Exam 1 - Advanced Cardiac Life Support

Question 1

List the four rhythms of cardiac arrest?

Answer 1

ventricular fibrillation (VF), pulseless ventricular tachycardia (pVT), pulseless electrical activity (PEA), asystole

Question 2

What is the immediate goal of BLS and ACLS?

Answer 2

return of spontaneous circulation (ROSC)

Question 3

Explain treatment involved in reversing cardiac arrest?

Answer 3

2-minute CPR cycles where each end checks pulse and rhythm

Question 4

What is involved in the first step of treating cardiac arrest? (3)

Answer 4

start CPR, give oxygen, attach monitor/defibrillator

Question 5

Which rhythms are shockable? (2) Which are not? (2)

Answer 5

VF, pVT; asystole, PEA

Question 6

If VF/pVT persists after __ shocks and ___, then what may be given?

Answer 6

2, CPR, epinephrine

Question 7

If VF/pVT persists after epinephrine and advanced airway capnography, then what may be given?

Answer 7

amiodarone or lidocaine

Question 8

Which medications can be given endotracheally? (5)

Answer 8

naloxone, atropine, vasopressin, epinephrine, lidocaine (NAVEL) all at 2-2.5x IV/IO dose

Question 9

List indications for epinephrine in cardiac arrest?

Answer 9

all types

Question 10

What is the dosing for epinephrine in cardiac arrest?

Answer 10

1 mg IV/IO q3-5 min

Question 11

List indications for amiodarone in cardiac arrest? (3)

Answer 11

VF, pVT, stable VT (with pulse)

Question 12

What is the dosing for amiodarone in VF/pVT cardiac arrest?

Answer 12

300 mg IV bolus, may repeat 150 mg IV bolus in 3-5 min (boluses followed by 20 mL normal saline)

Question 13

What is the dosing for amiodarone in stable VT (with pulse) cardiac arrest?

Answer 13

150 mg IV over 10 min

Question 14

What are AEs of amiodarone?

Answer 14

QTc prolongation

Question 15

List indications for lidocaine in cardiac arrest? (3)

Answer 15

VF, pVT, stable VT (with pulse)

Question 16

What is the dosing for lidocaine in VF/pVT cardiac arrest?

Answer 16

1-1.5 mg/kg IV/IO, may repeat 0.5-0.75 mg/kg q5-10 min

Question 17

What is the dosing for lidocaine in stable VT (with pulse) cardiac arrest?

Answer 17

0.5-0.75 mg/kg IV

Question 18

Explain considerations for lidocaine over amiodarone cardiac arrest treatment? (2)

Answer 18

amiodarone availability, torsades de pointes risk

Question 19

List indications for magnesium in cardiac arrest? (2)

Answer 19

VF, pVT

Question 20

What is the dosing for magnesium in cardiac arrest?

Answer 20

not well established, 2g IV bolus (boluses followed by 10-20 mL normal saline)

Question 21

List the reversible “H” causes of cardiac arrest? (6)

Answer 21

hypovolemia, hypoxia, hydrogen ion (acidosis), hyperkalemia, hypothermia, hypoglycemia

Question 22

List the reversible “T” causes of cardiac arrest? (4)

Answer 22

tension pneumothorax, tamponade, toxins, thrombosis (pulmonary and coronary)

Question 23

What is the treatment for hypovolemia as a cause of cardiac arrest?

Answer 23

fluids

Question 24

What is the treatment for hypoxia as a cause of cardiac arrest?

Answer 24

100% oxygen mask

Question 25

What is the treatment for hydrogen ion excess (acidosis) as a cause of cardiac arrest?

Answer 25

??? (maybe sodium bicarbonate if pre-existing condition)

Question 26

What is the treatment for hypothermia as a cause of cardiac arrest?

Answer 26

bear hugger, chest compressions

Question 27

What is the treatment for hyperkalemia as a cause of cardiac arrest? (3)

Answer 27

calcium chloride/gluconate, insulin, dextrose

Question 28

What is the treatment for toxins as a cause of cardiac arrest? (3)

Answer 28

opioids = naloxone, local anesthetic toxicity = lipid emulsion, TCAs = sodium bicarbonate

Question 29

What is the treatment for tamponade and tension pneumothorax as causes of cardiac arrest?

Answer 29

needle aspiration

Question 30

What is the treatment for thrombosis as a cause of cardiac arrest? (2)

Answer 30

pulmonary = thrombolytics, cardiologic = thrombolytics, PCI