Lecture 4 - ACLS Flashcards
Initial impression is really what?
unconscious vs conscious
Lethargy
drowsiness
Obtunded
loss of perception and ability to respond to the environment
Comatose
sleep like state with total absence of awareness of self and the environment
GCS
Eye (1-4) eyes open spontaneously opens eyes to command opens eyes to pain no eye opening
Verbal (1-5) oriented, fluent speech confused conversation inappropriate words incomprehensible words no speech
Motor (1-6) obeys commands localized pain withdrawals to pain decorticate posturing decerebrate posturing flaccid
What is the airway management for a pt with an advanced airway compared to a pt without an advanced airway?
no advanced airway: 2 breaths every 30 compressions
advanced: 8-10 breaths per minute with continuous chest compression
What are the two shockable rhythms?
Pulseless V. tach
V. fib
With a manual defibrillator, what Jewels are used?
biphasic: 120-200J
monophasic: 360J
ABCDE
airway breathing circulation disability -neuro funciton -responsiveness exposure -trauma -medical alert bracelet -hypo/hyperthermia
Hs and Ts
your DDx as to why this pt is unresponsive or is having CPR done (after your ABCDE)
Hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypoglycemia, hypothermia
Toxins, tamponade, tension pneumothorax, thrombosis (coronoary or PE), trauma
Secondary assessment
F, G, H
Fingers, Foley, and flip:
-rectal, UA/Utox, look at the back for trauma
Gastric/NG tube: blood, tablets, toxins
History: how much, how little (SAMPLE)
DCAP BTLS
deformities
contusions
abrasions
penetrating injuries
burns
tenderness
lacerations
swelling
What are the initial studies we get for a trauma or unconscious pt?
blood sugar CBC CMP ABG Seizure med levels toxicology screen ASA and acetaminophen levels EtOH level HCG UA CO level Bicarb level LFTs (lactate rises with hypoxia)
What is our method of EKG interpretation?
Rhythm Rate Axis Waves Intervals Hypertrophy Infarction
How do you calculate rate on an EKG?
6 second rule x 10
300, 150, 100, 75, 60, 50
1500/small boxes
300/large boxes
