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ACLS > ACLS Book > Flashcards

ACLS Book Flashcards

1
Q

What are the BCLS 4 steps?

A

1) check responsiveness - “are you alright” + scan for 5-10 sec
2) activate emergency response system + get AED
3) circulation - check pulse for 5-10sec
- – no pulse: CPR 30compression/2breathes
- – pulse: ONLY 1 breath/5-6sec
4) defibrillation - AED

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2
Q

If alone - how to do CPR?

A

1) call for help
2) bring AED
3) CPR THEN AED

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3
Q

What is the ACLS survey?

A

Airway
Breathing
Circulation
Ddx

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4
Q

How to monitor airway?

A

capnography

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5
Q

What to check for in “Airway” - ACLS?

A

check airway and monitor w/ capnography

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6
Q

What to do in “Breathing” - ACLS?

A

cardiac arrest - 100%

otherwise: >94% is sufficient

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7
Q

What to do in “Circulation” - ACLS?

A 
monitor CPR quality
-capnography is >10mmHg
-intra arterial pressure is >20mmHg
use of AED
IV/IO + drugs if needed
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8
Q

What are the 6 roles of a team?

A 
team leader
observer/recorder
compressor
airway
IV/IO/meds
monitor/defib
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9
Q

What are the 2 airway devices?

A

bag-mask

any advanced airway

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10
Q

How many ventilations during CARDIAC ARREST?

A

bag-mask: 30 compressions/2vents

any advanced airway: 1 vent/6-8secs

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11
Q

How many ventilations during RESPIRATORY ARREST?

A

ANY airway device: 1 vent/5-6secs

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12
Q

How to manage airway with suspected C-spine injury?

A

jaw thrust

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13
Q

What are 2 basic airway adjuncts?

A

oropharyngeal airway

nasopharyngeal airway

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14
Q

What should be confirmed before using oropharyngeal airway?

A

PATIENT IS UNCONSCIOUS - AVOID GAG REFLEX

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15
Q

How to insert OPA?

A

1) clear mouth
2) select PROPER OPA
3) insert OPA so it curves UP
4) rotate OPA so curve is pressing on top of the tongue
* moves tongue out of the way

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16
Q

What haps of OPA is too big?

A

trauma to laryngeal

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17
Q

What haps of OPA is too small?

A

push tongue and obstruct airway

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18
Q

When can you use NPA, when can you cannot?

A

yes: conscious, semiconscious
no: facial abrasions - cribiform fracture

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19
Q

How to insert NPA?

A

1) select size
2) lubricate
3) insert

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20
Q

When to use soft catheters for suctioning?

A

aspiration of THIN secretion from oropharynx and nasopharynx
pt has clenched teeth

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21
Q

When to use rigid catheters?

A

suctioning oropharynx with THICK matter

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22
Q

How to insert oropharyngeal suction?

A

1) measure- nothing LONGER than ear lobe to tip of nose and insert
2) suction + rotate

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23
Q

How to insert endotracheal tube section?

A

1) sterile technique
2) insert
3) suction attempts should NOT exceed 10 sec

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24
Q

Where can you place the AED pads?

A

anterolateral
anteroposterior
anterior - left infrascapular
anterior-right infrascapular

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25
Q

What drugs are used for VF/VT?

A 
Epinephrine 
Norepinephrine
Vasopressin
Amiodarone
Lidocaine
Mg sulfate
Dopamine
O2
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26
Q

How much epinephrine should be given during VF/pulseness VT?

A

IV/IO 1mg q3-5min

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27
Q

What can you give instead of epinephrine? How many doses of epinephrine?

A

Vasopressin IV/IO 40units for 1-2 doses

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28
Q

How much Amiodarone can you give during VF/pulselss VT?

A

300mg bolus then 150mg

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29
Q

What are reversible causes of VF/pulseless VT?

A 
Hypovolemia
Hypoxia
Hydrogen ion - acidosis
Hypo/hyper kalemia
Hypothermia
Tension pneumothorax
Tamponade, cardio
Toxins
Thrombosis, pulm
Thrombosis, coronary
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30
Q

How many volts for monophasic and biphasic defibrillator?

A

Monophasic: 360
Biphasic: 120-200

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31
Q

When do you check for rhythm?

A

Q2min

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32
Q

What can you use instead of Amiodarone - VF/ pulselessVT?

A

Lidocaine 1-1.5mg/kg then 0.5-0.75mg q5-10min

Max: 3mg/kg

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33
Q

What to use if pt has torsades de pointes + long QT interval?

A

Mg sulfate 1) 1-2g +10mg saline 2) bolus q5-20min

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34
Q

When should try to improve CPR quality - physiological monitoring during CPR?

A

End tidal co2

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35
Q

How to administer drugs through IV?

A

Drug by bolus
20ml bolus of fluid
Elevate extremity for 10-20sec

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36
Q

How much fluids for post cardiac arrest?

A

1-2L

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37
Q

How much epinephrine for post cardiac arrest?

A

0.1-0.5mcg/kg

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38
Q

How much dopamine after post cardiac arrest?

A

5-10mcg/kg/min

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39
Q

How much norepinephrine post cardiac arrest?

A

0.1-0.5mcg/kg/min

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40
Q

EKG: Narrow complex + rapid rate?

A

Hypovolemia

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41
Q

EKG: slow rate?

A

Hypoxia

42
Q

EKG: small amplitude QRS?

A

Acidosis

43
Q

EKG: tall and peaked T waves + Small P waves + wide QRS?

A

Hyperkalemia

44
Q

EKG: low T waves + U waves + prolonged QT + wide QRS?

A

Hypokalemia

45
Q

EKG: J waves?

A

Hypothermia

46
Q

How to tx hyper kalemia?

A

Ca chloride
Na bicarb
Glucose + insulin
+/- albuterol

47
Q

How to tx hypokalemia?

A

Mg

48
Q

EKG: narrow complex + slow rate?

A

Tension pneumothorax

49
Q

How to tx tension pneumothorax?

A

Needle decompression

Tube throacostomy

50
Q

EKG: narrow complex + rapid rate + no pulse? Tx?

A

Cardio tamopanode

Pericardiocentesis

51
Q

EKG: narrow complex + rapid rate + no pulse + distended neck? Tx?

A

Thrombosis-lung

Fibrinolytic

52
Q

Patients with coronary atheroscleorsis can have?

A

unstable angina
NSTEMI
STEMi

53
Q

How much ASA should be given for ichemia?

A

160-325mg

54
Q

What if pt has N&V -how to give ASA and how much?

A

300mg rectal suppositories

55
Q

How much and often should you give nitro - MI?

A

1 tab/spray q3-5min

56
Q

When is nitro and morphine contraindicated-MI?

A

hypotension from RV infarction

57
Q

When should morphine be given -MI?

A

STEMI NOT in NSTEMI

58
Q

MOA of morphine?

A

reduces catecholamine release
venodilation
decreases systemic vascular resistance

59
Q

What drug is contraindicated with MI?

A

NSAID

60
Q

When is ASA contraindicated-MI?

A

ASA allergy

GI bleeding

61
Q

What are potential delays in hosp - MI?

A

Door to data –> to decision –> to drug

62
Q

How long for fibrinolytic therapy -MI?

A

30min

63
Q

How long for PCI-MI?

A

90min

64
Q

IV nitro is used in MI for..?

A

relief of ischemic chest discomfort

improvement in pulmonary edem and HTN

65
Q

How should IV nitro be given?

A

titrate and keep SBP >90

66
Q

Criteria for symptomatic bradycardia?

A

HR is slow
pt has sx
sx are d/t slow HR

67
Q

Bradycardia sx? Also sx for?

A 
hypotension
mental status
chest pain
HF
unstable tachycardia
68
Q

What is the dose for atropine IV - bradycardia?

A

1) 0.5mg bolus

2) repeat q3-5min

69
Q

What is the dose for dopamine and epinepherine IV - bradycardia?

A

2-10mcg/kg/min

70
Q

What is bradycardia?

A
71
Q

First line for bradycardia?

A

atropine

72
Q

What to give pt before pacing-bradycardia?

A

parenteral benzo
parenteral narcotic
chronotropic infusion

73
Q

What is the demand rate on the TCP-bradycardia?

A

60

74
Q

Who should get TCP -EKG?

A

mobitz type II second deg AV block
third degree
bundle branch

75
Q

When is cardioversion contraindicated in tachycardia?

A

sinus tachycardia - usually d/t fever, shock, etc

76
Q

When should consult be obtained for tachycardia?

A

stable

77
Q

When should someone get cadrioverted in tachycardia?

A

> 150HR

78
Q

What are the sx of tachycardia that indicates cardioversion?

A

hypotension
shock
altered mental status
ischemic chest pain

79
Q

EKG is narrow and regular - tachycardic?

A

50-100J

80
Q

EKG is narrow and irregular-tachycardic?

A

120-200J biphasic

200J monophasic

81
Q

EKG is wide regular - tachycardic?

A

100J

82
Q

How much adenosine IV for tachycardia?

A

1) 6mg IV push + NS flush

2) 12mg if needed

83
Q

When should procainamide/amiodarone/sotalol be considered in tachycardia?

A

wide QRS

84
Q

How much procainamide- tachycardia?

A

20-50mg/min until needed

maintenance: 1-4mg/min

85
Q

When is procinamide contraindicated?

A

prolonged QT or CHF

86
Q

Amiodarone IV dose - tachycardia?

A

1) 150mg over 10min

maintenance 1mg/min for 6hrs

87
Q

Sotalol IV dose- tachycardia?

A

100mg over 5min

88
Q

If pt has CHF + tachycardia + wide QRS?

A

sotalol

NO procainamide

89
Q

When do you use sychronized shocks?

A

unstable SVT
unstable afib
unstable aflutter
unstable monomorphic tachycardia w/pulses

90
Q

When do you use unsychornized shocks?

A

pulselesness

cannot differentiate between monomorphic and polymorphic VT in usntable pt

91
Q

When to use 200J in synchronized cardioversion?

A

unstable SVT a flutter

unstable a fib

92
Q

Unstable monomorphic VT -cardioversion?

A

100J

93
Q

When is cardioversion contraindicated in tachycardia?

A

cx is fever, anemia, hypotension, blood loss, exercise

94
Q

How much adenosine IV - tachycardia?

A

1) 6mg IV rapid + NS flush

2) 12mg

95
Q

What to do when pt has irregular wide complex tachycardia?

A

NO DRUGS

96
Q

What to do if SVT does not respond to vagal maneuvers?

A

adenosine 6mg rapid IV push +20mL flush

then 12mg rapid IV push +20mL flush

97
Q

What are potential delays for stroke tx?

A 
8D
D-etectino
D-ispatch
D-eliverty
D-oor
D-ata
D-ecision
D-rug
D-isposition
98
Q

What is Cincinnati prehospital stroke scale?

A

facial droop
arm drift
abnormal speech

99
Q

What is the time line for stroke pts?

A

10min of assessment of pt
25 min of neurological assessment of pt
25 min of CT scan
45min of CT scan interpretation

100
Q

Who can have TPA for stroke?

A

w/in 3hrs

101
Q

Who canNOT have TPA for stroke?

A 
head trauma/stroke w/in 3 MO
sx-hemmorrhage
bleeding
high BP: >185/>110
low platelet ct
102
Q

What to NEVER GIVE after TPA?

A

anticoag or antiplatelet w/in 24hrs

ACLS (1 decks)

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