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Surgery and other stuff > ACLS class notes > Flashcards

ACLS class notes Flashcards

1
Q

True or false: the IV that is in place to infuse drugs is also used to draw labs

A

True

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2
Q

What is the indication for NS vs LR?

A

LR for trauma

NS for medical codes

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3
Q

What is the primary antiarrhythmic used in a code?

A

Amiodarone

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4
Q

What is the dosage on amiodarone for the first, and successive doses?

A

300 mg

150 mg for each additional dose

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5
Q

What is the dosage on lidocaine for the first and successive doses?

A

1.0-1.5 mg/kg for first dose, 0.5 to 0.75 mg

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6
Q

What are the 5 H’s?

A 
Hypoxia
Hydrogen ions
Hypo/hyperkalemia
Hypothermia
***
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7
Q

What are the five T’s?

A
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8
Q

What is the amount of oxygen (SpO2) that should be used on COPD patients?

A

94-99%

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9
Q

What is the max amount of ventilation during a code?

A

1 per 6 secs

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10
Q

What is the reasoning for pre-oxygenation?

A

3 breathes of oxygen prior to sucking all air out

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11
Q

What is the target body temperature with hypothermia? How long should this be maintained?

A

32-36 degrees C for 24 hours (different from book)

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12
Q

What is the first thing that is checked with a newly organized rhythm on the monitor?

A

Check pulse to assess for PEA

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13
Q

What is the SBP that is considered stable?

A

90 mmHg

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14
Q

What should be done if the SBP is only 70 mmHg?

A

Continue support with CPR

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15
Q

What is the normal response to prolonged hypothermia? What, then, must be monitored?

A

Inflammation. Thus need to monitor for fever, and manage appropriately.

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16
Q

What are the orders that need to be obtained post arrest?

A

ECG + basic labs

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17
Q

What are the two contraindications to ASA administration?

A

Enteric bleed within the last 2 weeks

Allergy

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18
Q

At what level of SpO2 should oxygen be given?

A

94% or less

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19
Q

What is the frequency of Nitro?

A

1 every 5 minutes, up to three doses

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20
Q

What are the contraindications to nitro?

A

Bradycardia

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21
Q

If RV infarction is present, should you use nitrates?

A

No

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22
Q

What EKG should be obtained if there shows an inferior lead STEMI? Why?

A

Right sides EKG, to evaluate for RV infarction

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23
Q

Should you use coated ASA?

A

No

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24
Q

What is the goal for fibrinolytics?

A

within 30 minutes of arrival in the ED

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25
Q

CXR should be obtained within what time frame after arrival to the ED?

A

30 minutes

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26
Q

What are the adjunctive treatment?

A

NTG
Heparin
Beta blocker

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27
Q

What is the goal PCI time?

A

Within 90 minutes of the onset of s/sx

28
Q

What is the goal PCO2 level to achieve with CPR?

A

15-20 mmHg

29
Q

What level of pCO2 indicates the ROSC?

A

30-45 mmHg

30
Q

What is the difference between monophasic and biphasic shocks, in terms of the amount of energy involved?

A

Biphasic is steadily increased

Monophasic is full blast

31
Q

What is the stepwise amount of joules given with biphasic?

A

120 J
150 J
200 J

32
Q

What is the first dose of atropine given with bradycardia? How often should this be repeated? Max dose?

A
  • 0.5 mg bolus
  • q 3-5 minutes
  • Max 3 mg
33
Q

What should be done if bradycardia is not causing s/sx?

A

Monitor and observe

34
Q

What should be done if bradycardia is causing s/sx?

A

Give atropine

35
Q

What should be done if atropine is ineffective in the first dose? What if that does not work?

A

Transcutaneous pacing, or dopamine/epi infusion.

Consult specialist

36
Q

What is the first and second dose of adenosine?

A

6 mg loading dose

12 mg if unresponsive

37
Q

What should be done if there is a persistent tachyarrhythmia is causing s/sx?

A

Synchronized cardioversion

38
Q

What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is a wide QRS??

A

IV access + ECG, and adenosine

39
Q

What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is NOT a wide QRS?

A

IV access with vagal maneuvers, adenosine,

40
Q

What should be done with hypotension post ROSC?

A

IV bolus + vasopressors + ECG

41
Q

When should induced hypothermia be performed following ROSC?

A

Hypotension and is not responsive to commands

42
Q

What is the indication for PCI?

A

STEMI or high suspicion of AMI

43
Q

If there is not a suspicion for a STEMI, what should be done post ROSC?

A

Advanced critical care

44
Q

Is there a max amount of epi that can be given?

45
Q

HOw long should CPR intervals last?

46
Q

What is the max atropine?

47
Q

What is the dopamine dose?

A

2-10 mcg / kg /min

48
Q

What is the epi dose in bradycardia?

A

2-10 mcg/min

49
Q

What is synchronized cardioversion used for?

50
Q

What is the dose of defibrillation for a narrow, regular rhythm?

51
Q

What is the dose of defibrillation for a narrow, irregular rhythm?

52
Q

What is the dose of defibrillation for a wide, regular rhythm?

53
Q

What is the dose of defibrillation for a wide, irregular rhythm?

A

Defibrillation–no dose

54
Q

What is the dosing on sotalol?

A

100 mg over 5 minutes

55
Q

What is the maintenance dose of amiodarone?

A

1 mg/min q 6 hours

56
Q

What should be done immediately after shocking with cardioversion if there is asystole?

A

Compressions

57
Q

What are the 8 D’s of stroke?

A
  • Detection
  • Dispatch
  • Delivery
  • Door
  • Data
  • Decision
  • Drug
  • Disposition
58
Q

What is the timeframe of fibrinolytics for strokes?

A

3-4.5 hours

59
Q

What is the amount of time needed for s/sx to appear with a stroke?

A

10 seconds

60
Q

When should oxygen be given to stroke patients?

A

Less than 94% or unknown SpO2

61
Q

What is the first lab that should be obtained with a stroke patient?

62
Q

Pronator drift should be assessed after how long?

A

10 seconds

63
Q

What must a hospital have to be considered a stroke center?

64
Q

CT scan should be done within what timeframe once in the ED?

A

10 minutes

65
Q

What are the three components of the cincinnati stroke scale?

A
  • Facial droop
  • Arm drift
  • Abnormal speech
66
Q

What are the three inclusion criteria for tPA?

A
  • Ischemic stroke causing measurable deficits
  • Onset of s/sx less than 3 hours ago
  • Age over 18 years
67
Q

Head trauma in what timeframe is a contraindication to tPA?

Surgery and other stuff (25 decks)

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