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ACLS > ACLS Stuff > Flashcards

ACLS Stuff Flashcards

1
Q

What does the BLS Assessment entail? (4)

A
  1. Check Pt responsiveness
  2. Activate Code (blue/66)
  3. Check for breathing/pulse
  4. Start BVM and CPR if indicated
  • 30:2 (depth 6cm)
  • 1 breath every 6 seconds if pulse present
  • agonal gaps are not real breaths
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2
Q

How would you check Pt responsiveness on a prone patient?

A

Tap and shout “are you okay””

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3
Q

How long do you check for breathing/pulse?

A

5 - 10 secs

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4
Q

When you start BVM and CPR, what ratio of compressions and breaths do you give?

A
  • 30:2 (depth 6cm)
  • 1 breath every 6 seconds if pulse present
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5
Q

ABC(DE) primary assessment consists of?

A
  • Airway
  • Breathing
  • Circulation
  • Disability
  • Exposure
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6
Q

Primary assessment: what do you check on the airway assessment?

A

Patency/obstruction

  • ETT required? confirmed? secured?
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7
Q

Primary assessment: What do we check for breathing?

A

Check for Adequate ventilation and oxygenation via

  • ETCO2 and SpO2
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8
Q

Primary assessment: Exposures?

A
  • Trauma
  • Bleeding
  • Burns
  • Hypothermia
  • Medical alert braclets
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9
Q

Primary assessment: Disabilities

A
  • Neurological function
  • LOC
  • Pupil dilation
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10
Q

Primary assessment: What do we look for in circulation?

A
  • Effective CPR
  • Shockable rhythm? Defib vs cardioversion?
  • IV/IO?
  • ROSC?
  • Volume resuscitation?
  • Meds for rhythm or BP?
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11
Q

What 6 things are apart of the secondary assessment [SAMPLE]?

A
  1. Signs and symptoms
  2. Allergies
  3. Meds
  4. Past med history
  5. Last meal
  6. Events
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12
Q

What do we consider during the secondary assessment for: Events?

A
  • Sudden onset or gradual?
  • Scene hazards?
  • Time of onset?
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13
Q

What do we consider during the secondary assessment for: Past med history

A
  • Illness/hospitalizations
  • Family hx
  • surgeries/immunization status
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14
Q

What do we consider during the secondary assessment for: Signs and Symptoms?

A
  • Breathing concerns
  • Fever, headaches
  • Tachypnea and tachycardia
  • Bleeding
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15
Q

Purpose of code 66?

A

Codes are called to intervene/prevent pt from becoming unstable.

  • prevent code blue
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16
Q

Positions for a 6-person high performance team?
- team formation basically for optimal resuscitation

A

Res. triangle
- Compressor
- AED/monitor/defib
- Airway

Leadership roles
- team lead
- iv/io meds
- time/recorder

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17
Q

What are common rhythms of acute coronary syndrome support?

A
  • Sudden cardiac death
  • VTs
  • Hypotensive bradycardias
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18
Q

Difference between STEMI and NSTEMI?

A
  1. STEMI = (ST-Elevation Myocardial Infarction)
  2. NSTEMI (Non ST-Elevation MI)
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19
Q

How does acute coronary syndrome develop?

A
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20
Q

What does ABCDE describe for acute coronary syndrome?

A

Development of clots that lead to coronary issues.

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21
Q

What is a good indicator that there is a coronary issue?
- aka symptomatic vs asymptomatic

A

Troponin

  • When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood.
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22
Q

Suggested plan for ischemia/infarction?

A

Look at the diagram and get an idea of the workflow

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23
Q

Therapies:
- What are oxygen goals for acute coronary syndrome?

A

SpO2 >= 90%

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24
Q

What phrenological treatments are there for acute coronary syndrome
- what drugs are given?
- Give brief description

A

- Aspirin (stop clot formation)

- Nitroglycerin (reduce LV and RV preload via peripheral arterial and venous dilation)

- morphine (reduces chest pain if nitro can’t)

- Fibrinolytic therapy (clot busters)

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25
Q

3 Indications for CPR

A
  1. Unresponsiveness: If a person is unresponsive and not breathing normally, CPR should be started immediately.
  2. Absence of Pulse: If a person is unresponsive and not breathing normally, check for a pulse. If there is no pulse, CPR should be started immediately.
  3. Cardiac Arrest: If a person is experiencing cardiac arrest (a sudden loss of heart function), CPR should be started immediately
26
Q

3 indications for BVM

A
  1. Inadequate Breathing: If a person is breathing inadequately (e.g., gasping for air, breathing very slowly), a BVM may be used to assist with breathing until advanced medical care arrives.
  2. Respiratory Arrest: If a person is in respiratory arrest (i.e., not breathing at all), a BVM should be used to provide artificial ventilation until advanced medical care arrives.
  3. Anesthesia: During anesthesia, a BVM may be used to assist with breathing and maintain adequate oxygen levels in the body.1
27
Q

What is percutaneous coronary interventions?

A

Angioplasty with stent

28
Q

2 types of stroke?

A

Ischemic and hemorrhagic

29
Q

Ischemic stroke is caused by?

A

Occlusion of an artery

30
Q

Hemorrhagic stroke is caused by?

A

Sudden Blood vessels rupture in the brain.
- Avoid clot busters

31
Q

Stroke plan?

  • hint determine if it thrombotic or hemorrhagic
A
32
Q

Alteplase use?

A

Clot buster

  • fibrinolytic therapy
33
Q

Drugs for bradycardia?

A

- Atropine

Less commonly used:
- Dopamine

  • Epinephrine
34
Q

Traits for a symptomatic bradycardia?

A

HR < 50 bpm

normally brady is < 60bpm

35
Q

ECG Rhythms for bradycardia

A
  • Sinus brady
  • First degree AV block
  • Second degree AV block (Mobitz I & II)

-Third degree AV block

36
Q

Does atropine work for mobitz II or 3rd degree heart blocks?

A

unlikely

37
Q

Bradycardia is a sign of what?

A

- Hypoxia

  • Elevated ICP

- Check if its hypo or hypertension

38
Q

What helps a unstable bradycardia?

A

Transcutaneous pacing (stimulate contraction and rhythm)

  • must confirm electrical and mechanical capture
39
Q

Things to consider for transcutaneous pacing?

A

Sedation of the pt

Starting rate (should be 60-80)

39
Q

Things to consider for transcutaneous pacing?

A

Sedation of the pt

Starting rate (should be 60-80)

40
Q

Bradycardia workflow

A
41
Q

Which HR range should be cardioverted right away?

A

HR >= 150 BPM

42
Q

Rhythms associated w/tachycardia?

A

Sinus tach
A fib
A flutter
SVT
Monomorphic VT
Polymorphic VT
Wide-complex tachy

43
Q

Drug admin order for a tachycardia?

A
  1. Vagal maneuver (if reg)
  2. Adenosine (if reg)
  3. Beta blockers or Calcium Channel blockers
44
Q

Drugs usually associated w/Stable and wide QRS tachycardia?

A
  • Procainamide (Wide tachy)
  • Amiodarone
  • Beta blockers or calcium channel blockers
45
Q

Drug usually associated w/synchronized cardioversions?

A

Adenosine

46
Q

Signs of respiratory distress?

edit

A
  • Increased HR
  • Increased RR
  • Decreased LOC

(add more)

47
Q

Signs of respiratory failure?

edit

A
  • Severely decreased LOC
  • Absent air movement

(add more)

48
Q

Respiratory arrest is also known as?

A

Apnea

49
Q

How do you manage resp. arrest/apnea?

A
  • Avoid excessive ventilation
  • Deliver 1 breath every 6 seconds if pulse present and recheck every 2 mins.
  • Open airway (OPA, O2, head tilt, suction)
50
Q

What does Amiodarone do?

A

Slows HR and reduces electrical activity in the heart.

  • For VF and VT
51
Q

What is Adenosine is used to treat?

A

SVT; temporarily blocks electrical conduction in the AV node

  • Admin via intravenous bolus
52
Q

Atropine use?

A

Treats Bradycardia by increasing HR

53
Q

factors that prevent excessive ventilation?

A
  • Increased intrathoracic pressure
  • Decreased venous return
  • Decreased CO
  • Cerebral vasoconstriction
54
Q

Ask someone

A
55
Q

Drugs for cardiac arrest

A
  • Epinephrine every 3-5 mins (vasopressor)
  • Amiodarone (antiarrhythmic)
  • Lidocaine (antiarrhythmic)
  • Magnesium sulfate (torsades de pointes - ecg rhythm, )
  • Dopamine
  • O2
56
Q

What are indicators that a pt is in shock?

A
  • If in VF/pVT
  • Agonal resp
57
Q

Understand the workflow

A
58
Q

Post Cardiac Arrest Care

A
  • Still need to consider Hs & Ts
  • Manage the ABCs
  • Targeted Temp Management
  • Monitor EtCO2 – May be one of the first signs the patient is arresting again!
  • Treat hypotension (drugs or volume)
  • Neuroprognostication – Hypoxic-ischemic injury
59
Q

How can hyperventilation be detrimental?

A
  1. Increased intrathoracic pressure
  2. Decrease venous return to the heart
  3. Diminished CO
60
Q

When do you cardiovert?

A
  • Atrial fibrillation (AF),
  • Atrial flutter
  • Stable ventricular tachycardia;
    when medications have failed to convert the rhythm, or when the patient is becoming unstable and the rhythm must be immediately terminated.
61
Q
A

ACLS (2 decks)

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