Advanced Cardiac Life Support Flashcards

1
Q

Chain of survival

A
  1. Early recognition + call
  2. Early CPR
  3. Early defibrillation
  4. Early advanced care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of cardiac arrest

A

Unconscious + absence of normal breathing

  • Call for help, start CPR
  • Pulse check unreliable in indicating adequate myocardial and cerebral perfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When to use precordial thump

A

Ventricular tachycardia if defibrillator not immediately available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why do you continue CPR for 2 mins after shock?

A
  • Allow recovery from myocardial stunning

- Maintains myocardial perfusion pressure until ROSC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are shockable rhythms?

A
  1. Ventricular fibrillation
    - Bizarre, irregular waveforms
    - No recognisable QRS wave
  2. Ventricular tachycardia
    - Rapid
    - Constant QRS morphology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are non-shockable rhythms?

A
  1. PEA (pulseless electrical activity)
    - Electrical activity without a pulse
    - Cardiac arrest
  2. Asystole
    - Absent QRS activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hazards to defibrillation

A
  • Water
  • Oxygen
  • Jewellery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Safe method for defibrillation

A
C: compressions continue
O: oxygen away
A: all others clear
C: charging defibrillator
H: hands off
E: evaluating rhythm
D: difibrillate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the reversible causes of cardiac arrest? ***

A

Hypoxia
- Treatment: advanced airway, capnography

Hypovolaemia

  • Causes: haemorrhage, surgical drains, wounds, trauma, sepsis
  • Treatment: blood, fluids

Hypo/hyperkalaemia

  • Causes: diuretic use, D+V, medications, kidney disease
  • Treatment: lab, drugs, fluids

Hypo/hyperthermia

  • Causes (hyper): exercise, dehydration, GA, drug toxicity
  • Signs (hyper): seizure, rhabdomyolysis, metabolic acidosis
  • Treatment (hyper): active cooling, 0.5’C/hr, fluid electrolyte replacement

Tension pneumothorax (air in intrapleural space)

  • Cause: trauma, procedure, asthma
  • Signs: decreased chest rise/fall, decreased breath sounds, tracheal deviation, tube position
  • Treatment: needle decompression, thoracotomy, chest drain

Tamponade (blood in pericardial space)

  • Cause: trauma, procedure, cardiac surgery
  • Signs: chest pain, anxiety, relief by sitting forward, hypertension, LOC
  • Treatment: pericardiocentesis

Toxin

  • Cause: overdose, recreational drug, medication
  • Treatment: antidote

Thrombus

  • Cause: DVT
  • Signs: SOB, chest pain, hypoxia, arrhythmia
  • Treatment: fibrinolytic e.g. heparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common cardiac arrest drugs

A
  1. Adrenaline
    - MOA: a+b adrenergic agonist -> vasoconstriction + contraction
    - Admin: IV push
    - Dose: 1mg
    - Use: VF, VT, PEA, AS
  2. Amiodarone
    - MOA: anti-arrhythmia -> prolongs action potential, slows SR
    - Admin: IV push
    - Dose: 300mg, 150mg
    - Use: VF, VT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cardiac drug routes of administration

A
  1. CVC if insitu - rapid
  2. PVC
  3. IO
  4. ET
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Post resus care

A
  • A-G re-evaluation
  • Precipitating causes
  • ECG, BSL, Pathology
  • Temp management
  • Oxygenation
  • Optimise cerebral perfusion
  • Resus injuries (ribs, tension ptx, tamponade)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nursing responsibilities in ACL

A
  • Team leader
  • Airway management
  • Compression
  • Defibrillator
  • Drugs
  • Runner
  • Scribe
  • Ward
  • Family
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nursing responsibilities post resus

A
  • Monitoring
  • Care planning
  • Documentation
  • Family support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ACLS components/algorhythm

A
  1. Start CPR - attach defibrillator - assess rhythm

SHOCKABLE: 1st shock - CPR 2mins - assess rhythm, 2nd shock - CPR 2mins - assess rhythm - Adrenaline 1mg, 3rd shock - CPR 2mins - assess rhythm - Amio 300mg

NON-SHOCKABLE: Adrenaline immediately - CPR 2mins - assess rhythm - CPR 2 mins - assess rhythm - adrenaline etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Purpose of CPR

A

Temporarily maintain circulation to preserve brain function

17
Q

When not to do CPR

A

Traumatic cardiac arrest - hypovolaemia, hypoxaemia

CPR won’t reverse any of these, treat the cause

18
Q

What to document during ACLS

A
  • Time of event
  • Actions and pt response (defibrillation, drugs, procedures, airway management)
  • Team members present
  • Vital signs
  • End result
19
Q

Family support during ACLS

A
  • Stay with them
  • Provide information
  • Visitation after arrest
  • Religious support
  • Social work