ALS ERC 2024 Flashcards
Vagal maneuvers
- Carotid sinus massage
- Valsalva maneuver
Causes of regular narrow complex tachycardia
- Sinus tachycardia
- AVNRT (commonest SVT)
- AVRT- associated with WPW syndrome
- AF with regular AV conduction (2:1 usually)
Causes of irregular narrow complex tachycarida
AFib with uncontrolled ventricular response
OR
AFlutter with variable AV block
Do not use ___ in obvious AFib or AFlutter
Adenosine
Cardiac arrest chain of survival
- Early recognition and calling for help
- Management of deteriorating patient to prevent cardiac arrest
- Prompt defibrillation, high quality CPR, minimal interruptions of chest compressions
- Treatment of reversible causes
- Post-resuscitation care
Causes of hypovolemia
- Hemorrhage (reduced intravascular volume)
- Severe vasdilation- sepsis, anaphylaxis, spinal cord injury
Post-cardiac arrest syndrome
- Brain injury
- Myocardial dysfunction
- Systemic ischemia/ reperfusion response
- Persistent precipitating pathology
Information provided by monitoring EtCO2 in CPR
- Tube placement
- Quality of CPR (2.0-2.5 kPa)
- ROSC- immediate, sustained increase in EtCO2
- Guide to rate of ventilation (help prevent hyperventilation)
- Prognostication- higher EtCO2 during resus -> better results
Peri-arrest state
- Cardiovascular instability
- Hypotension
- Loss of peripheral pulse in uninjured region
- Deteriorating consciousness level without obvious CNS cause
4 E’s of successful resuscitative thoracotomy (RT)
Expertise
Equipment
Environment
Elapsed time
Anaphylaxis likely when all 3 are present:
- sudden onset and rapid progression of symptoms
life-threatening Airway and/or - Breathing and/or Circulation problems
- skin and/or mucosal changes (flushing, urticaria, angioedema)
Sepsis Hour-1 Bundle (5 steps)
- Measure lactate level
- Obtain blood cultures before administering antibiotics
- Administer broad spectrum antibiotics
- Begin rapid administration of crystalloid
- Apply vasopressors if hypotensive
Sepsis Hour-1 Bundle (5 steps)
- Measure lactate level
- Obtain blood cultures before administering antibiotics
- Administer broad spectrum antibiotics
- Rapid administration of 30ml/kg crystalloid fluids
- Apply vasopressors if hypotensive to maintain MAP ≥ 65mmHg
Function of aldosterone
Reabsorption of sodium, excretion of potassium in collecting tubule cells
5 key treatment strategies for hyperkalemia
- Cardiac protection
- Shifting potassium into cells
- Removing potassium from the body
- Monitoring serum potassium and glucose levels
- Prevention of recurrence of hyperkalemia