Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 exams > Intermediate life support > Flashcards

Intermediate life support Flashcards

1
Q

reversible causes of cardiac arrest can be remembered by

A

5Hs and 5Ts

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

5 Hs

A

Hypovolaemia
Hypoxia
Hydrogen ion excess (acidosis)
Hypokalemia
Hypothermia

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

5Ts

A

Tamponade
Toxins
Tension pneumothorax
Thromosis (pulmonary)
Thrombosis (coronary)

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

signs and treatment of: Hypovolaemia

A

Signs
- rapid heart rate
- narrow QRS
- blood loss

Management
- obtain IO/IV access
- administer fluids/blood
- use fluid challenge
- high flow oxygen if required

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

signs and treatment of: hypoxia

A

Signs
- slow heart rate
- cyanosis

Treatment
- ensure airway is open
- ventilate
- ensure oxygen supply is adequate

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

signs and treatment of: Hydrogen ion excess (acidosis)

A

Signs
- low amplitude QRS

Management
- ABG
- provide adequate ventilations
- sodium bicarbonate

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

signs and treatment of: hypo/hyperkalamaeia

A

Signs
- Hypokalemia - flattened T waves and U wave
- Hyperkalemia- peaked T waves and widened QRS

Management
- Ventilate (resp)
- Sodium bicard (metabolic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

signs and treatment of: Hypothermia

A

Signs
- shivering
- previous exposure to cold temp

Management
- active warming measures

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

signs and treatment of: Tamponade

A

Signs
- rapid heart rate
- narrow QRS
- jugular vein distension
- no pulse
- muffled heart sounds

Management
- pericardiocentesis
- thoracotomy

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

signs and treatment of: toxins

A

Signs
- prolonged QT interval

Management
- based on overdose agent
- supportive care

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

signs and treatment of: tension pneumothorax

A

Signs
- slow heart rate
- narrow QRS
- unequal breathing
- JVD
- tracheal deviation

Management
- Needle decompression
- Insertion of a chest tube

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

signs and treatment of: Thrombosis (pulmonary)

A

Signs
- rapid heart rate
- narrow QRS
- shortness of breath
- decreased oxygen
- chest pain (pleuritic)

Management
- embolectomy
- fibrinolytic therapy
- anticoagulant therapy

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

signs and treatment of: thrombosis (coronary)

A

Signs
- abnormal ECG
- cardiac sounding chest pain

Management
- MONA
- angioplasty
- stent placmeent
- coornary bypass surgery

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

how can rhythms be classified in ILS

A

Shockable vs non-shockable

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

non- shockable rhythmas

A
  • Asystole
  • Pulseless electrical activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

briefly summarise managemet of non-shockable cardiac arrest

A
  • Continue CPR and recheck rhythm every 2 mins
  • Establish IV or IO
  • Administer 1mg 1:10,000 adrenaline IV
  • Repeat every 3-5 mins whilst patient remains in cardiac arrest
  • Consider reversible causes e.g. 5Hs and 5Ts
17
Q

describe this rhythm strip

A

Asystole

18
Q

outline ILS management of Asystole

A

1) Recognise as asystole
2) Continue CPR and chassess rhythm every 2 minutes
3) Establish IV or IO access
4) Immediately administer 1mg:10,000 adrenaline IV
5) Repeat every 3-5 minutes whilst patient remains in cardiac arrest
6) Consider reversible causes of cardiac arrest e.g. hypovolaemia give fluids

19
Q

describe this rhythm

A

Pulseless electrical activity (PEA)

20
Q

what is PEA

A

patient does not have a pulse, however they do have rhythm normally associated with cardiac output
(can resemble many recognizable rhythms)

21
Q

outline ILS management of PEA

A

1) Recognise as PEA
2) Continue CPR and chassess rhythm every 2 minutes
3) Establish IV or IO access
4) Immediately administer 1mg:10,000 adrenaline IV
5) Repeat every 3-5 minutes whilst patient remains in cardiac arrest
6) Consider reversible causes of cardiac arrest e.g. hypovolaemia give fluids

22
Q

shockable cardiac rhythms

A
  • Ventricular fibrillation
  • Pulseless ventricular tachycardia
23
Q

brief summary of management of shockable rhythms

A
  • When shockable rhythm established immediately give 1st shock at 200 joules
  • Continue CPR immediately after
  • Reassess the rhythm every 2 mins
  • Deliver 2nd shock at 300 joules
  • After 2 further minutes of CPR give 3rd shock at 360 joules
  • Give all subsequent shocks at 360 joules
  • After 3rd shock administer 1mg 1:10,000 adrenaline and 300mg amiodarone with big flushes
    o IV adrenaline can be given every 3-5 mins
    o Amiodarone only given once
24
Q

describe this rhythm

A

ventricular fibrillation

25
Q

recongising VF

A

VF can be caorse or fine. Electrical activity observed as “chaotic” with random frequency and amplitude and with no recognisable QRS complexes

26
Q

ILS management of Ventricular fibrillation

A

1) VF is not compatible with life sop requires immediate initial 1st shock at 200 joules
2) Carry on CPR in between shocks
3) Reassess the rhythm every 2 minutes. If patient remains in VF deliver a 2nd shcok at 300 joules
4) After a further 2 minutes of CPR and if patient remains in VF deliver 3rd shock at 360
5) All subsequent shcoks delivered at 360 joules
6) Immediately after 3rd shock give 1mg:10,000 adrenaline IV and 300mg amiodarone IV- both followed by a large flush

27
Q

describe this rhythm

A

pulseless ventricular tachycardia

28
Q

pulseless ventricular tachycardia

A

ventricular tachycardia is recogised by regular broad comples QRS generally greater than 180 bpm
- can be compatible with life
- in cardiac arrest siutatio it is essential to check that the patien tdoes not have a pulse to confirm the rhythm is a pulseless ventiruclar tachycardia

29
Q

ILS management of pulseless ventricular tachycardia

A

1) VT is not compatible with life sop requires immediate initial 1st shock at 200 joules
2) Carry on CPR in between shocks
3) Reassess the rhythm every 2 minutes. If patient remains in VF deliver a 2nd shock at 300 joules
4) After a further 2 minutes of CPR and if patient remains in VF deliver 3rd shock at 360
5) All subsequent shcoks delivered at 360 joules
6) Immediately after 3rd shock give 1mg:10,000 adrenaline IV and 300mg amiodarone IV- both followed by a large flush

30
Q

order of shock strength

A

200j
300j
360j ,360j, 360j……..

31
Q

giving amiodarone and adrenaline in caridac arrest

A

For shockable rhythms
- 300mg IV Amiodarone (only give once during cardiac arrest)
- 1mg:10,000 IV Adrenaline (given every 3-5 minutes after initial dose for the duration of the cardiac arrest)

32
Q

DKA

A
  • Rapid A to E
  • IV access, bloods
  • ECG
  • IV fluid resus: IV 0.9 NaCL
  • Fixed rate insulin infusion (FRII) at 0.1 units/k/h
  • Potassium replacement if needed
33
Q

Myocardial infarction

A
  • Bloods
  • IV access
  • Morphine
  • Oxygen
  • Nitrates
  • Aspirin
34
Q

Pneumothorax

A
  • > 2cm -> aspirate via needle decompression
  • If no reduction insert chest drain
35
Q

Anaphylaxis

A
  • A to E
  • Remove triggers e.g. stop any infusion
  • Lie patient flat
    o If pregnant- left lateral position
  • IM adrenaline in anterolateral aspect 1:1000 500 mg
  • Give high flow oxygen
    o Monitor: pulse oximetry, ECG, BP
  • If no response repeat adrenaline after 5 mins
  • IV fluid bolus (500ml over 15 mins)
  • If no improvement in breathing or circulation despite 2 doses of adrenaline -> commence CPR
36
Q

Choking

A
  • Encourage person top cough
  • If cough becomes ineffective give 5 back blows
    o Lean person forward
    o Between shoulder blades with heel of hand
  • If back blows ineffective give 5 abdominal thrusts
  • If chocking not relieved after 5 abdominal thrusts, continue alternating between 5 BB and % AR until relived
  • If person becomes unresponsive start CPR
37
Q

Seizure

A
  • Support airway and breathing
  • Gain IV/IO access
  • Give benzodiazepine (buccal, IV or IO)
  • If 2 staggered benzos failure give either:
    o Phenytoin or levetiracetam
  • If the above fails -> thiopentol for rapid induction
38
Q

major haemorrhage protocol

A

How to activate Major Haemorrhage Protocol

Phone 2222 and say “Major Haemorrhage, Children’s Hospital” stating location of patient (i.e. ward / department).

Blood Bank will call the ward
Porter will go to the Blood Bank.

General response

  • Control bleeding
  • Venous access
  • Avoid hypothermia - warm fluids
  • Take appropriate blood tests and send urgently to appropriate Laboratory

Immediate blood tests

  • FBC
  • Crossmatch
  • Coagulation screen (including Fibrinogen)
  • Biochemistry (including Calcium
  • Blood gases (if appropriate).

Information required by Blood Bank

  • Urgency of the situation
  • Patient details:
  • Conscious patient – forename, surname; DOB; gender; CHI number.
  • Unconscious/unidentified patient – minimum of gender and CHI number.
  • Whether cross match has been sent
  • Location of Patient
  • Contact number – need to establish clear lines of communication
  • Patient diagnosis
    -Nominate one person to liaise with Blood Bank

Blood component availability

Factor in time for samples to reach Blood Bank and any blood product to be delivered from Blood Bank.

  • Immediate – Group O Negative blood
    (4 units available in Paediatric theatres fridge)
  • 15 minutes – group specific blood (ABO + RhD grouping)
  • 35 minutes – fully cross-matched blood.
  • Platelets – Platelets supplies are limited so these may be delayed.
  • Fresh Frozen Plasma (FFP) and Cryoprecipitate – allow up to 20 minutes for thawing (plus delivery time)

Year 4 exams (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions