Code Blue

Question 1

Prior to CPR there should be ___ breaths every ___ sec

Answer 1

1 breath 5-6 seconds

Question 2

Once CPR is in place, how often and how many breaths do you give ?

Answer 2

after 30 compressions you give 2 breaths

Question 3

How often are breaths given to an intubated patient that is receiving CPR?

Answer 3

1 breath every six seconds

Question 4

What color should the ETCO2 detector be?

Answer 4

GOLD

Question 5

Which rhythms are shockable?

Answer 5

Vfib and pulseless VT

Question 6

Which rhythms are not shockable?

Answer 6

asystole and PEA

Question 7

Shockable rhythm cycle

Answer 7

Shock –> CPR 2min: IV/IO access –> shock –> CPR 2 min: epinephrine 1mg IV/IO q 3-5 min –> shock –> CPR 2 min, treat reversible causes, amiodarone: first dose 300 mg bolus, 2nd dose 150mg

Question 8

How deep should compressions be?

Answer 8

at least 2 inches

Question 9

epinephrine dose

Answer 9

1 mg q 3-5 min

Question 10

amiodarone 1st and 2nd dose

Answer 10

1st –> 300 mg bolus

2nd –> 150 mg

Question 11

Reversible causes 5 H’s

Answer 11

hypovolemia
hypoxia
hyper/hypokalemia
hypothermia
h+ ions (acidosis)

Question 12

reversible causes 5 T’s

Answer 12

tamponade cardiac
tension pneumothorax 
thrombosis, pulmonary
thrombosis, cardiac
toxins

Question 13

What is ROSC?

Answer 13

return of spontaneous circulation

Question 14

how to know ROSC was achieved (3)

Answer 14

• pulse and BP present
• abrupt sustained increase in PETCO2 (typically greater than 40 mmhg)
• spontaneous arterial pressure waves with intraarterial monitoring

Question 15

goals post resuscitation

Answer 15

• optimize cardiopulmonary function
• transport to critical care
• identify and treat cause of arrest

Question 16

What is the most important question to ask post ROSC?

Answer 16

is the patient able to follow commands?

Question 17

What is done if a patient is unresponsive post ROSC?

Answer 17

-therapeutic hypothermia

Question 18

When should therapeutic hypothermia start?

Answer 18

ASAP (ideally 4-6 hours post arrest)

Question 19

Nursing care during hypothermia: monitor core body temp (2)

Answer 19

• Bladder catheter with temperature probe

- NO axillary, tympanic, and oral probes

Question 20

Nursing care during hypothermia: shivering (3)

Answer 20

• Increases oxygen consumption
• Increases body temperature
• Control with IV sedatives, analgesics, neuromuscular blockade medications

Question 21

Nursing care during hypothermia (4)

Answer 21

• monitor core body temp
• shivering
• hyperglycemia management
• drugs can mask seizure activity: continuous EEG

Question 22

Bradycardia algorithm –> what question do you ask yourself?

Answer 22

Are they symptomatic?

Question 23

Bradycardia algorithm –> what do you do if the pt is symptomatic?

Answer 23

atropine 1mg q 3-5 min max 3mg

Question 24

Bradycardia algorithm –> what do you do if pt is unresponsive to atropine? (3)

Answer 24

• transcutaneous pacing
• dopamine IV 5-20 mcg/kg/ min
• epinephrine 2-10mcg/min

Question 25

Tachycardia with a pulse algorithm if pt is symptomatic what do you do?

Answer 25

cardio version

Question 26

Tachycardia with a pulse algorithm –> if pt is not symptomatic, but has a wide QRS what do you do?

Answer 26

adenosine 6mg followed my 20 ml NS flush

Question 27

tachycardia with a pulse algorithm –> what do you do if pt is not symptomatic and the QRS is normal?

Answer 27

vagal maneuvers