Advanced Life Support (Adult)

Question 1

What are the stages of ALS (adult)?

Answer 1

Unresponsive and not breathing normally.
CPR 30:2, attach defibrillator/monitor, minimise interruptions.
Assess rhythm.

Question 2

What is the process if a shockable (VF/pulseless VT) is presented?

Answer 2

1 shock.
Immediately resume CPR for 2 mins.
Reassess rhythm.

Question 3

What is the process if a non shockable (PEA/Asystole) rhythm is found?

Answer 3

Immediately resume CPR for 2 mins.

Reassess rhythm.

Question 4

What do you do if return of spontaneous circulation happens?

Answer 4

Immediate post cardiac arrest treatment

Question 5

What is involved in post cardiac arrest treatment?

Answer 5

Use CABCDE approach.
Aim for SpO2 of 94-98%.
Aim for normal PaCO2.
12 lead ECG.
Treat precipitating cause.
Targeted temperature management.

Question 6

What drugs should be given in CPR?

Answer 6

Give adrenaline every 3-5 minutes.

Give amiodarone after 3 shock, consider half dose after 5th shock.

Question 7

Things to consider during ALS (adult)

Answer 7

Ultrasound imaging.
Mechanical chest compressions to facilitate transfer/treatment.
Coronary angiography and percutaneous coronary intervention.
Extracorporeal CPR.

Question 8

Possible reversible causes of cardiac arrest in adults?

Answer 8

Hypoxia
Hypovolaemia
Hyper/hypokalaemia/metabolic
Hypothermia
Thrombosis (coronary or pulmonary)
Tension pneumothorax
Tamponade (cardiac)
Toxic/therapeutic disturbances