General Concepts Flashcards
Name the BLS steps for CPR including:
- rate of compressions
- depth of compressions in adults and chilren
- when to give compressions in adults and children
- how often to give breaths to adults and children
- how often to give breaths if advanced airway is used
- how soon to defibrillate
- Recognize: (not or abn. breathing/unresponsive)
- Activate: Call EMS and get AED
- Pulse: (carotid adult/child & brachial infant.
Name the general steps to manage choking
CHOKING
- Ask if they are choking
- Abd. Thrusts
- If unresp. = CPR algorithm + (check for FBO)
For a lone rescuer how does the BLS algorithm change for adults and children when collapse is witnessed? Not witnessed?
Witnessed: Adult: Activate EMS and get AED Then CPR. Child: 2 min. CPR then Activate and get AED.
Not witnessed or drowning: 1 cycle CPR, then Activate and get AED.
What is the basic ACLS algorithm for cardiac arrest given a monitor read of VF/VT? Asystole? PEA?
- Recognize
- ACTIVATE/AED
- ABC IV O2 Monitor
a. SHOCK: VF/VT->shock #CPR2min+EPI(3-5min)1MG/Amio300mg,150mg. Airway, capno.#RPT.
b. No SHOCK: Asyst/PEA-> #CPR2min+EPI(3-5min)1MG Airway, capno.#RPT. - ROSC?->HR, BP, PETCO2>40= O2>94%, TX BP SBP>90 w/ 1-2 L fluid, Epi 0.1-.5mcg/kg/Dop 5-10mcg/kg/min.
12-lead. A&O? Y: coronary repro, N: hypothermia.
What are the 3 main treatments for ROSC?
O2>94%,
TX BP SBP>90 w/ 1-2 L fluid, Epi 0.1-.5mcg/kg/Dop 5-10mcg/kg/min.
12-lead. A&O? Y: coronary repro, N: hypothermia.
What is bradycardia? What are symptoms of bradycardia and how is it treated for asymptomatic patients vs symptomatic patients?
BRADYCARDIA (<50/MIN)
1. ABC IV O2 Monitor
2. SX (BP, MS, Shock, Chest pain/disc, CHF)
If no SX: monitor,
If SX Atropine 0.5mg q3-5 mx3mg., TCP/Dop 2-10mcg/kg/min / EPI 2-10 mcg/min.
What is tachycardia? When is it symptomatic and what are the symptoms?
tachycardia >100 bpm. Symptoms often occur over 150 bpm. SX = BP, MS, Shock, Chest pain/disc, CHF
What is the treatment for symptomatic tachycardia with regular and narrow QRS and what are common rhythms found with this?
Try adenosine then 100J cardioversion. Atrial flutter and SVT.
What is the treatment for symptomatic tachycardia with regular and wide QRS and what are common rhythms found with this?
100 J cardioversion. V-tach, SVT
What is the treatment for symptomatic tachycardia with irregular and narrow QRS and what are common rhythms found with this?
200 J. A-fib
What is the treatment for symptomatic tachycardia with irregular and wide QRS and what are common rhythms found with this?
Defibrilation. V-fib.
What is the treatment for asymptomatic tachycardia with regular and narrow QRS?
QRS<.12 : Vagal/Adenosine 6mg,12mg/BB(atenolol5mg)/CC(diltiazem20mg)/Consult.
What is the treatment for asymptomatic tachycardia with regular and wide QRS?
QRS>.12 reg monomorphic: Adenosine. Polymorphic antiarrythmic (amiodarone 150mg for 10 min).
Name the basic steps in management of stroke
Identify Activate EMS ABC IV O2 monitor, check blood glucose Asses stroke and time of onset Get to stroke center CT
What is the plan for stroke if CT shows hemorrhage?
Send to neurosurgery
What is the plan for stroke if CT shows no hemorrhage?
Determine if candidate for fibrinolytics:
- Yes: review Procedures, alternatives, risks and questions. If patient agrees then rtPA (no anticoagulant/anti-platelets for 24h)
- No: give ASA and consult with neurosurgery.
What is the Cincinnati Pre-hospital Stroke Scale and what does it mean if one of the tests is right?
- Face droop.
- Arm drift.
- Abnormal speech.
1/3 = 73% probability.
Describe the basics of the Glasgow Coma Score
GCS: 4E5V6M. 4 levels of eye response 5 levels of verbal response 6 levels of motor response >14 mild, >13 mod, </= 10 severe. 3 is the minimum.
Major inclusion criteria for fibrinolytic to treat stroke?
stroke occured /= 18 yoa.
- you can give it up to 4.5 hours if patient is not >80, not using anticoagulants and has no history of diabetes or ischemic stroke.
Major exclusion criteria for fibrinolytics to treat stroke?
Head trauma within 3 months, subarachnoid hem, hx intracran hem, BP>185/110, INR>1.7, PT>15, plt<100k
What is the basic treatment for someone with chest pain?
ABC, MONA (morphine, oxygen, nitro, asa), IV, Monitor
How does a STEMI show on ECG?
ST elevation> .1mm / t-wave inv in 2+ contiguous limb leads, or >2mm in 2+ contiguous precordial leads, new lbbb
If you see STEMI what is the criteria for reperfusion therapy?
has to be within 12 hours of STEMI, but you should actually do either PCI or fibrinolysis even it its over 12 hours given the chance you could save some of the heart.
Your patient has a confirmed STEMI what are the goals of reperfusion therapy? When is fibrinolysis indicated? PCI? What labs/tests are helpful?
- If you can get the patient to PCI w/in 2 hours then PCI is the therapy of choice.
- If no PCI in 2 hours and qualify for fibrinolysis, then TX w/ fibrinolysis…ideally w/in 30 minutes of medical contact.
Get, but don’t wait for:
- cardiac markers
- electrolytes
- coags
- chest x-ray