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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
CXR should be obtained within what time frame after arrival to the ED?
30 minutes
26
What are the adjunctive treatment?
NTG Heparin Beta blocker
27
What is the goal PCI time?
Within 90 minutes of the onset of s/sx
28
What is the goal PCO2 level to achieve with CPR?
15-20 mmHg
29
What level of pCO2 indicates the ROSC?
30-45 mmHg
30
What is the difference between monophasic and biphasic shocks, in terms of the amount of energy involved?
Biphasic is steadily increased | Monophasic is full blast
31
What is the stepwise amount of joules given with biphasic?
120 J 150 J 200 J
32
What is the first dose of atropine given with bradycardia? How often should this be repeated? Max dose?
- 0.5 mg bolus - q 3-5 minutes - Max 3 mg
33
What should be done if bradycardia is not causing s/sx?
Monitor and observe
34
What should be done if bradycardia is causing s/sx?
Give atropine
35
What should be done if atropine is ineffective in the first dose? What if that does not work?
Transcutaneous pacing, or dopamine/epi infusion. Consult specialist
36
What is the first and second dose of adenosine?
6 mg loading dose 12 mg if unresponsive
37
What should be done if there is a persistent tachyarrhythmia is causing s/sx?
Synchronized cardioversion
38
What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is a wide QRS??
IV access + ECG, and adenosine
39
What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is NOT a wide QRS?
IV access with vagal maneuvers, adenosine,
40
What should be done with hypotension post ROSC?
IV bolus + vasopressors + ECG
41
When should induced hypothermia be performed following ROSC?
Hypotension and is not responsive to commands
42
What is the indication for PCI?
STEMI or high suspicion of AMI
43
If there is not a suspicion for a STEMI, what should be done post ROSC?
Advanced critical care
44
Is there a max amount of epi that can be given?
No
45
HOw long should CPR intervals last?
2 minutes
46
What is the max atropine?
3 mg
47
What is the dopamine dose?
2-10 mcg / kg /min
48
What is the epi dose in bradycardia?
2-10 mcg/min
49
What is synchronized cardioversion used for?
SVTs
50
What is the dose of defibrillation for a narrow, regular rhythm?
50-100 J
51
What is the dose of defibrillation for a narrow, irregular rhythm?
120-200 J
52
What is the dose of defibrillation for a wide, regular rhythm?
100 J
53
What is the dose of defibrillation for a wide, irregular rhythm?
Defibrillation--no dose
54
What is the dosing on sotalol?
100 mg over 5 minutes
55
What is the maintenance dose of amiodarone?
1 mg/min q 6 hours
56
What should be done immediately after shocking with cardioversion if there is asystole?
Compressions
57
What are the 8 D's of stroke?
- Detection - Dispatch - Delivery - Door - Data - Decision - Drug - Disposition
58
What is the timeframe of fibrinolytics for strokes?
3-4.5 hours
59
What is the amount of time needed for s/sx to appear with a stroke?
10 seconds
60
When should oxygen be given to stroke patients?
Less than 94% or unknown SpO2
61
What is the first lab that should be obtained with a stroke patient?
BG
62
Pronator drift should be assessed after how long?
10 seconds
63
What must a hospital have to be considered a stroke center?
CT
64
CT scan should be done within what timeframe once in the ED?
10 minutes
65
What are the three components of the cincinnati stroke scale?
- Facial droop - Arm drift - Abnormal speech
66
What are the three inclusion criteria for tPA?
- Ischemic stroke causing measurable deficits - Onset of s/sx less than 3 hours ago - Age over 18 years
67
Head trauma in what timeframe is a contraindication to tPA?
3 months

Surgery and other stuff (25 decks)

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