BLS and ACLS Flashcards
BLS SURVEY
– Check responsiveness – Activate 911 and get the AED – Circulation • Check for carotid pulse < 10 seconds • Start CPR – Defibrillation • If no pulse assess shock able rhythm / AED • Provide shock if indicated • Resume CPR following shocks
ACLS SURVEY
Airway
• Airway patent
• Is an advanced airway indicated
• Confirm and secure tube
– Breathing
• Adequate oxygenation and ventilation?
• Arrest 100% O2 –Non arrest O2 if SPO2 <94%
– Circulation
• Adequate chest compressions if in arrest
• Rhythm interpretation / 12 lead
• Is defibrillation, cardioversion, pacing indicated
• Has IV/IO been established
• Administer fluids and medications
– Differential diagnosis
• Why did patient develop symptoms or arrest
• Is there a reversible cause that can be treated
OPENING THE AIRWAY
• No evidence of trauma
Head tilt chin lift)
OPENING THE AIRWAY
• Evidence of trauma
(Jaw thrust)
Oropharyngeal Airway
Keeps tongue from blocking the airway
– Indications
• Unconscious patient
• Absence of a gag reflex
Oropharyngeal Airway
Sizing
Corner of the mouth to the angle of the mandible
Oropharyngeal Airway Insertion
- Upside down to uvula then rotate to fully insert
- Sideways to uvula then rotate to fully insert
- Must be flush with the mouth
NASOPHARANGEAL Indications
Indications
– Conscious or semi conscious patient
– Patient with a gag reflex
NASOPHARANGEAL Sizing
Nose to tragus of the ear
NASOPHARANGEAL Insertion
Lubricate well – Choose the largest nostril – Gently use a spiral motion to insert – Check patient ventilation – If resistance is encountered remove and try the other nostril
NASOPHARANGEAL Caution
Do not use on patients with serious head injuries
– Contraindicated with basilar skull fractures
ADVANCED AIRWAYS
• SUPRAGLOTIC
– Combitube
– King airway
– LMA (laryngeal mask airway)
– SALT airway
Meds that can be given ET (NAVEL)
Narcan • Atropine • Vasopressin • Epinephrine • Lidocaine
Rules for ET administration
• Use 2-2.5 times the IV dose (except vasopressin) • Stop compressions • Use 10 ml total volume (dilute with N.S. or sterile water) • Ventilate several times • Resume compressions
EPINEPHERINE Dose
1-3 mg every 3-5 minutes
EPINEPHERINE
Mix 8 mg /500ml in D5W or N.S.
• Infuse at 2-10 mcg/min for bradycardia
• Infuse at 8-40 mcg / min for hypotension
AMIODARONE (CORDARONE)
Indications
Indications
• VT/VF
• Rapid atrial arrhythmias
AMIODARONE (CORDARONE)
Dosage (IV/IO)
Cardiac arrest- 300 mg in 10 ml Repeat 150 mg 3-5 min
• Perfusing patients 150 mg over 10 min. Repeat in 10 min.
LIDOCAINE Indications
• VT, VF, PVC’S
LIDOCAINE Dosage
Cardiac arrest- 1-1.5 mg/kg repeat half dose to 3mg/kg
• VT /PVC’S 0.5-0.75 mg/kg @ 5-10 min as needed
• ATROPINE Indication
Symptomatic bradycardia
ATROPINE Dosage
0.5 mg Repeat every 3-5 minutes
• Maximum dose 3 mg
ADENOCARD (ADENOSINE)
Indications
– SVT (Specifically atrial tachycardia)
– Wide complex undiagnosed tachycardia
ADENOCARD (ADENOSINE)
Dosage
– 6mg rapid IV push followed by a saline flush
– 12 mg IV rapid push followed by a saline flush
CARDIZEM (DILTIAZEM)
Indications
SVT (Especially A-fib and A- flutter)
CARDIZEM (DILTIAZEM)
Dosage
Give 0.25 mg/kg over 2 minutes (15-20 mg)
– May repeat 0.35 mg/kg in 15 minutes
– Infuse 125 mg/100ml at 5-15 mg/hr
MAGNESIUM SULFATE
Indiations
Refractory dysrhythmias
– Torsades
– Hypomagnesemia
MAGNESIUM SULFATE
Dosage
VF /pulseless VT – 1-2 gm over 1-2 minutes
– VT with pulse – 1-2 gm in 10 ml over 1-2 minutes
– Hypomagnesemia w/o ectopy 0.5-1 mg/hr infusion
DOPAMINE Indications
Symptomatic hypotension (SBP70-100 Shock) – Refractory bradycardia
DOPAMINE Dosage
2-20 mcg/kg/min (usual start dose -5mcg/kg/min)
– Estimate start dose as 10% of the patient’s weight
