E ACLS Flashcards

1
Q

What to do post defibrillation

A

get right back to CPR

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2
Q

What to do while AED charges

A

continue CPR

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3
Q

end tidal volume is 500ml of bag, while you ventilate there is a residual of 5ml left in your lungs every time you squeeze the bag, if it builds it can lead to things like bilateral pneumothorax — this is due to increase in thoracic pressure from over ventilating, what happens

A

Decreases Cardiac output

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4
Q

what is intubation prevent

A

prevent aspiration

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5
Q

Intubation is ___ open/closed loop circuit and what does it do?

A

Closed loop circuit and measures CPR efficacy in real time

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6
Q

With intubation how many seconds ventilation

A

every 6 seconds OR 10 times a minute with ventilation

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7
Q

How to measure oropharyngeal airway

A

place against side of face/cheek , measure mouth to mandible. Properly sized OPA results in proper alignment with glottic opening

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8
Q

What is purpose of end tidal Co2

A

CPR efficacy measurement - to ensure CPR efficacy

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9
Q

What does it mean if end tidal Co2 is decreasing

A

quality of CPR is decreasing, CPR performance dropping

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10
Q

What is diagnostic for ACS

A

12 lead EKG

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11
Q

What is needed to Dx STEMI

A

at least 2+ ST elevation in same lead

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12
Q

what is ASA dose

A

160-325po

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13
Q

when do caution nitroglycerin use

A

Right ventricle STEMI MI RV1, hold nitro or give with fluids

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14
Q

what is considered SICK pt

A

SOB, CP, hypotension

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15
Q

Best way to confirm/monitor the position of endotracheal tube?

A

End Tidal CO2

CXR= NOT answer

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16
Q
  • Pt had stents placements 2 weeks ago can have reinfarction?
A

If they are not properly anticoagulated (ex:plavix)

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17
Q

: Patient with a lot of chest pain, couple days of ago went to ER, ended up at Cath lab, placed 2 stent, 2 days later recovered but now with CP and SOB, why is the patient having CP and SOB despite having stents 2 days ago?

A

Likely cause is re-infarct in same place, clots in the stent when you are not anticoagulated, having ACS again

18
Q

Within how many hours to administer fibrinolyic therapy

A

3 hours of symptoms onset IF CT shows no bleeding or hemorrhage

19
Q

Can you administer anticoagulant or antiplatelet 24 hours after rtPA

A
  • Do not administer anticoagulants or antiplatelets for 24 hours after administration of rtPA, until a a follow up CT scan at 24 hrs show no intracranial hemorrhage
20
Q

What are 5 steps to Vib Vtachy

A
  1. CPR
  2. Defibrillate
  3. Vascular access
  4. epi [1mg every 4 minutes]
    5 amidarone [300mg first, 150mg second]
21
Q

What rhythms does not need debrilliation

A

PEA and asystole

22
Q

What to do when symptomatic bradycardia

A

atropine

23
Q

Sick patient with CP, SOB, Hypotension with strip that shows monomorphic ventricular tachycardia, says nothing about 12 lead EKG or Trops in the question. Which Algorithm should be followed

A

Adult Tachycardia

- CP and SOB are not empirical data of ACS, only EKG and troponin can

24
Q

What is empirical data of ACS

A

EKG and trop, NOT NOT NOT CP SOB

25
Q
  • Pt w/ chest pain, SOB, heart racing and sick :what to do?
A

cardioversion

26
Q

what to give with torsades de pointe

A

Magnesium Sulfate

27
Q

What are Cincinnati Pre-hospital stroke scale

A
  1. facial droop
  2. arm drift
  3. abnormal speech
28
Q

Need to rule out what before giving lytics?

A

Bleed!

29
Q

___ hours of symptoms onset to be able to administer fibrinolytics

A

3

30
Q

ick pt CP SOB and HYPOTENSION
Monomorphic Ventricular Tachycardia strip
Describes sick nothing about 12 ECH or Trops
Which Adult Algorithm to check

A

CP and SOB are not empiral data of ACS - does not give ECG or Troponin.
Answer: Adult Tachycardia!

31
Q

Unstable tachycardia with symptoms tx?

A

cardioversion

32
Q

Wide stable tachycardia tx?

A

seek expert consultation

33
Q

narrow stable tachy tx?

A

vagel manuever then adenosine

34
Q

what timeframe for lytic

A

stroke w normal head CT, must be within 3*** hours, start lytic right away. 3 hours is time frame but answer RIGHT AWAY

35
Q

5 steps to vtach v fib cardiac arrest

A

5 steps*******

  1. CPR [preserve heart and brain]
  2. defibrillate [corrects the rhythm] —- interrupt the correct heart and flatline/asystole, joule is a watt second of that delivery of electricity then more likely to be successful. Less joules are comfortable for alive pt. 200 joules. [charge and active CPR, then clear, then shock, resume CPR]
  3. vascular access IV/IO
  4. Epinephrine - always first drug we give during CPR every 4 minutes 1 mg with no max dose [every other cycle of CPR bc each CPR is 2 minutes]
  5. Amiodarone [ in between epi doses, epi Amiodarone 300, epi Amiodarone 150, then epi rest]
36
Q

number 9 test

A

complete block thrid degree

37
Q

what happens in shockable rhythm

A

Shockable Algorithm

  1. Start CPR, give oxygen, attach monitor/defibrillator [no pulse]
  2. Shockable cardiac VF/pVT , keep CPR while it charges
  3. Shock
  4. Resume CPR 2 minutes
  5. Vascular Access IO IV
  6. Rhythm analysis 2 minutes
  7. shockable - charge 200 J - shock 2nd time, CPR
  8. Give epi 1mg favorable retribution blood to heart
  9. CPR, shock, CPR charge
  10. Amio 300 IVIO
  11. CPR shock CPR charge

AHA, only 1 med at a time.

38
Q

1

A

2nd degree type2

39
Q

5

A

2nd degree type 1

40
Q

9

A

3rd degree type complete block

41
Q

what are steps to V. Fib ?

A

v fib #40 1. CPR

  1. defib
  2. vascular access
  3. epi
  4. amidarone
42
Q

R longer and dropped beat

A

second degree block type 1 NUMBER 5