BLS and ACLS + Flashcards
1
Q
question
A
answer
2
Q
VF cardiac arrest survival rates decrease how much per minute delay in defibrillation WITHOUT CPR
A
7-10%
3
Q
survival rates decrease how much per minute delay in defibrillation WITH CPR
A
3-4%
4
Q
Rescue breathing cycle
A
1 breath every 5-6 seconds
or 10-12 breaths/min
5
Q
CPR Cycles
A
30 compressions and 2 breaths
6
Q
CPR compression rate
A
100 - 120 per min
7
Q
CPR compression depth
A
2” adult
5cm child
8
Q
What two condition do you shock patients?
A
VF/pVT
9
Q
In ACLS what medicine do you give every 3-5 minutes
A
Ephinephrine
10
Q
in ACLS what medicine do you give for VF/pVT
A
Amiodarone
11
Q
In cardiac arrest algorithm, after BLS what are the two main branches?
A
VF/VT
PEA/Asystole
12
Q
In cardiac arrest algorithm, What do you do after determining it is VF/VT?
A
Shock 360/200 + CPR > SAS
Shock 360/200 + CPR + Epinephrine 1 mg > SAS
Shock 360/200 + CPR + Amiodarone 300mg
13
Q
In cardiac arrest algorithm, What do you do after determining it is PEA/Asystole?
A
CPR + Epinephrine 1mg
14
Q
In cardiac arrest algorithm, how much epinephrine is administered?
A
1mg
15
Q
In cardiac arrest algorithm, how much amiodarone is administered?
A
300mg
16
Q
What is the acronym for cardiac arrest algorithm?
A
SCREAM
Shock CPR Rhythm Check Epinephrine Amiodarone
17
Q
What are the Hs that need ACLS (5)
A
hypoxia hypovolemia hydrogen ion hyper/hypokalemia hypothermia
18
Q
What are the Ts that need ACLS (5)
A
tension pneumothorax tamponade toxins thrombosis, pulmo thrombosis, coronary
19
Q
In bradycardia algorithm, what are the two main branches after BLS?
A
Unstable
Stable
20
Q
In bradycardia algorithm, what are the steps for unstable?
A
atropine So4 0.5mg TIV > trancutaneous pacing > dopamine/epinephrine infusion > transvenous pacing
21
Q
In bradycardia algorithm, how much atropine is administered?
A
0.5mg TIV
22
Q
In bradycardia algorithm, what are the steps for stable?
A
observe and monitor
23
Q
In tachycardia algorithm, what are the two main branches?
A
stable and unstable
24
Q
In tachycardia algorithm, how are the two main branches subdivided?
A
wide (VT)
narrow
25
In tachycardia algorithm, what are the steps for untable wide (VT)?
Sedate + Cardiovert 100J
26
In tachycardia algorithm, what are the steps for unstable narrow?
Regular (SVT) > sedate + cardiovert 50-100J + Adenosine
Irregular (AF) > sedate + cardiovert 120-200J
27
In tachycardia algorithm, what are the steps for stable wide (VT)?
. Adenosine
. Amiodarone
. Sotalol
. Procainamide
28
In tachycardia algorithm, what are the steps for stable narrow?
. Vagal maneuvers
. Adenosine
. Bb/ccb
. Expert consultation
29
In tachycardia algorithm, what is the common medicine?
Adenosine
30
In what two conditions are amiodarone administered in ACLS?
cardiac arrest VF/VT
tachycardia stable wide VT
31
In what two conditions are adenosine administered in ACLS?
tachycardia unstable narrow regular svt
tachycardia stable wide VT
32
Which tachycardia state receives cardiovert 100J?
tachycardia unstable wide vt
33
which tachycardia state receives cardiovert 50-100J?
tachycardia unstable narrow regular svt
34
which tachy cardia state receives cardiovert 120-200J?
tachycardia unstable narrow irregula af
35
In SCA, which is more important?
Chest compression
Maintain O2 and eliminate CO2
Chest compressions
36
In SCA, when is maintaining O2 and eliminate CO2 more important than chest compressions?
prolonged VF in SCA and asphyxial arrest
37
Why is 100% oxygen optimised oxyhemoglobin content important?
hopoxemia leads to anaearobic metabolism which may blunt benefits of chemical and electrical therapy
38
What underlying conditions could be a cause of hypoxia in the SCA patient?
. Underlying respiratory disease
. low cardiac output
. intrapulmonary shunting
. ventilation-perfusion mismatch
39
What is the oxygen level in exhaled air for rescue breathing?
16-17%
40
What is the best practice for bag-valve device in ventilation?
2 operators: 1 to hold mask, 1 to ventilate
41
a 1-2 L of O2 bag capacity delivers how much O2?
600ml
42
oral airways are used for what type of patient?
unconscious
43
nasal airways are used for what type of patient?
with trismus and biting
44
What is a considering of using advance airways in ACLS?
minimal interruption of cardiac compression
45
what are the advantages of laryngeal mask airway (LMA) in ACLS?
. more secure and reliable than BVM
. LMA equavalent ventilation than ET
. LMA not require larygonscopy and visualization of vocal cords
46
Whare are the advantages of ET intubation in ACLS?
. Isolates the airway, keeping it patent
. reduce risk of aspiration
. provides conduit for suctioning secretions
. delivers high concentration of oxygen
. provides route for drug administration
. ensures delivery of selected tidal lung volume to maintain lung inflation
47
What are the drugs for ACLS that are administered thru ETT?
```
. Naloxone
. Atropine
. Vasopressin
. Epinephrine
. Lidocaine
```
48
What is the size of the ETT for adult male?
8.0-8.5 mm ID
49
What is the size of the ETT for adult female?
7.0-7.5 mm ID
50
What is are parts of postintubation care in ACLS?
. Record the depth of the ET
. Secure the ET using tapes
. Chest X-Ray for confirm position
51
What are the 4 arrest rythms?
. VF
. VT
. Pulseless Electrical Activity
. Asystole
52
Jugular, Subclavian femoral, Supraclavicula
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
a. Centeral IV access
53
Rapid arrival of drug at site of action
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
a. Centeral IV access
54
Increase risk of complications : subcutaneous emphysema, pneumothorax
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
a. Centeral IV access
55
Antecubital or external jugular
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
b. Peripheral IV access
56
Antecubital or external jugular
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
b. Peripheral IV access
57
Easier to learn, few complications
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
b. Peripheral IV access
58
No interruption CPR
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
b. Peripheral IV access
59
Venous access is not achieved
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
c. Intraoseaous access
60
Jamshidi needle
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
c. Intraoseaous access
61
proximal tibia below the tuberosity or at the distal femur
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
c. Intraoseaous access
62
Pediatric patients
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
c. Intraoseaous access
63
osteomyelitis
a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access
c. Intraoseaous access
64
What are IV fluid expanders? Which are given to pediatric patients?
. Fresh Whole Blood
. Crystalloid solutions - pedia
. Colloid Solutions - pedia
65
What type of IV fluid is preferred for CPR?
Plain NSS or LR
66
What is volume administration recommeded in routine cardiac arrest?
indication of volume depletion
67
Which has a worse neurologic outcome? What is MOA? Hyperglycemia or hypoglycemia
Hyperglycemia due osmotic diuresis
68
Sodium overload is rare/common
rare
69
What is the dose for volume expanders in neonates?
Dose 10 ml / kg
70
What are the IV fluids given to neonates?
Plain NSS or LR
71
Lidocaine
• Amiodarone
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
a. control heart rhythm and rate
72
* Adenosine
* Beta-Blockers
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
a. control heart rhythm and rate
73
* Procainamide
* Atropine
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
a. control heart rhythm and rate
74
• Verapamil/ Diltiazem
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
a. control heart rhythm and rate
75
Epinephrine
• Norepinephrine
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
b. improve cardiac output and blood pressure
76
* Dopamine
* Dobutamine
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
b. improve cardiac output and blood pressure
77
* Sodium Nitroprusside
* Nitroglycerine
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
b. improve cardiac output and blood pressure
78
* Digitalis
* Diuretics
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
b. improve cardiac output and blood pressure
79
* Morphine SO4
* Oxygen
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
c. myocardial infarction
80
* Nitroglycerine
* Aspirin
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
c. myocardial infarction
81
• Thrombolytic agents : Streptokinase, r- TPA, Heparin
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
c. myocardial infarction
82
* Glycoprotein IIb/IIIa inhibitors
* Beta Blockers
a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction
c. myocardial infarction
83
Steps of post cardiac arrest care
```
Insertion of an NGT >
decompress the stomach of
air due BVM ventilation
• Insertion of foley catheter >
measure urine output
• Take a 12 lead ECG
• Do portable chest radiographs
• Therapeutic hypothermia
• Antibiotics
• Nutrition
```
84
In post cardiac arrest care what is the purpose of insertion of an NGT?
decompress the stomach of air due BVM ventilation
85
In post cardiac arrest care what is the purpose of insertion of foley catheter?
measure urine output
86
irreversible cerebral damage in how many minutes?
```
1-2 min
2-3 min
3-4 min
4-5 min
5-6 min
```
3-4 min
87
What happens with no CPR after?
0 minutes
4-6 minutes
6-10 minute
> 10 minutes
0 minutes: breathing stops, heart will soon stop
4-6 minutes: brain damage possible
6-10 minute: brain damage likely
> 10 minutes: irreversible brain damage certain
88
depth of chest compressions (min and max)
2 inch min and 2.4 inch max
89
rate of compressions
100-120 compressions/min
90
for which do we phone before 1st cycle?
adult
infant/child
adult (phone first)
pedia (phone fast)
91
which of a peripheral pulses is the last to go?
carotid pulse
92
depth of compression for
adult
child
infant
- Adult : at least 2 inches or 5 cm depth
– Child : about 2 inches or 5 cm depth
– Infant : 1 ½ inches or 4 cm depth
93
number of compressions and breaths in cpr cycle
30 compressions/2 normal breaths
94
after how many cycles of cpr do you check pulse
5 cycles of 30:2
95
what do you do when pulse returns but no breathing
- Give 1 rescue breath every 5 seconds.
| - 12 rescue breaths per minute.
96
differences between adult and pedia cpr (3)
```
1. If the rescuer has
no help, give about
2 minutes of CPR
before activating
the EMS system
```
2. Use the heel of one hand or 2 hands in chest compressions at the lower ½ of sternum
```
3. Depress the
sternum one third
AP diameter or
about 2 inches or
5 cm depth
```
97
Where to feel pulse in infant?
brachial pulse
