ALS

Question 1

List the chain of survival?

Answer 1

-Early recognition and call for help
-Early CPR
-Early defibrillation
-Post resus care

Question 2

Outline the ALS Algorithm

Answer 2

1. Unresponsive and not breathing normally
2. CPR 30:2 - attach defib and monitor
3. Assess rhythm
   A) shockable (pVT/VF) x1 shock and restart CPR
   B) ROSC - post ROSC care
   C) non shockable (PEA/asystole) immediate CPR

Question 3

List the reversible causes of cardiac arrest?

Answer 3

Hypo/ hyperthermia
Hypoxia
Hypo/ hyperkalaemia
Hypovolaemia
Toxins
Tension pneumothorax
Tamponade - cardiac
Thrombosis - coronary or pulmonary

Question 4

What drugs are given during cardiac arrest?

Answer 4

A) shockable: adrenaline 1:10000every 3-5 mins. Amiodarone 300mg after 3rd shock, 150mg after 5th shock.
B) non shockable: adrenaline 1:10000 ASAP

Question 5

Outline post ROSC care?

Answer 5

-Assess using A-E approach
-Aim spo2 94-98%
-12 lead ECG
-Identify and treat cause
-Temperature control

Question 6

What should be collected when information gathering?

Answer 6

-Location of arrest
-Info from staff about events leading up
-Notes
-Confirm who’s present for the arrest team

Question 7

What tasks are expected during an arrest?

Answer 7

-Planning and briefing the team
-Identifying resources required
-Monitoring fatigue and stress
-Managing conflict
-Communication between staff and relatives
-Escalating to the appropriate experts

Question 8

What does SBARD and RVSP stand for?

Answer 8

1: situation, background, assessment, recommendation, decision

2: reason, story, vital signs, plan

Question 9

What is the chain of prevention?

Answer 9

-Education
-Monitoring
-Recognition
-Call for help
-Response

Question 10

What are non technical skills?

Answer 10

-Situational awareness
-Decision making
-Team working including leadership
-Task management

Question 11

What does TEAM stand for?

Answer 11

Team Emergency Assessment Measure

Question 12

List recognition signs of airway issues?

Answer 12

-difficulty breathing, choking, distressed
-inability to talk normally
-short of breath
-noises breathing (strider, wheeze, gurgle)
- seesaw pattern
-use of accessory muscles

Question 13

What is treatment for airway issues?

Answer 13

-Airway opening (head tilt chin lift/ jaw thrust)
-advanced techniques (igel, endotracheal tube)
-give o2 ASAP

Question 14

When would you use a nasopharyngeal and oropharyngeal airway?

Answer 14

1) nasopharyngeal: In awake patients
2) oropharyngeal: In unconscious patients

Question 15

What are recognition signs for breathing issues?

Answer 15

-respiratory distress, use of accessory muscles, chest deformity, conscious level
-noisy breathing sounds
-feel for expansion, percussion and tracheal position

Question 16

How can you tell if an airway is partially or completely obstructed?

Answer 16

Partial - noisy breathing effort
Complete - silent with no air movement at patients mouth

Question 17

What is the treatment for breathing issues?

Answer 17

-ensure airway is clear and maintained
-give o2 initially high flow and once stable aim spo2 of 94-98%
-treat underlying cause
-if breathing becomes inadequate it must be supported (bag mask)

Question 18

List recognition signs for circulatory issues?

Answer 18

-pulse rate and rhythm
-central and peripheral perfusion - capillary refill time
-BP
-reduced organ perfusion - chest pain, altered mental state, reduced urine output
-bleeding or other fluid losses