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Assessment > ACLS/etc > Flashcards

ACLS/etc Flashcards

Test 1

1
Q

What is my best indication and 3 other indicators that my pt is not perfusing & in cardiac arrest?

A

End tidal CO2
Art line
BP
Ultrasound on heart/artery

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2
Q

What is the fastest indicator that the patient is not perfusing?

A

End tidal CO2

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3
Q

If we get a pulse back, what do we do immediately after?

A

Get BP

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4
Q

What is your role in CPR, as an anesthesiologist?

A

Head of code: I am doing meds and directing

Need to delegate:
Compressions
Bagging
Get code cart
Recorder/time keeper

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5
Q

All unstable/symptomatic patients get ___________

A

shockeddddddd

Zapp

Please read the questions on the test dummy. Keep looking at this flashcard. If it says unstable –> shock the patient. PERIODDDD

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6
Q

What rhythms do we shock during CPR? No shock?

A

Shock: V-fib
pulseless V-tach

No shock: asystole
PEA

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7
Q

How much energy do we use to shock an adult in cardiac arrest?

A

Biphasic: Initial = 200 J
subsequent = increase doses

Monophasic: 360 J

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8
Q

In ACLS, we do a rhythm check every ________ and give epi every ________

A

2 minutes

3-5 minutes

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9
Q

After ____ rounds of CPR, what other types of medications can we consider?

A

3

amio/lidocaine

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10
Q

What is the dose for Epi in ACLS?

A

1 mg every 3-5 mins

1:10,000

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11
Q

What is the amio dose in ACLS?

A

1st: 300 mg bolus
2nd: 150 mg

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12
Q

What is the lidocaine dose in ACLS?

A

1st: 1 - 1.5 mg/kg
2nd: 0.5 - 0.75 mg/kg

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13
Q

ACLS requires 1 breath every ____ seconds

A

6

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14
Q

What are my H&Ts? Which 2 are the most common?

A

Hypovolemia
Hypoxia
Hydrogen ions (acidosis)
Hypo/hyperkalemia
Hypothermia
Tension pneumothorax
Tamponade
Toxins
Thrombosis, pulmonary/ coronary

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15
Q

What medications can I give down the ET tube?

A

LEAN

Lidocaine
Epi
Atropine
Narcan

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16
Q

How can we treat acidosis?

A

Good ventilation and bicarb

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17
Q

What can I use during CPR instead of intubating?

A

LMA

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18
Q

T/F: I use lidocaine/amio in nonshockable rhythms

A

F

Only use these in ventricular rhythms

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19
Q

Cardiac tamponade presents with _______. What are the symptoms of this?

A

Beck’s triad

Decreased BP
Narrowing PP
JVD

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20
Q

tension pneumothorax causes what symptoms?

A

JVD
tracheal deviation

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21
Q

What is an easy way to Dx Cardiac tamponade or tension pneumothorax?

A

ultrasound

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22
Q

What is the antidote for tricyclic antidepressants overdose?

A

Bicarb

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23
Q

How do you Tx symtomatic bradycardia?

A

Transcutaneous pacing

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24
Q

How do you treat non-symptomatic bradycardia or ineffective Tx of symptomatic bradycardia?

A

1st: Atropine
2nd: Epi drip
3rd: Dopamine drip

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25
Q

What is the dose for atropine in bradycardia?

A

1mg

repeat 2 times every 3-5 mins

(max 3mg)

26
Q

What is the dose for epi drip in bradycardia?

A

2 - 10 mcg/min

27
Q

What is the dose for dopamine drip in bradycardia?

A

5 - 20 mcg/kg/min

28
Q

What is the dose for Adenosine w/ stable narrow tachycardia (SVT)?

A

1st: 6mg rapid IVP followed by flush
2nd: 12 mg if required

29
Q

What is the dose for Amio w/ stable wide complex tachycardia?

A

1st: 150 mg over 10 mins (repeat as needed if VT occurs)

Maintenance: 1mg/min for 6 hours

30
Q

What is the dose for Sotalol w/ stable wide complex tachycardia? What considerations should I have?

A

100 mg (1.5mg/kg) over 5 mins

Avoid w/ long QT

31
Q

What is the dose for Procainamide w/ stable wide complex tachycardia? What considerations should I have?

A

1st: 20-50mg/min until arrhythmia suppressed; hypotension; QRS duration increases >50%; at max dose 17mg/kg

Maintenance: 1-4 mg/min

Avoid with prolonged QT or CHF

32
Q

What are the medications used in the tachycardia algorithm?

A

Adenosine
Procainamide
Amiodarone
Sotalol

Beta blockers
CCB

33
Q

What non-pharmacological intervention can be used to treat stable narrow complex tachycardia? How do we do this?

A

Vagal maneuvers:

-rub on carotid
-Bear down
-ice/cold water on face

34
Q

Why do we put increased emphasis on ventilation in pediatrics in cardiac arrest?

A

Respiratory issues are the main reason pediatrics code

35
Q

What causes vFib/Vtach in pediatrics?

A

Underlying cardiac issues
Electrocution

36
Q

If a patient is in a nonshockable rhythm, what do we want to do 1st?

A

give Epi asap!!!!!!
Even before compressions if only you

37
Q

What is the compression-ventilation ratio in pediatric CPR?

A

15:2

38
Q

How often do we give a breath in pediatric CPR?

A

Every 2-3 secs

39
Q

At what J do we shock in pediatrics CPR?

A

1st: 2J/kg

2nd: 4J/kg

subsequent: > 4J/kg

max 10J/kg or adult dose

40
Q

What is the dose for Epi in pediatric CPR?

A

0.01 mg/kg

Max dose 1mg

ET tube: 0.1 mg/kg

41
Q

What is the pediatric dose for Amio in CPR?

A

5 mg/kg bolus

May be repeated up to 3 times

42
Q

What is the dose for lidocaine in pediatric CPR?

A

1 mg/kg

43
Q

What is my main focus in pediatric CPR?

A

Getting an airway early on these patients

44
Q

What is the pediatric dose for atropine w/ stable bradycardia?

A

0.02 mg/kg

min dose of 0.1 mg
max dose of 0.5 mg

45
Q

What is a very common T (reversible cause) in pediatrics?

A

Toxins

46
Q

When do we start CPR in a pediatrics?

A

HR < 60

47
Q

What drug do we give initially in bradycardia in pediatrics? Why would we give any other medication? What would that medication be?

A

Epi

Atropine: if we believe that the bradycardia is due to increased vagal tone or AV block

48
Q

What does glycopyrrolate do? What does it treat?

A

Increases HR

Bradycardia

49
Q

If we give pediatrics succs, what mediation do I need to have close by? Why?

A

Atropine

Succs has a byproduct that causes bradycardia in pediatrics

50
Q

When do we start treating tachycardia in pediatrics?

A

Infant: HR < 220

Child: HR < 180

51
Q

What are the main reasons for tachycardia in pediatrics?

A

fever
volume deletion

52
Q

What J do we use to cardiovert a pediatric patient with unstable tachycardia?

A

0.5 - 1.0 J/kg

increase to 2 J/kg

53
Q

What is the dose for Adenosine in pediatrics with tachycardia?

A

1st: 0.1 mg/kg
(max 6mg)

2nd: 0.2 mg/kg
(max 12mg)

54
Q

Why do we only use vagal maneuvers in narrow complex tachycardia?

A

It’s originating from the atria, which is influenced by the vagus

Wide complex is originating in the ventricles and is not influenced by the vagus

55
Q

What happens if you bag a neotate for a long time? How do we treat this?

A

Gastric distention

Gastric tube to decompress

56
Q

What do we do if a neonate HR drops below 100, apnea/gasping?

A

ventilate

Consider intubation/LMA in persists

57
Q

What do we do if neonate has labor breathing or is blue?

A

position
suction
O2/CPAP

58
Q

What are the main H/T in neonates?

A

Hypovolemia
Tension pneumothorax

59
Q

What volume do we use to bag in neonates?

A

6 ml/kg

60
Q

What can cause hypovolemia in neonates?

A

Raising the baby higher than the placenta before they cut it.

61
Q

What are the main considerations with pregnancy & CPR?

A
  1. Provide continuous lateral uterine displacement
  2. If receiving magnesium, STOP. Give Calcium instead
  3. Perform perimortem C-section in 5 mins if no ROSC

Able to treat mom & baby separately bc it lowers mortality

Assessment (7 decks)

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