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CP3 > INTRO TO ACLS > Flashcards

INTRO TO ACLS Flashcards

1
Q

Required knowledge & skills for CLS

A

BLS Skills
-ECG Interpretation for core ACLS rhythms
-Knowledge of airway management and adjuncts
-Basic ACLS drugs and pharmacology knowledge
-Effective high-performance team skills

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2
Q

Interpretation of what rhythms

A

Sinus Rhythm
Atrial Fibrillation
Atrial Flutter
Bradycardia
Tachycardia
Supraventricular Tachycardia
AV Blocks
Asystole
PEA
Ventricular tachycardia (VT)
Ventricular fibrillation (VF)

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3
Q

Chain of Survival

A

Prevention and preparedness
 Responder training, early recognition, rapid response
Activation of the emergency response system
 Either outside and inside hospital
High-quality CPR
 Early defibrillation of VF and VT
Advanced resuscitation interventions
 Medications, advanced airway interventions, CPR
Post-cardiac arrest care
 Critical care, targeted temperature management
Recovery
 Effective support for physical, cognitive, emotional, and family
needs

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4
Q

In Hospital Cardiac Arrest (IHCA)
IHCA Chain of Survival

A

In Hospital Cardiac Arrest (IHCA)
IHCA Chain of Survival
 Early recognition and prevention
 Activation of emergency response (RRT)
 High-quality CPR
 Defibrillation
 Post cardiac arrest care
 Recovery

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5
Q

In Hospital Rapid Response Team (RRT)
RRT Alert Activated in following criteria are present

A

In Hospital Rapid Response Team (RRT)
RRT Alert Activated in following criteria are present
 Threatened airway
 RR less than 6/min or more than 30/min (know baseline)
 HR less than 40/min or greater than 140/min (know baseline)
 Systolic BP less than 90mmHg (know baseline)
 Symptomatic HTN
 Unexpected decreased LOC
 Unexplained agitation
 Seizure
 Significant fall in urine output
 Subjective concern of the patient

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6
Q

Respiratory Distress

A

Tachypnea
Increased respiratory effort
Inadequate respiratory
effort
Abnormal airway sounds
Tachycardia
Pale, cool skin
Changes in LOC
Use of abdominal muscles to
help breathe

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7
Q

Respiratory Failure

A

Marked tachypnea
Bradypnea, apnea
No respiratory effort
Poor to absent air movement
Tachycardia (early), bradycardia
(late)
Cyanosis
Stupor, coma(late

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8
Q

High Performance Teams

A

Timing
Quality
Coordination
Administration

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9
Q

Timing

A

Time to first compression and first shock, chest compression
fraction greater than 80%, minimize preshock pause, early
response time

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10
Q

Quality

A

Rate, depth, chest recoil, minimizing interruptions,
switching compressions, avoiding excessive ventilation, use
of feedback device

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11
Q

Coordination

A

Team members working together, proficiency

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12
Q

Administration

A

Leadership, measurement, CQI, number of code team
members.

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13
Q

High Performance Teams

A

Team Leader
Team Member
CPR Coach

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14
Q

Role of TEAM LEADER in High Performance Team

A

Role of Team Leader
-Organize the group
-Monitor individual performance of team members
-Backs up team member
-Models excellent team behavior
-Trains and coaches
- Facilitates understanding
-Focuses on comprehensive patient care
- Temporarily designation another member as leader if advance procedure is required

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15
Q

Role of TEAM MEMBER in High Performance Team

A

Role of the Team Member
-Proficient in performing skills within scope of practice
-Clear about role assignments
-Prepared to fulfill their role responsibilities
-Well practiced in resuscitation skills
-Knowledge about the algorithm
-Committed to success

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16
Q

Role of CPR COACH in High Performance Team

A

Role ofCPR Coach
-Coordinate the start of CPR
-Coach to improve the quality of chest compressions
-State the midrange targets
-Coach to the midrange targets
-Help minimize the length of pauses in compressions

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17
Q

Elements of Effective Team Dynamics

A

-Clear roles and responsibilities
-Knowing your limitations
-Constructive Interventions
-Knowledge Sharing
-Summarizing and Reevaluating
-Effective Communication

18
Q

Effective Communication

A

Closed-Loop Communications
Clear Messages
Mutual Respect

19
Q

Closed-Loop Communication

A

Closed-Loop Communications
-TL gives a message, order, or assignment to a TM.
-By receiving a clear response and eye contact, the TL confirms
that the TM heard and understood the message.
- The TL listens for confirmation of the task performance from the TM before assigning another task

20
Q

Clear Messages

A

Clear Messages
- Concise communication spoken with distinctive speech in a controlled tone of voice

21
Q

Mutual Respect

A

Mutual Respect
- Work together in a collegial, supportive manner

22
Q

Systematic Approach

A

Initial assessment
BLS Assessment
Primary Assessment
Secondary Assessment

23
Q

Initial Assessment

A

Visualization
Verify scene safety
Determine conscious vs unconscious patient

24
Q

BLS Assessment

Check Responsiveness

A

Check Responsiveness
Tap and Shout “Are you Ok?”
Shout/Seek for Nearby Help
Shout for nearby help
Activate emergency response system
Get AED (if available) or send someone to get
AED and activate emergency response system

Check Breathing and Pulse
 Scan chest for 5-10 seconds for movement for absent or abnormal
breathing
 Check pulse simultaneously (5-10 seconds)
 No pulse within 10 seconds – start chest compression
 If pulse – rescue breathing (1 breath every 5 – 6 seconds)
 Check pulse every 2 mins
Defibrillation
 If no pulse, check for shockable rhythm
 Provide shock as indicated
 Follow each shock immediately with CPR, beginning with
compressions

25
Q

BLS Assessment

Check Breathing and Pulse

A

Check Breathing and Pulse
 Scan chest for 5-10 seconds for movement for absent or abnormal
breathing
 Check pulse simultaneously (5-10 seconds)
 No pulse within 10 seconds – start chest compression
 If pulse – rescue breathing (1 breath every 5 – 6 seconds)
 Check pulse every 2 mins

26
Q

BLS Assessment

Defibrillation

A

Defibrillation
 If no pulse, check for shockable rhythm
 Provide shock as indicated
 Follow each shock immediately with CPR, beginning with
compressions

27
Q

BLS Assessment

3 Steps

A

Check Responsiveness

Shout/Seek for Nearby Help

Check breathing and pulse

Defibrillate

28
Q

CPR Adult

A

Compress chest at least 2 inches (5 cm)
Compress chest at a rate of 100-120/min
Allow complete chest recoil after each compression
Compress hard and fast
Minimize interruption in compressions (10 seconds of
less)
Avoid excessive ventilation (30:2)
Switch compressor every 2 mins (or earlier if
fatigued)

29
Q

Primary Assessment
ABCDE

A

Airway
Breathing
Circulation
Disability
Exposure

30
Q

Airway

A

Airway
 Maintain patency in unconscious patients
 Use advanced airway management if needed
 Confirm proper CPR-Ventilation coordination
 Secure device to prevent dislodgment
 Monitor airway placement with capnography waveform

31
Q

Breathing

A

Breathing
 Given supplemental O2 if indicated
 Monitor adequacy of Ventilation and Oxygenation
 Avoid excessive ventilation

32
Q

Circulation

A

Circulation
 Monitor CPR quality
 Attach monitor/defibrillator for arrhythmias or cardiac
arrest rhythms
 Provide defibrillation/cardioversion
 Obtain IV/IO access
 Give appropriate Drugs
 Give IV/IO fluid if needed
 Check glucose and temperature
 Check perfusion issues

33
Q

Disability

A

Disability
 Check for neurologic function
 Quickly assess for responsiveness, LOC, Pupil dilation
 AVPU: Alert, Voice, Painful, Unresponsiveness

34
Q

Exposure

A

Exposure
 Remove clothing to perform physical examination
 Looking for obvious signs of trauma, bleeding, burns,
unusual markings, or medical alert bracelets

35
Q

Secondary Assessment
SAMPLE

A

S – Signs and symptoms
 Breathing difficulty, tachypnea, tachycardia, fever, headache,
abdominal pain, bleeding
A – Allergies
 Medications, foods, latex, etc. and associated reactions
M – Medications (including the last dose taken)
 Patient medications, including OTC, vitamins, inhalers, herbal
supplements, last dose and time, home meds
P – Past Medical History
 Health history, family history, significant underlying health problems,
past surgeries, immunization status
L – Last meal consumed
 Time and nature of last intake of liquid or food
E – Events
 Events leading to current illness, hazards at scene, treatment course,
estimated time of onset

36
Q

Secondary Assessment
H’s & T’s

A

The most common causes of cardiac arrest
Hs –
Hypvolemia
Hypoxia
Hydrogen ions (acidosis)
Hypo-hyper kalemia
Hypothermia

37
Q

Secondary assessment
H’s & T’s

A

The most common cause of cardiac threats.
Ts –
Tension ptx
Tamponade (cardiac)
Toxins
Thrombosis (pulmonary or coronary)

38
Q

Indications for Advanced Airway

A

Indications for Advanced Airway
 Inability to oxygenate patient
 (SpO2 < 90%, PaO2 < 55)
 Inability to ventilate patient
 (rising PaCO2, respiratory acidosis, mental status
change or other symptoms)
 Patient unable to protect the airway

39
Q

Airway management
Providing basic ventilation

A

Providing Basic Ventilation
 Head tilt-chin lift
 Jaw thrust without head extension
Suspected cervical spine trauma
 Mouth to mouth ventilation
 Mouth to nose ventilation
 Mouth to barrier device ventilation
 Bag-mask ventilation
Flow inflating vs Self inflating

40
Q

Airway adjuncts

A

Airway Adjuncts
Nasopharyngeal Airway (NPA)
Oropharyngeal Airway (OPA)
Laryngeal Mask Airway (LMA)
Combitube
Endotracheal Tube (ETT)

41
Q

LMA

A

LMA
Plugs esophagus
Air holes take air to trachea
AMBU Bag patient
Listen for breath sounds
Look at chest
Add End Tidal CO2 detector
Check BS over stomach
Make sure air is Not going to stomach
Esophagus is blocked by large cuffed end of tube
Trachea is open for air to enter
Air from holes in tube goes to trachea

CP3 (16 decks)

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