Advanced Cardiac Life Support (ACLS) Flashcards
What is cardiac arrest, what are signs it is present
Abrupt loss of heart function/ absence of pulse, unresponsiveness, apnea (no breathing)
Why do patients develop cardiac arrest
Coronary artery disease, cardiomyopathy, structural abnormality, electrical abnormality, asthma, trauma
What is the chain of survival for cardiac arrest
Immediate recognition and activation of the emergency response system, early CPR (emphasis on chest compressions), Rapid defibrilation, effective advanced life support, intergrated post cardiac arrest care
When giving CPR for cardiac arrest what is the target compression per minute, depth
100-120 compressions per minute, 2-2.4 inches (rotate compressions every two minutes if needed to meet target)
What is acronym for Basic Life Support for Cardiac Arrest
Circulation: chest compressions through CPR (little interruptions)
Airway: Open and secure airway (endotracheal intubation)
Breathing: Rescue breaths (endotracheal intubation)
Defibrillation: AED (automatic external defibrillator)/Rapid defibrillation if necessary
If there is a break in compressions what is the longest it should last
10 seconds
What are the best routes of administration for cardiac arrest
Intravenous (central or peripheral), Intraosseous, Endotracheal (not preferred)
What drugs can be administered endotracheal
Naloxone, Atropine, Versed/Vallium/Vasopressin, Epinephrine, Lidocaine
How must the dose be changed if given Endotracheal
2-2.5 times the normal dose, followed by 10 ml normal saline flush
What are the intraosseous lines placed, how
Femoral head or tibia, Drill
What are the various rhythms that indicate Cardiac arrest
Ventricular fibrillation (VF), Pulseless ventricular tachycardia (VT), Asystole (flatline), Pulseless electrical activity (PEA)
What are the Hs that cause PEA
Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/hyperkalemia, Hypothermia
What are the Ts that cause PEA
Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary or coronary)
When a person goes into cardiac arrest what is the first thing that should be done
Give CPR and attach monitor/defibrillator
What are the rhythm shockable states of Cardiac Arrest
Ventricular Fibrillation and Pulseless ventricular Tachycardia
What are the non rhythm shockable states of cardiac arrest
Asystole and Pulseless electrical Activity
If a patient is giving CPR and they have VF/pVT what should be done
Shock with defibrillator, CPR for 2 mins (within 10 seconds after defibrillator) while also searching for IV/IO access
If after giving CPR for 2 mins after the first shock what should be done next if rhythm shockable
Shock with defibrillator, CPR for 2 mins (within 10 seconds after defibrillator) PLUS give Epinephrine 1 mg Every 3 to 5 minutes
(consdier advancerd airway and capnography)
If after giving CPR for 2 minutes after the 2nd shock plus Epinephirne what should be done next if rhythm shockable
Shock with defibrillator, CPR for 2 mins (within 10 seconds after defibrillator) PLUS either Amiodarone 300 mg bolus AND 150 mg second dose OR Lidocaine 1-1.5 mg/kg for the first dose AND 0.5-0.75 mg/kg for the second dose while also fixing the underlying problem
What should be done if a patient is NOT rhythm shockable since they are in asystole or pulseless electrical activity
CPR for 2 minutes with IV/IO accest found, Epinephrine 1 mg every 3 to 5 minutes (consider advanced airway,capnography)
What should be done if the patient still is not rhythm shocable after epinipherine dose
CPR for 2 minutes then treat reversible causes
T/F: If the patient never becomes rhythm shockable they should not receive Lidocaine or Amiodarone
True
What are ways of knowing the CPR quality
If PETCO2 is less than 10 mmHg improve CPR quality, If diastolic pressure is less than 20 mmHG improve CPR quality
When advanced airway is in place how many breaths is given per minute
10 breaths per min