EMT Cardiac ACLS SOP Flashcards

1
Q

What is the sequence in which orders to treat the cardiac arrest patient are received?

A

first, by the sending physician
then, by the Standing Operating Procedures approved by Exceptional Medical Transport in conjunction with the Exceptional Medial Director
and finally, online medical control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In the absence of of specific orders to treat the cardiac arrest patient by the sending physician, what prevails?

A

Exceptional Medical policies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who can supercede Exceptional policies, and when?

A

the Medical Director, at any time, can override Exceptional policies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens when the patient has cardiac arrest at the sending hospital?

A

resuscitation will be the responsibility of the sending physician and nursing staff, The Exceptional team, if not needed should then request to be called back when the patient is stable for transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is arrest happens during transfer from the patient bed to the ambulance?

A

the patient should be diverted to the ER. SCT team may attempt airway and dysrhythmia stabilization enroute to the ER if it is in the best interest of the patient. A specialty care transport Chart will be filled out with the details of the incident along with an incident report attached.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens when a patient arrests during transport to the receiving hospital?

A

SCT team will resucitate according to the orders given by the sending physician, Exceptional Medical Director, and the SOP as they apply. Team will notify dispatch of arrest and the need to divert. Team will manage airway with BLS technique until intubation or King tube placement or arrival to intended ED.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

After the patient has been delivered to the intended ER when diversion is needed for cardiac arrest while transporting, who are the 5 people that the SCT RN is required to notify?

A
Sending physician 
Sending RN
Original Receiving RN 
Exceptional SCT medical director 
Chief transport nurse 
All names of personnel notified will be included in the chart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens if cardiac arrest occurs enroute from the ambulance to the receiving hospital bed?

A

The patient will be diverted to the receiving hospital ER for definitive treatment. Airway and dysrhythmia stabilization may be attempted enroute to ER. Sending physician then Exceptional SOP will be followed until report can be given to the ER staff. All events will be documented in the patient chart along with an incident report

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens if cardiac arrest occurs on the recieving unit?

A

Report is given to the recieving staff. Al events are documented in the patients record along with an incident report. The SCT RN will give notification to the sending physician, sending RN, Exceptional SCT medical director, and chief transport RN. All names of persons notified will be included in the Exceptional patient chart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Per ACLS Adult Cardiac Arrest Algorithm, what two heart rhythms are considered shockable?

A

ventricular fibrillation

pulseless V tach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Per ACLS Adult Cardiac Arrest Algorithm, what is the timeframe for a round of CPR?

A

2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Per ACLS Adult Cardiac Arrest Algorithm, what is the dose, frequency, and point of initiation of Epinephrine?

A

1 mg every 3-5 minutes

after the first round of CPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Per ACLS Adult Cardiac Arrest Algorithm, what is the dose of the first round of Amiodarone?

A

300 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Per ACLS Adult Cardiac Arrest Algorithm, what is the dose of the 2nd round of Amiodarone?

A

150 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the best indicator of ROSC?

A

abrupt, sustained Petco2 increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Per ACLS Adult Cardiac Arrest Algorithm, what are the H’s of the H’s and T’s?

A
hypovolemia 
hypoxia
Hydrogen atom (acidosis) 
Hypo/ hyperkalemia 
Hypothermia
17
Q

Per ACLS Adult Cardiac Arrest Algorithm, what are the T’s of the H’s and T’s?

A
Tension pneumothorax 
Tamponade 
Toxins 
Thrombosis, pulmonary 
Thrombosis, coronary
18
Q

If the patient is in Vfib / Pulseless V tach, what are the 8 steps you should take?

A
  1. CPR until defibrilator is available
  2. Defibrillate q2min
  3. establish IV w/ NSS KVO
  4. Give epinephrine 1mg q 3-5 minutes throughout resucitation while continuing CPR
  5. During next round of CPR, give amiodarone or lidocaine
  6. If rhythm is terminated by Lidocaine, start lidocaine drip. If rhythm is terminated by amiodarone, 150mg bolus over 10 minutes
  7. if Torresades administer Magnesium
  8. consider advanced airway
19
Q

Per ACLS Adult Cardiac Arrest Algorithm, what is the drug and dose to treat Torsades De Pointes?

A

Magnesium Sulfate 1 gram in 50 cc D5W to run over 2 minutes

20
Q

PEA encompasses a group of rhythms that are organized or semi organized but lack a palpable pulse. PEA rhythms include (5)

A
EMD (electromechanical dissociation) 
Idioventricular rhythms 
Ventricular escape rhythms 
Brady-asystolic rhythms 
Post defibrilation Idioventricular Rhythms
21
Q

when transporting the patient in PEA, CPR should be maintained throughout treatment with puls check every __ minutes

A

2

22
Q

Give __ ml NSS bolus per SOP when treating the patient in PEA

A

500

23
Q

While resuscitating the patient in PEA, what is the dose and frequency for epinephrine throughout resuscitation attempt?

A

Epinephrine 1.0 mg 1:10,000 IV push and repeat q 3 min

24
Q

when administering epinephrine when you don’t have IV access but you do have a King tube is place, what is the dose?

A

2 times the recommended dose diluted in 10 cc NS

25
Q

Total amount of solutions given via ETT/King tube are not to exceed __ cc

A

50 cc

26
Q

If unable to maintain adequate oxygenation with BVM and 15L O2, what should you do?
And if you do, what should you be monitoring?

A

intubate or or insert King tube

monitor ETCO2 by waveform capnography

27
Q

what is the normal range for waveform capnography?

A

35 - 45 mmHg

28
Q

High quality CPR is achieved when the ETCO2 value is at least __ - __ mmHg

A

10 - 20

29
Q

when performing CPR with waveform capnography in place, what would you expect to see if you achieve ROSC?

A

an increase in ETCO2 to 35- 45 mmHg indicating that more CO2 is being dumped into the lungs

30
Q

Reversable causes of PEA include the H’s (6) and T’s (5)

What are they?

A
Hypovolemia 
Hypoxia
Hypothermia
Hypo. / Hyperkalemia 
Hypoglycemia 
Hydrogen atom (acidosis) 
Tamponade (cardiac) 
Tension pneumothorax 
Thrombosis, pulmonary or cardiac 
Toxins 
Trauma
31
Q

Exceptional SOP is the same for Asystole as it is for PEA except for one thing you can do for Asystole, what is it?

A

External Pacing

32
Q

what are the 6 ECG rhythms with a heart rate less than 60/min that are classified s Bradycardia?

A
Sinus bradycardia 
first degree AV block 
second degree AV block 
Type I Wenckenback/ Mobitz I 
Type II Mobitz II
Third-degree AV block / complete block