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Chapter 1 Flashcards

1
Q

Disease of the coronary arteries and their resulting complications such as angina pectoris and acute MI

A

Coronary heart disease

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2
Q

Disease of the arteries that supply the heart muscle with blood

A

Coronary artery disease

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3
Q

A sudden loss of effective blood flow that’s caused by cardiac and/or peripheral vascular factors that may reverse spontaneously (like syncope) or only with intervention (like cardiac arrest)

A

Cardiovascular collapse

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4
Q

The absence of cardiac mechanical activity, which is confirmed by the absence of a detectable pulse, unresponsiveness and apnea or agonal gasping breathing

A

Cardiopulmonary (cardiac) arrest

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5
Q

A natural death of cardiac cause that’s preceded by an abrupt loss of consciousness within one hour of the onset of an acute change in cardiovascular status

A

Sudden cardiac death

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6
Q

What are the heart rhythms that may be observed in a cardiac arrest?

A
  1. Pulseless VT (wide regular QRS faster than 120 bpm)
  2. VFib (irregular chaotic deflections that vary in shape and height are observed but there’s no coordinated ventricular contraction)
  3. Asystole (no cardiac electrical activity is present
  4. Pulseless electrical activity (Electrical activity is visible on EKG but central pulses are absent)
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7
Q

What are the shockable rhythms? the nonshockable?

A

Shockable - VT and VF

nonshockable - Asystole and PEA

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8
Q

What are the links in the chain of survival?

A
  1. early recognition and activation
  2. early CPR
  3. Early defibrillation
  4. Effective advanced life support
  5. Integration of post-cardiac arrest care
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9
Q

Who makes up a medical emergency team or a rapid response team?

A

A physician and a nurse with critical care training who are available at all times

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10
Q

What are the components of basic life support?

A
  1. recognition of signs of cardiac arrest, heart attack, stroke and foreign body airway obstruction.
  2. relief of foreign body airway obstruction
  3. cardiopulmonary resuscitation (CPR)
  4. defibrillation with an automated external defibrillator (AED
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11
Q

When performing chest compressions, when is systole and when is diastole?

A

Systole is in the chest compression phase and diastole is in the release phase

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12
Q

Whats the key detereminant of the success of resuscitation ?

A

Coronary perfusion pressure, generated when performing external chest compressions

note that adequate cerebral and coronary perfusion pressures are critical to neurologically normal survival

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13
Q

when you determine that CPR is needed what is the initial action performed?

A

Chest compression - this enables better delivery of the oxygen that’s already present in the lungs and arterial circulation to the heart and brain

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14
Q

What’s the Cardiac output during CPR?

A

25-33% of normal

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15
Q

What makes high quality chest compressions?

A
  • Pushing had on a victims chest
  • Ccompressing at a rate of at least 100 compressions/minute allowsing full chest recoil after each compression (so the heart can refill)
  • Minimizing the interruptions in chest compressions
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16
Q

How hard should you push on an adults chest?

A

at least 2 inches (5cm) in adults

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17
Q

How hard should you push on an infants chest?

A

A depth of at least one third the AP diameter of the chest or about 1.5 inches (4cm)

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18
Q

how hard should you push on a childs chest?

A

about 2 inches (5cm)

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19
Q

What is the post-cardiac arrest syndrome?

A

Pathophysiology due to the ischemia-reperfusion response that occurs during cardiac arrest and subsequent return of spontaneous circulation

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20
Q

What are the components of the post cardiac arrest syndrome?

A
  • post-cardiac arrest brain injury
  • post-cardiac arrest myocardial dysfunction
  • systemic ischemia/reperfusion response
  • persistent precipitating pathology that caused or contributed to the cardiac arrest
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21
Q

What are the PATCH-4-MD possible treatable causes of cardiac emergencies?

A

Pulmonary embolism - anticoagulant, surgery
Acidosis - ventilation, correct acid-base disturbance
Tension pneumothorax - needle decompress
Cardiac tamponade - pericardiocentesis
Hypovolemia - replace volume
Hypoxia - ensure adequate oxygenation and ventilation
Hypothermia/Hyperthermia
Hypo/Hyperkalemia (and other electrolytes) - monitor glucose carefully wile correcting electrolytes
Myocardial infarction - reperfusion therapy
Drug overdose/accidents

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22
Q

What are the 5 H’s for possible treatable causes of cardiac emergencies?

A 
Hypovolemia
Hypoxia
Hypothermia
Hypo/Hyperkalemia
Hydrogen ion (acidosis)
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23
Q

What are the 5 T’s for possible treatable causes of cardiac emergencies?

A 
Tamponade, cardiac
Tension pneumothorax
Thrombosis: lungs (massive PE)
Thrombosis: heart (ACS)
Tablets/Toxins
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24
Q

What are the three phase of cardiopulmonary resuscitation due to VF?

A
  1. Electrical phase
  2. Circulatory (hemodynamic) phase
  3. Metabolic phase
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25
What is the time frame and intervention of phase 1 of cardiopulmonary resuscitation?
Electrical phase Occurs from the time of VF arrest to about the first 5 min after the arrest Intervention is electrical therapy (defibrillation)
26
What is the time frame and intervention of phase 2 of cardiopulmonary resuscitation?
Circulatory (hemodynamic) phase Occurs from 5 min to 15 min after VF arrest Intervention is CPR before electrical therapy
27
What is the time frame and intervention of phase 3 of cardiopulmonary resuscitation?
Metabolic phase Occurs after about 15 minutes Intervention is therapeutic hypothermia
28
What type of drug may improve perfusion pressures during cardiac arrest?
Vasopressors
29
What is a common cause of intrathoracic pressure during CPR?
Hyperventilation | Increased pressure can decrease venous return during the release (diastolic) phase of chest compression
30
What therapeutic method should be part of a standardized treatment strategy for comatose survivors of cardiac arrest?
Therapeutic hypothermia - suppresses damaging chemical reactions - can improve oxygen deliver to the brain - Decreases HR and increases TPR while maintain stroke volume and BP
31
What is the interval preceding a cardiac arrest called?
Prearrest period
32
What is the time period called 1 hr before and 1 hr after a cardiac arrest?
Periarrest period
33
What acronym should you use for making a general impression of a patient (determining stable from unstable patient)?
Appearance (work of) Breathing Circulation
34
What is the ABCDE sequence of the primary survey?
During this phase, assessment and management occur at the same time (treat as you find) ``` Airway Breathing Circulation Disability/Defibrillation Exposure ```
35
When should you repeat the primary survey?
Change in the patient's condition; when interventions aren't working; unstable vital signs; before any procedures; with a change in cardiac rhythm
36
What's the point of the secondary survey?
detect potentially life-threatening conditions | advanced life support interventions and management
37
What are the action steps of the secondary survey?
``` Obtain vital signs/ history Reassess: Airway, breathing, circulation Differential diagnosis/Diagnostic procedures Evaluate interventions, pain management Facilitate family presence ```
38
What component of patient assessment includes focusing on advanced life support assessment and interventions?
secondary survey
39
What component of patient assessment includes applying pads to the patients bare chest and defibrillating, if indicated
primary survey
40
What component of patient assessment includes the purpose is to develop a sense if the patient is sick or not sick?
general impression
41
What component of patient assessment includes evaluating interventions and pain management
secondary survey
42
What component of patient assessment includes when the purpose is to detect the presence of life-threatening problems and immediately correct them?
primary survey
43
What component of patient assessment includes determining if breathing is adequate or inadequate
primary survey
44
What component of patient assessment includes when the purpose is to detect potentially life-threatening conditions and provide care for those conditions?
secondary survey
45
What component of patient assessment includes assessing for visible movement of the chest or abdomen from a distance, looking for signs of breathing effort and the presence of audible airway sounds?
general impression
46
What component of patient assessment includes focusing on basic life support assessment and interventions?
primary survey
47
What component of patient assessment includes asking the patient, family, bystander or others questions regarding the patient's history?
secondary survey
48
What component of patient assessment includes inserting an advanced airway if needed
secondary survey
49
What component of patient assessment includes obtaining vital signs, attaching a pulse oximeter, EKG, and BP monitoring?
secondary survey
50
What component of patient assessment includes establishing vascular access
secondary survey
51
What component of patient assessment includes opening the airway is the patient is unresponsive?
primary survey
52
What component of patient assessment includes searching for, finding and treating reversible causes of the cardiac arrest, rhythm or clinical situation?
secondary survey
53
Examples of breathing that may be evident in the first few minutes of cardiac arrest
apnea or agonal, gasping breathing
54
first link in the adult chain of survival
Early recognition and access
55
Second phase of CPR
Circulatory (hemodynamic) phase
56
One of the factors affecting perfusion pressures during cardiac arrest
Vascular resistance
57
The "D" in the secondary survey
Differential diagnosis
58
Chest compression rate for adults, children and infants
at least 100/minute
59
Cardiac rhythm in which electrical activity is visible on the ECG but central pulses are absent
Pulseless electrical activity
60
The absence of cardiac mechanical activity, confirmed by the absence of a detectable pulse, unresponsiveness and apnea or agonal, gasping breathing
Cardiac arrest
61
Phase of CPR during which the effectiveness of immediate defibrillation and CPR followed by defibrillation decreases rapidly and survival rates appear to be poor
Metabolic phase
62
Third link in the adult chain of survival
Early defibrillation (if indicated)
63
Period of the cardiac cycle during which most coronary blood flow occurs
Diastole
64
Chest compression depth for adults
At least 2 inches (5 cm)
65
First phase of CPR
Electrical phase
66
interruptions in chest compressions cause this to fall rapidly
cerebral and coronary perfusion pressures
67
conditions that occur as a result of the ischemia-reperfusion response during cardiac arrest and subsequent return of spontaneous circulation
Post-cardiac arrest syndrome
68
Memory aid used to assess level of responsiveness
AVPU
69
Recognized treatment strategy for comatose survivors of cardiac arrest
therapeutic hypothermia
70
A (sudden) loss of effective blood flow caused by cardiac and/or peripheral vascular factors that may revert spontaneously or only with interventions
Cardiovascular collapse
71
The ideal series of events that should take place immediately following the recognition of onset of sudden illness
Chain of survival
72
Cardiac rhythm in which irregular chaotic deflections that vary in shape and height are observed on the ECG but there's no coordinated ventricular contraction
Ventricular fibrillation
73
Chest compression depth for infants
about 1.5 inches (4 cm)
74
Fifth link in the adult chain of survival
post-cardiac arrest care

ACLS (5 decks)

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