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ACRM > Anesthesia ACLS, Bradycardia, Power Outage > Flashcards

Anesthesia ACLS, Bradycardia, Power Outage Flashcards

1
Q

Most recent changes to anesthesia-specific ACLS:

A
  • CAB versus ABC
  • removed Vasopressin
  • includes opioid-associated algorithm
  • more attn to post-arrest care
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2
Q

Perioperative cardiac arrest is…

A
  • uncommon
  • variable causes
  • usually witnessed
  • frequently anticipated
  • rescuer knowledgeable
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3
Q

Frequency of intraoperative cardiac arrest

A

5-7 per 10,000 anesthetics

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4
Q

Sources of intraoperative cardiac arrest

A
  • hypoxia
  • emergency surgery
  • intraop cardiac events
  • hemorrhage, hypovolemia
  • PO resp depression
  • auto-PEEP
  • vagal response
  • human factor related complications
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5
Q

Predictors of intraop cardiac arrest

A
  • # of RBC transfusions
  • ASA >=3
  • poor preop fxnl status
  • type of sx
  • emergency sx
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6
Q

Top 3 causes of cardiac arrest in perioperative setting

A
  • vasovagal events
  • hypovolemia
  • hypoxia
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7
Q

Most common presenting rhythm associated with intraop cardiac arrest

A

bradycardia
(then asystole, tachy/VT/VF)

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8
Q

Treatment for stable bradycardia

A

Ephedrine 5mg
Glycopyrrolate 0.2mg

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9
Q

Treatment for unstable bradycardia

A

Epi 10-100mcg up to 1mg
Atropine 0.5-1mg up to 3mg

  • prepare to TCP
  • begin Epi/Dopamine infusions
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10
Q

Treatment for overdose of a BB

A

Glucagon 2-5mg IVP

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11
Q

Treatment for overdose of CCB

A

Calcium chloride 1g IV

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12
Q

Treatment for overdose of Digoxin

A

Digoxin immune FAB - ask pharmacy for pt-specific dosing

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13
Q

Frequency of delayed defibrillation

A

1 out of 7 pts with VT/VF in perioperative setting

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14
Q

EtCO2 value associated with successful ROSC

A

EtCO2 = or > 20mmHg

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15
Q

EtCO2 value associated with failure of ROSC

A

EtCO2 < 10mmHg after 20mins ACLS

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16
Q

Anesthesia ACLS calls for continuing resuscitative efforts for…

A

at least 45-60 mins

(60-75 mins?)

17
Q

Diastolic pressure and CVP associated with higher rate of ROSC?

A

Diastolic 30-40mmHg via art line

CVP >15mmHg

18
Q

Epi dose for LAST

A

<1mcg/kg

19
Q

Drugs to avoid in treatment of LAST

A
  • Vasopressin
  • CCB
  • BB
  • other LA
20
Q

When treating LAST, CPR should be continued for…

A

60-75 mins

21
Q

Failing RV is best managed by 2 things:

A

1) pulm vasodilators
2) positive inotropes

22
Q

What electrolyte imbalance should be considered for any new wide complex tachycardiac?

A

hyperK+

23
Q

First treatment for hyperk+ should involve cardiac protection. What drug should be administered?

A

calcium chloride or calcium gluconate 1-2g IV

24
Q

ACLS modifications for MH treatment include…

A

treating the underlying disorders (hyperK+ and acidosis)

25
Q

Hs and Ts specific to anesthesia ACLS

A

hyperthermia (MH)
hypervagal (bradycardia)

toxins (anaphylaxis, anesthesia)
qT prolongation

26
Q

The airway management algorithm of anesthesia ACLS emphasizes…

A
  • airway management with minimal disruptions in chest compressions
  • avoiding hyperventilation
  • avoiding fixation errors
27
Q

4 ways in which use of emergency manuals affected emergency situations

A

1) reduced stress of individual clinicians
2) fostered calm working environment
3) improved teamwork, role clarification, communication
4) positively impacted patient care by adhering to evidence based guidelines

28
Q

Most common cause of power outage

A

regional disasters and extreme weather events

29
Q

How much more battery life can you get if you turn the ventilator off?

A

1 hour

30
Q

Backup lifespan of the internal battery on our anesthesia machines

A

30 mins

31
Q

Backup lifespan of the internal battery on our medication pumps

A

4 hours

32
Q

Backup battery lifespan of Pyxis machine

A

30 mins

33
Q

Color of emergency outlets in the ORs

A

red

34
Q

4 key steps if you experience power failure in the OR while delivering an anesthetic

A

1) if ventilator is still working, use it
2) prevent hypoxemia
3) locate alternative light sources
3) confirm critical equipment is plugged into red outlets

ACRM (9 decks)

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