s for reversible causes?

Answer 14

Hyper/Hypo-kalemia
Hypoxemia
Hypovolemia  
Hypothermia
Hydrogen ion (acidosis)

Question 15

What are the 5 T’s for reversible causes?

Answer 15

Tension pneumothorax 
Tamponade, cardiac 
Toxins 
Thrombosis, pulmonary 
Thrombosis, coronary

Question 16

What is considered a wide QRS?

Answer 16

≥ 0.12 s

Question 17

List 5 things you would do (in order), for a patient with narrow complex tachycardia, assuming they are not acutely decompensating?

Answer 17

• IV access and 12 lead ECG if available.
• vagal maneuvers
• adenosine (if regular)
• B-blocker or CCB
• consider expert consultation

Question 18

What do you do if someone has tachycardia and they are decompensating?

Answer 18

synchronized cardioversion

Question 19

Heart rate is typically ≥ ____ if tachyarrhythmia

Answer 19

≥150/min

Question 20

Heart rate is typically < _____ if bradyarrhythmia

Answer 20

<50

Question 21

If someone is bradycardic and atropine is not effective what can you do?

Answer 21

1) transcutaneous pacing OR
2) dopamine infusion OR
3) Epinephrine infusion

Question 22

When ROSC is obtained, what are the steps in the initial stabilization phase?

Answer 22

• manage airway - early placement of endotracheal tube
• manage respiratory parameters (start 10 breaths/min, spO2 92-98%, PaCo2 35-45mmHg)
• Manage hemodynamic parameters (SBP >90 and mean arterial BP >65mmHg)
• obtain a 12-lead EKG

Question 23

What are the obstetrical interventions in the ACLS algorithm for pregnancy?

Answer 23

• provide continuous lateral uterine displacement
• detach fetal monitors
• prepare for perimortem cesarean delivery

Question 24

What are the maternal interventions in the ACLS algorithm for pregnancy

Answer 24

• perform airway management
• administer 100% O2, avoid excess ventialtion
• place IV above diaphragm
• if receiving IV mg, stop and give calcium chloride or gluconate

Question 25

For a pregnant women if no ROSC in ___ minutes, consider immediate perimortem c-section

Answer 25

5

Question 26

What are the components of post-cardiac care?

Answer 26

• oxygenation and ventilation - 94-99%
• hemodynamic monitoring
• targeted temperature management
• neuromonitoring (with continuous EEG) and consider early brain imaging + treat seizures
• electrolytes and glucose - measure BS and avoid hypoglycemia
• sedation
• Prognosis -consider EEG and neuroimaging during the first 7 days