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NURS3007 > advanced cardiac life support > Flashcards

advanced cardiac life support Flashcards

1
Q

Identify the ALS algorithm

A
  • Start CPR
  • Attach defib/monitor
  • Assess rhythm

If shockable
- shock, then CPR

If non-shockable
- CPR for 2 mins

ROSC - post rests care

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2
Q

Identify the principles for chest compressions

A
  • 30 compressions: 2 breaths
  • Delivered over the lower half of the sternum at a depth of at least 5cm
  • Heel of hand along the lower half of the sternum
  • Rate: at least 100 per minute
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3
Q

Identify shockable rhythms

A

Ventricular fibrillation & Ventricular tachycardia

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4
Q

Identify characterising factors for VF

A
  • bizarre irregular waveform and non-recognisable QRS complexes
  • uncoordinated electrical activity
  • coarse/fine
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5
Q

Identify characterising factors for VT

A
  • broad complex rhythm
  • rapid rate
  • constant QRS morphology
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6
Q

Identify non-shockable rhythms

A

Asystole & pulseless electrical activity

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7
Q

Explain COACHED

A

A safe method for defibrillation

Compressions continue
Oxygen away
All others clear
Charging defibrillator
Hands off
Evaluating rhythm
Defibrillate or disarm

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8
Q

Identify the 4 H’s and 4 T’s

A

Hypoxia
Hypovolaemia
Hypo/hyperthermia
Hypo/hyperkalemia
Tamponade
Tension pneumothorx
Thrombosis
Toxins

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9
Q

Identify considerations for hypoxia

A
  • pre-arrest Spo2 - dependent upon perfusion
  • consider advanced airway and avoid hyperventilation (use capnography)
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10
Q

Identify causes and treatment of hypovolaemia

A
  • internal/external haemorrhage
  • wounds/surgical drains
  • history of trauma
  • sepsis
  • anaphylaxis
  • gastro

Treatment: control haemorrhage + replace blood, distributive shock: IV fluids

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11
Q

Identify considerations for hypo/hyperkalaemia

A
  • diuretic use
  • D & V
  • kidney disease + hyperglycaemia
  • drug chart and fluid I&O
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12
Q

Identify cause and treatment for hypothermia

A

Ill patients tend to have disrupted thermoregulation

Treatment: re-warming, IV fluids, consider cardiopulmonary bypass or ECMO

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13
Q

Identify cause and treatment for hyperthermia

A

Core temp is greater than 38 degrees celsius, and life threatening if over 41.5

Causes: drug toxicity, dehydration

Heat stroke aan resemble septic shock

Treatment: no quicker ran 0.5 Degrees celsius per hour - electrolyte and fluid replacement

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14
Q

Define tension pneumothorax and treatment

A

Air in intrapleural space

  • Check position of tube, check for rise and fall of chest, decreased breath sounds, tracheal deviation
    Treatment: needle decompression
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15
Q

Define tamponade and treatment

A

Blood or fluid in the pericardial space

Examination: anxiety, hypertension/tachypnoea, discomfort relieved when leaning forward

Treatment: needle pericardiocentesis, resuscitare thoracotamy

Nurses role is to identify, escalate and facilitate treatment

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16
Q

Define thrombosis and treatment

A

Clot in pulmonary vein often caused by DVT

Clinical characteristics: chest pain, SOB, hypoxia

Treatment: fibrinolytic - heparin, percutaneous infusion

In cardiac arrest, if fibrinolytic therapy given: min 30 mins CPR

17
Q

Describe the MOA of adrenaline

A

CNS stimulation - increases CO and HR by causing vasoconstriction

  • alpha and beta adrenergic effects
18
Q

Identify when to administer adrenaline during ALS

A

VF/VT after initial counter shocks have failed (after 2nd shock loop)

Asystole and PEA in initial loop (then every 2nd loop)

19
Q

Describe the MOA of amiodarone

A
  • antiarrhythmic
  • prolongs action potential and slows sinus rate
20
Q

Identify when to administer amiodarone in ALS

A
  • VF/pulseless VT (between 3rd and 4th shock)
  • AF
21
Q

Describe the MOA of lignocaine

A

anti-arrhythmic

22
Q

Identify when to administer lignocaine in ALS

A

Ventricular arrhythmias
Not to be used in SVT

23
Q

Describe the MOA of atropine

A
  • anticholinergic
  • parasympathetic agonist
  • acts on conduction system of the heart and accelerates the transmission of electrical impulses through cardiac tissue
24
Q

Identify when to administer atropine during ALS

A
  • bradycardia
  • asystole
25
Q

What does the acronym AMPLE stand for? When is it used?

A

Allergies
Medications
Past medical history
Last meal
Events surrounding injury

Used for secondary survey to further gather patient information

26
Q

Identify when to administer potassium in ALS

A

persistent VF

27
Q

Identify when to administer magnesium in ALS

A

Torsade de pointes, digoxin toxicity, pulseless VT, hypokalaemia

28
Q

Identify when to administer calcium chloride in ALS

A

hyper K+, hypo Ca, overdose calcium channel blockers

29
Q

Identify the routes of med administration during ALS

A
  • CVC if already in situ - rapid circulation time but time consuming to insert
  • peripheral line - wide bore cannula
  • intraosseous route
30
Q

Outline what to do upon return of spontaneous circulation

A

Post resus care

31
Q

Outline what to do in post resus care

A
  • re evaluate A-G
  • 12 lead ECG
  • pathology
  • Treat precipitating causes: 4 H’s and 4 T’s
  • Temp management
32
Q

Outline the roles within the resus team

A

Team leader
- airway management
- compressions
- defib person
- drugs
- scribe
Runner

NURS3007 (10 decks)

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