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Surgery and other stuff > ACLS notes > Flashcards

ACLS notes Flashcards

1
Q

What are the two indications that CPR is ineffective?

A

PETCO2 is less than 10 mmHg

DBP is less than 20 mmHg

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2
Q

What are the components of the ACLS survey?

A

Airway (need to establish one?)
Breathing (oxygenation and ventilation adequate)
Circulation (CPR effective)
Differential (Search for a cause)

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3
Q

What are the things that should be assessed for in ensuring adequate circulation? (3)

A
  • IV access
  • Cardiac rhythm/need for defibrillation
  • Meds/fluids needed?
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4
Q

What are the two major reasons for understanding team member roles?

A

Knowledge of how to communicate and work as a member of a team

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5
Q

What are the components of the BLS survey? (4)

A
  • Check responsiveness
  • Activate EMS/ AED
  • Breathing and circulation (CPR)
  • Defibrillator
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6
Q

How long should interruptions in CPR be?

A

No more than 10 seconds

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7
Q

How often should providers be switched while performing CPR?

A

2 minutes

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8
Q

What are the three ways of monitoring oxygenation during CPR?

A

Clinical criteria (cyanosis, chest rise)
Quantitative waveform capnography
Oxygen sat

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9
Q

What is the main role of the team leader?

A

Ensuring comprehensive patient care

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10
Q

Who “closes the loop” in closed loop communication?

A

The team member performing the action

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11
Q

What is the oxygen saturation that should be achieved post arrest?

A

94%

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12
Q

Why is it necessary to avoid over ventilating a patient? (2)

A
  • Decreased cerebral blood flow with PaCO2 decreases

- Increase risk of aspiration if air in stomach

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13
Q

What is the rate of ventilation post cardiac arrest?

A

10-12 / min

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14
Q

What is the goal PETCO2 post cardiac arrest?

A

35-40 mmHg

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15
Q

Can PCI be done in patients that are cooled?

A

Yes

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16
Q

What is the goal BG levels post arrest?

A

144-180 mg/dL

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17
Q

What is the frequency and duration of the pulse checks in respiratory arrest?

A

Recheck every 2 minutes

5-10 secs for checks

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18
Q

What are the components of the ACLS survey for respiratory arrest?

A
  1. Check responsiveness
  2. Activate EMS/AED
  3. Circulation
  4. Defibrillation PRN
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19
Q

What is the rate of breaths given during CPR wwo an advanced airway for cardiac arrest? For respiratory arrest?

A

CPR w/o = 30:2
CPR w/ = 1 vent / 6-8 secs
Respiratory arrest = 1 / 5-6 seconds

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20
Q

The benefit of an advanced airway is always weight against what?

A

Stopping compressions

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21
Q

What is the general order of the ACLS survey for respiratory arrest?

A

ABCD

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22
Q

What is the appropriate tidal volume delivery for bag masks (in mLs)?

A

600 mL

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23
Q

How do you select the proper OPA?

A

tip of OPA should reach the angle of the mandible

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24
Q

How is an OPA inserted?

A

Curve upwards, then turn down

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25
Q

Which can be used in conscious patients: NPAs or OPAs?

A

NPAs

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26
Q

How is the appropriate diameter of the NPA selected?

A

Should not blanch the nostril (pinky rule)

27
Q

How is the appropriate length of an NPA selected?

A

Tip of nose to earlobe

28
Q

What should always be assessed for immediately after placement of an OPA or NPA?

A

Spontaneous return of breathing

29
Q

What are the indications for soft vs hard suction tubing respectively?

A

Soft - Intratracheal or through an airway

Hard - Thick particulate matter

30
Q

How far should a suction catheter be inserted?

A

No further than the distance from the tip of the nose to the earlobe

31
Q

How is suction applied appropriately?

A

With withdrawal

32
Q

How long (in seconds) should suction attempts be made with ET tubes? Do the tubes have to be sterile?

A

No more than 10 seconds

Need sterile tubing

33
Q

What should always be monitored for with suctioning an ET tube?

A

Heart rate and breathing

34
Q

True or false: you must still pause for ventilations while during CPR when an advanced airway is in place

A

False

35
Q

Should the pulse be assessed for prior to, or after calling for an AED?

A

After

36
Q

Why is CPR started immediately after a shock?

A

Heart needs time to resume

37
Q

What are the three indications for an AED?

A
  1. No response
  2. Absent or abnormal breathing
  3. No pulse
38
Q

Are agonal gasps adequate breathing?

A

No

39
Q

Do you turn on the AED before or after hooking it up to the patient?

A

Before

40
Q

Should AEDs be used in patients with defibrillators?

A

Yes, but ensure that you’re not placing the AED pad over the defibrillator, and allow time for it to shock

41
Q

What is the equation for coronary perfusion pressure?

A

Aortic DBP - Right atrial DBP

42
Q

Why is Epi used in the treatment of VF/VT or asystole/PEA?

A

Alpha adrenergic causes vasoconstriction, which increases cerebral and coronary perfusion

43
Q

What is the MOA of vasopressin?

A

Causes vasoconstriction

44
Q

What are the doses of Epi/Vasopressin?

A

1 mg of epi

40 units of vasopressin

45
Q

What is the role of antiarrhythmics given during cardiac arrest? What is the drug of choice?

A

Not been shown to help

Amiodarone

46
Q

What is the dosing of amiodarone?

A

300 mg IV bolus

47
Q

What is the drug of choice if amiodarone is not available? Dose?

A

Lidocaine–1 - 1.5 mg/kg

48
Q

When is MgSO4 given? Dosage?

A

TdP

1-2 g loading dose in 10 mL

49
Q

How far should the chest recoil with compressions?

A

2 inches (5 cm)

50
Q

What are the 5 H’s of reversible causes of cardiac arrest?

A 
Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo/hyperkalemia
Hypothermia
51
Q

What are the five Ts of reversible causes of cardiac arrest?

A 
Tension pneumothorax
Tamponade
Toxins
Thrombosis, pulmonary
Thrombosis, cardiac
52
Q

Values of PETCO2 of less than what in intubated patients indicates that ROSC is unlikely?

A

10 mmHg

53
Q

How often should epi be administered during a cardiac arrest?

A

1 mg q 3-5 minutes

54
Q

What should be done following administration of epi?

A

Give a 20 mL flush of IVF and elevate the extremity above the level of the heart for 10-20 seconds

55
Q

What is the role of MgSO4 in the treatment of TdP?

A

Prevents recurrence–still needs shock

56
Q

Flat neck veins in a cardiac arrest pt = ?

A

Dehydration–give IVF

57
Q

What are the EKG findings of a dehydration pt?

A

Narrow complexes and rapid rate

58
Q

What are the EKG findings of hypoxia?

A

Slow rate

59
Q

What are the EKG findings of acidosis?

A

Smaller amplitude QRS complexes

60
Q

What are the EKG findings of Hypokalemia?

A
  • U waves

- Flattened T waves

61
Q

What are the EKG findings hyperkalemia?

A

Peaked T waves

62
Q

What are the EKG findings of tension pneumothorax?

A

Narrow complexes and slow rate

63
Q

What are the EKG findings of tamponade?

A

Narrow complexes

Rapid rate

64
Q

Is volume infusion appropriate for treating cardiac tamponade?

A

Yes–should be given

Surgery and other stuff (25 decks)

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