Cardiac Arrest - ACLS Flashcards
______ is a certification course designed for
healthcare providers who either direct or participate in the management of
cardiopulmonary arrest or other cardiovascular emergencies
Advanced Cardiovascular Life Support (ACLS)
two distinct system-specific Chains of
Survival:
○ In-Hospital Cardiac Arrest
(IHCA)
○ Out-of-Hospital Cardiac
Arrest (OHCA)
The ______ assesses, attempts to stabilize the
patient, and initiates the Code Team
if necessary
Rapid Response Team (RRT)
More than half of IHCAs result from _____,
and changes in physiology such as tachypnea, tachycardia, and hypotension
foreshadow most of these events.
respiratory failure or hypovolemic shock
Ideally, a full code team will have ____ members, including a team leader who is
at the helm
6
Critical Concepts for BLS assessment:
■ Minimizing interruptions: Limit interruptions to chest compressions
to less than 10 seconds to maximize CCF.
■ High-quality CPR:
● Compression the chest hard and fast (100-120 per minute)
● Compress at least 2 inches and allow for complete recoil
● Switch compressor about every 2 min or earlier if fatigued
What is Agonal Breathing (AKA Agonal Gasps)?
○ Agonal gasps are not normal breathing and may be present in the first
minutes after sudden cardiac arrest.
○ The mouth may be open and the head, neck, or jaw may move with the
gasps, and you may hear a snort, snore, or groan
Starting CPR when you are not sure about a pulse
○ If you are unsure about the presence of a pulse, begin chest
compressions and ventilations.
○ Failing to provide compressions when needed is more harmful that
providing unnecessary compressions
In the Primary Assessment, we address the following (ABCDE)
○ Airway
○ Breathing
○ Circulation
○ Disability
○ Exposure
Primary assessment: Airway
○ Maintain patent airway in unconscious patients.
■ Head tilt-chin lift, OPA, and/or NPA.
○ Use advanced airway management if needed.
■ LMA, ET tubes, etc.
The Primary Assessment: Breathing
○ Give supplemental oxygen when indicated.
■ For those in cardiac arrest, 100% oxygen should be administered.
○ Monitor the adequacy of ventilation and oxygenation.
■ Clinical assessment (Good chest rise? Any cyanosis?)
○ Avoid excessive ventilation (what is the proper rate?)
The Primary Assessment: Circulation
○ Monitor CPR quality.
■ Quantitative waveform capnography (PETCO2 of at least 10 mmHg
suggests high-quality chest compressions
○ Attach monitor/defibrillator to monitor/address rhythm.
■ Provide defibrillation/cardioversion as indicated
○ Obtain IV (or IO) access, provide fluids if indicated.
○ Administer appropriate, indicated drugs (for rhythms and BP).
■ Discussed with the specific algorithms
○ Check glucose, temperature, and perfusion issues.
The Primary Assessment: Disability
○ Quickly assess neurologic function.
■ Check for responsiveness, level of consciousness, pupil dilation, etc.
○ Consider using AVPU.
■ Alert, Voice, Painful, Unresponsive
The Primary Assessment: Exposure
○ Remove clothing to perform a physical examination.
■ Check for obvious signs of trauma, bleeding, burns, other unusual markings, and medical alert bracelets.
The Secondary Assessment involves:
● The Secondary Assessment involves the differential diagnosis. Includes:
○ Focused medical history (SAMPLE)
○ Searching for and treating underlying causes (H’s and T’s
Secondary assessment: SAMPLE
○ Signs and symptoms
○ Allergies
○ Medications (including last dose taken)
○ Past medical history (especially relating to current illness)
○ Last meal consumed
○ Events
The _____ remind us of the most common causes of cardiac arrest
H’s and T’s
The H’s and T’s
H’s
Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo/Hyperkalemia
Hypothermia
T’s
Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis (pulmonary)
Thrombosis (coronary)
What is Cardiac Arrest
Cardiac Arrest is an abrupt, sudden loss of heart function in a person who
may or may not have diagnosed heart disease.
○ Occurs most commonly in those with known heart disease, whether it’s
coronary artery disease, heart failure, cardiomyopathy, etc.
○ Can occur in individuals in whom no heart disease diagnosis has ever
been established (can be the presenting sign of a heart problem
Cardiac Arrest presents with a classic clinical triad
○ Loss of consciousness (LOC)
○ Apnea (no breathing or agonal gasps)
○ Loss of apical or central pulses (carotid or femoral)
____% or more of individuals who suffer OHCA do not survive.
90
About ____% of those who suffer IHCA do not survive.
75
____, especially if performed within the first few minutes of cardiac arrest, can double or triple a individual’s chance of surviva
CPR
There has been a gradual improvement
in the survival rate in recent years.
○ Studies show that this is due to two
main factors:
■ Minimizing interruptions of
high-quality chest compressions
■ Early defibrillation
