ALS Flashcards
What are the two categories of rhythms in adult advanced life support?
‘Shockable’ rhythms: ventricular fibrillation/pulseless ventricular tachycardia (VF/pulseless VT)
‘Non-shockable’ rhythms: asystole/pulseless-electrical activity (asystole/PEA)
What is the ratio of chest compressions to ventilation in adult advanced life support?
30:2
What is the protocol for chest compressions during defibrillation?
Chest compressions are continued while a defibrillator is charged.
What is the recommended action for VF/pulseless VT?
A single shock followed by 2 minutes of CPR.
What should be done if cardiac arrest is witnessed in a monitored patient?
Up to three quick successive (stacked) shocks are recommended.
What is the first-line method for drug delivery during cardiac arrest?
IV access should be attempted.
What should be done if IV access cannot be achieved?
Drugs should be given via the intraosseous route (IO).
Is drug delivery via a tracheal tube recommended?
No, it is no longer recommended.
When should adrenaline be administered for non-shockable rhythms?
Adrenaline 1 mg should be given as soon as possible.
When is adrenaline given during a VF/VT cardiac arrest?
Adrenaline 1 mg is given once chest compressions have restarted after the third shock.
How often should adrenaline be repeated during ALS?
Repeat adrenaline 1 mg every 3-5 minutes whilst ALS continues.
What is the recommended dose of amiodarone for VF/pulseless VT after 3 shocks?
Amiodarone 300 mg should be given.
What is the further dose of amiodarone after 5 shocks?
A further dose of amiodarone 150 mg should be given.
What alternative can be used if amiodarone is not available?
Lidocaine can be used as an alternative.
When should thrombolytic drugs be considered?
If a pulmonary embolus is suspected.
What should be done if thrombolytic drugs are given?
CPR should be continued for an extended period of 60-90 minutes.
Is atropine recommended for routine use in asystole or PEA?
No, it is no longer recommended.
What should be done following successful resuscitation regarding oxygen?
Oxygen should be titrated to achieve saturations of 94-98%.
What are the ‘Hs’ in reversible causes of cardiac arrest?
Hypoxia, Hypovolaemia, Hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia, hypothermia.
What are the ‘Ts’ in reversible causes of cardiac arrest?
Thrombosis (coronary or pulmonary), Tension pneumothorax, Tamponade - cardiac, Toxins.
