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E Med > BLS and ACLS + > Flashcards

BLS and ACLS + Flashcards

1
Q

question

A

answer

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2
Q

VF cardiac arrest survival rates decrease how much per minute delay in defibrillation WITHOUT CPR

A

7-10%

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3
Q

survival rates decrease how much per minute delay in defibrillation WITH CPR

A

3-4%

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4
Q

Rescue breathing cycle

A

1 breath every 5-6 seconds

or 10-12 breaths/min

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5
Q

CPR Cycles

A

30 compressions and 2 breaths

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6
Q

CPR compression rate

A

100 - 120 per min

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7
Q

CPR compression depth

A

2” adult

5cm child

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8
Q

What two condition do you shock patients?

A

VF/pVT

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9
Q

In ACLS what medicine do you give every 3-5 minutes

A

Ephinephrine

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10
Q

in ACLS what medicine do you give for VF/pVT

A

Amiodarone

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11
Q

In cardiac arrest algorithm, after BLS what are the two main branches?

A

VF/VT

PEA/Asystole

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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

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13
Q

In cardiac arrest algorithm, What do you do after determining it is PEA/Asystole?

A

CPR + Epinephrine 1mg

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14
Q

In cardiac arrest algorithm, how much epinephrine is administered?

A

1mg

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15
Q

In cardiac arrest algorithm, how much amiodarone is administered?

A

300mg

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16
Q

What is the acronym for cardiac arrest algorithm?

A

SCREAM

Shock
CPR
Rhythm Check
Epinephrine
Amiodarone
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17
Q

What are the Hs that need ACLS (5)

A 
hypoxia
hypovolemia
hydrogen ion
hyper/hypokalemia
hypothermia
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18
Q

What are the Ts that need ACLS (5)

A 
tension pneumothorax
tamponade
toxins
thrombosis, pulmo
thrombosis, coronary
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19
Q

In bradycardia algorithm, what are the two main branches after BLS?

A

Unstable

Stable

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20
Q

In bradycardia algorithm, what are the steps for unstable?

A

atropine So4 0.5mg TIV > trancutaneous pacing > dopamine/epinephrine infusion > transvenous pacing

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21
Q

In bradycardia algorithm, how much atropine is administered?

A

0.5mg TIV

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22
Q

In bradycardia algorithm, what are the steps for stable?

A

observe and monitor

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23
Q

In tachycardia algorithm, what are the two main branches?

A

stable and unstable

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24
Q

In tachycardia algorithm, how are the two main branches subdivided?

A

wide (VT)

narrow

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25
Q

In tachycardia algorithm, what are the steps for untable wide (VT)?

A

Sedate + Cardiovert 100J

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26
Q

In tachycardia algorithm, what are the steps for unstable narrow?

A

Regular (SVT) > sedate + cardiovert 50-100J + Adenosine

Irregular (AF) > sedate + cardiovert 120-200J

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27
Q

In tachycardia algorithm, what are the steps for stable wide (VT)?

A

. Adenosine
. Amiodarone
. Sotalol
. Procainamide

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28
Q

In tachycardia algorithm, what are the steps for stable narrow?

A

. Vagal maneuvers
. Adenosine
. Bb/ccb
. Expert consultation

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29
Q

In tachycardia algorithm, what is the common medicine?

A

Adenosine

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30
Q

In what two conditions are amiodarone administered in ACLS?

A

cardiac arrest VF/VT

tachycardia stable wide VT

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31
Q

In what two conditions are adenosine administered in ACLS?

A

tachycardia unstable narrow regular svt

tachycardia stable wide VT

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32
Q

Which tachycardia state receives cardiovert 100J?

A

tachycardia unstable wide vt

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33
Q

which tachycardia state receives cardiovert 50-100J?

A

tachycardia unstable narrow regular svt

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34
Q

which tachy cardia state receives cardiovert 120-200J?

A

tachycardia unstable narrow irregula af

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35
Q

In SCA, which is more important?

Chest compression
Maintain O2 and eliminate CO2

A

Chest compressions

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36
Q

In SCA, when is maintaining O2 and eliminate CO2 more important than chest compressions?

A

prolonged VF in SCA and asphyxial arrest

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37
Q

Why is 100% oxygen optimised oxyhemoglobin content important?

A

hopoxemia leads to anaearobic metabolism which may blunt benefits of chemical and electrical therapy

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38
Q

What underlying conditions could be a cause of hypoxia in the SCA patient?

A

. Underlying respiratory disease
. low cardiac output
. intrapulmonary shunting
. ventilation-perfusion mismatch

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39
Q

What is the oxygen level in exhaled air for rescue breathing?

A

16-17%

40
Q

What is the best practice for bag-valve device in ventilation?

A

2 operators: 1 to hold mask, 1 to ventilate

41
Q

a 1-2 L of O2 bag capacity delivers how much O2?

A

600ml

42
Q

oral airways are used for what type of patient?

A

unconscious

43
Q

nasal airways are used for what type of patient?

A

with trismus and biting

44
Q

What is a considering of using advance airways in ACLS?

A

minimal interruption of cardiac compression

45
Q

what are the advantages of laryngeal mask airway (LMA) in ACLS?

A

. more secure and reliable than BVM
. LMA equavalent ventilation than ET
. LMA not require larygonscopy and visualization of vocal cords

46
Q

Whare are the advantages of ET intubation in ACLS?

A

. 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
Q

What are the drugs for ACLS that are administered thru ETT?

A 
. Naloxone
. Atropine
. Vasopressin
. Epinephrine
. Lidocaine
48
Q

What is the size of the ETT for adult male?

A

8.0-8.5 mm ID

49
Q

What is the size of the ETT for adult female?

A

7.0-7.5 mm ID

50
Q

What is are parts of postintubation care in ACLS?

A

. Record the depth of the ET
. Secure the ET using tapes
. Chest X-Ray for confirm position

51
Q

What are the 4 arrest rythms?

A

. VF
. VT
. Pulseless Electrical Activity
. Asystole

52
Q

Jugular, Subclavian femoral, Supraclavicula

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

a. Centeral IV access

53
Q

Rapid arrival of drug at site of action

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

a. Centeral IV access

54
Q

Increase risk of complications : subcutaneous emphysema, pneumothorax

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

a. Centeral IV access

55
Q

Antecubital or external jugular

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

b. Peripheral IV access

56
Q

Antecubital or external jugular

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

b. Peripheral IV access

57
Q

Easier to learn, few complications

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

b. Peripheral IV access

58
Q

No interruption CPR

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

b. Peripheral IV access

59
Q

Venous access is not achieved

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

c. Intraoseaous access

60
Q

Jamshidi needle

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

c. Intraoseaous access

61
Q

proximal tibia below the tuberosity or at the distal femur

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

c. Intraoseaous access

62
Q

Pediatric patients

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

c. Intraoseaous access

63
Q

osteomyelitis

a. Centeral IV access
b. Peripheral IV access
c. Intraoseaous access

A

c. Intraoseaous access

64
Q

What are IV fluid expanders? Which are given to pediatric patients?

A

. Fresh Whole Blood
. Crystalloid solutions - pedia
. Colloid Solutions - pedia

65
Q

What type of IV fluid is preferred for CPR?

A

Plain NSS or LR

66
Q

What is volume administration recommeded in routine cardiac arrest?

A

indication of volume depletion

67
Q

Which has a worse neurologic outcome? What is MOA? Hyperglycemia or hypoglycemia

A

Hyperglycemia due osmotic diuresis

68
Q

Sodium overload is rare/common

A

rare

69
Q

What is the dose for volume expanders in neonates?

A

Dose 10 ml / kg

70
Q

What are the IV fluids given to neonates?

A

Plain NSS or LR

71
Q

Lidocaine
• Amiodarone

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

a. control heart rhythm and rate

72
Q
  • Adenosine
  • Beta-Blockers

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

a. control heart rhythm and rate

73
Q
  • Procainamide
  • Atropine

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

a. control heart rhythm and rate

74
Q

• Verapamil/ Diltiazem

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

a. control heart rhythm and rate

75
Q

Epinephrine
• Norepinephrine

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

b. improve cardiac output and blood pressure

76
Q
  • Dopamine
  • Dobutamine

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

b. improve cardiac output and blood pressure

77
Q
  • Sodium Nitroprusside
  • Nitroglycerine

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

b. improve cardiac output and blood pressure

78
Q
  • Digitalis
  • Diuretics

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

b. improve cardiac output and blood pressure

79
Q
  • Morphine SO4
  • Oxygen

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

c. myocardial infarction

80
Q
  • Nitroglycerine
  • Aspirin

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

c. myocardial infarction

81
Q

• Thrombolytic agents : Streptokinase, r- TPA, Heparin

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

c. myocardial infarction

82
Q
  • Glycoprotein IIb/IIIa inhibitors
  • Beta Blockers

a. control heart rhythm and rate
b. improve cardiac output and blood pressure
c. myocardial infarction

A

c. myocardial infarction

83
Q

Steps of post cardiac arrest care

A 
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
Q

In post cardiac arrest care what is the purpose of insertion of an NGT?

A

decompress the stomach of air due BVM ventilation

85
Q

In post cardiac arrest care what is the purpose of insertion of foley catheter?

A

measure urine output

86
Q

irreversible cerebral damage in how many minutes?

1-2 min
2-3 min
3-4 min
4-5 min
5-6 min
A

3-4 min

87
Q

What happens with no CPR after?

0 minutes
4-6 minutes
6-10 minute
> 10 minutes

A

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
Q

depth of chest compressions (min and max)

A

2 inch min and 2.4 inch max

89
Q

rate of compressions

A

100-120 compressions/min

90
Q

for which do we phone before 1st cycle?

adult
infant/child

A

adult (phone first)

pedia (phone fast)

91
Q

which of a peripheral pulses is the last to go?

A

carotid pulse

92
Q

depth of compression for

adult
child
infant

A
  • 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
Q

number of compressions and breaths in cpr cycle

A

30 compressions/2 normal breaths

94
Q

after how many cycles of cpr do you check pulse

A

5 cycles of 30:2

95
Q

what do you do when pulse returns but no breathing

A
  • Give 1 rescue breath every 5 seconds.

- 12 rescue breaths per minute.

96
Q

differences between adult and pedia cpr (3)

A 
1. If the rescuer has
no help, give about
2 minutes of CPR
before activating
the EMS system
  1. 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
Q

Where to feel pulse in infant?

A

brachial pulse

E Med (13 decks)

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