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Surgery and other stuff > More ACLS > Flashcards

More ACLS Flashcards

1
Q

What is the flow rate for a NC?

A

1-6 L/min

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2
Q

What is the minimum flow rate for the simple face mask? What will happen if this is too low?

A

6 L/min

Re-breathe CO2

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3
Q

What type of mask can deliver up to 100% oxygen?

A

Face mask with reservoir

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4
Q

What type of patients need a face mask with a reservoir?

A

Those who need an ET tube, but still maintain their airway reflexes, or will need one soon

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5
Q

True or false: you should use cricoid pressure when inserting an LMA

A

False–increase incidence of misplacement

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6
Q

What should always be inserted into the mouth with an LMA?

A

Bite block or OPA

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7
Q

What sizes of LMA fit most men and women respectively?

A

5 for men

4 for women

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8
Q

What is a laryngeal tube?

A

tube with a cuff that is inserted into the esophagus. The cuff inflates to seal off esophagus, leaving only the larynx open for air

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9
Q

Who should not receive a laryngeal tube? (4)

A
  • Under 16 year or under 4 feet tall.
  • Absent gag reflex
  • Suspected esophageal injury
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10
Q

How does the dose of medications change when going from the standard IV route to the ET tube?

A

2x higher

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11
Q

How are drugs prepared to be placed in the ET tube?

A

Mix the dose in 5-10 mL of sterile water (preferable) or saline. Ventilate and hold compressions briefly to allow for uptake

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12
Q

What size ET tube is used for adult males and females respectively?

A 
Males = 8
Females = 7
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13
Q

What are drugs that can cause 1st degree AV blocks?

A

beta blockers, CCBs, and digoxin

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14
Q

What type of MI can present with AV block (anterior, lateral, posterior etc).

A

Inferior AMI

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15
Q

What is the site of pathology for a second degree AV block type I and II respectively?

A

Type I = AV node

Type II = infrahisian

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16
Q

What is the etiologies for second degree AV blocks type I? (3)

A
  • RCA infarct
  • Drugs
  • Parasympathetic
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17
Q

What is the etiology of type II second degree AV block?

A

left coronary infarct

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18
Q

What is the etiology of third degree AV blocks?

A

Ischemia of the left coronary, (LAD)

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19
Q

What is the amount of joules needed for a-fib? Stable VT? SVT?

A

a-fib = 120-200 J
Stable VT = 100J
SVT = 50-100 J

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20
Q

True or false: you can use the AED safely and effectively if the patient is covered in water

A

False-need dry chest

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21
Q

True or false: you can use the AED safely and effectively if the patient is in the snow or laying in a puddle of water, so long as the pads and chest are not wet

A

True

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22
Q

What is the defibrillation dose of monophasic electrodes?

A

360 J

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23
Q

Where should the arm with an IV be relative to the patient if giving fluids or drugs?

A

At level of the heart

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24
Q

Where is the IO insertion site for the tibial plateau?

A

two finger breadths inferior, then medial of the tibial tuberosity

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25
Q

What should be done immediately after inserting an IO to ensure that it did not go through the bone?

A

Infuse with IVFs and ensure that no swelling occurs posteriorly

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26
Q

What should be done to IV tubing with an IO needle to ensure that it does not tear out the needle?

A

tape tube to skin

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27
Q

What is the cause of a slow heart rate with low BP?

A

RV infarct

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28
Q

What are the two components of the breathing part of the ABCs?

A

Ventilation and oxygenation

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29
Q

What is the dose of Naloxone IM and intranasally? How often can this be repeated?

A

IM = 0.4 mg
IN = 2 mg
q4 minutes

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30
Q

True or false: you should perform CPR on an opioid overdose patient if they’re not breathing (regardless of pulse)

A

True

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31
Q

What is the goal oxygen saturation for cardiac arrest patients?

A

94%–only give enough oxygen to get to here.

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32
Q

How long after induced hypothermia should you wait to assess for returned neurologic function?

33
Q

What are the 6 roles for cardiac arrest?

A
  • Leader
  • Compressor
  • AED
  • Airway
  • IV/IO meds
  • Timer
34
Q

What qualifies for low blood pressure in the normotensive and hypertensive individual?

A 
Normal = less than 90 mmHg
Hyper = more than 30 mmHg drop
35
Q

How long must you wait to give nitrates in a patient who has taken nitrates?

A
  • 24 hours for sildenafil or vardenafil

- 48 hours for tadalafil

36
Q

Why is morphine in particular good for MIs?

A

Venodilator and CNS depressant

37
Q

Are other NSAIDs besides ASA safe for use in MIs?

38
Q

What are the goals for PCI in hospital and transfers?

A

90 minutes door to balloon in hospital, 120 minutes if transfer

39
Q

What is the goal for door to fibrinolytics?

A

30 minutes

40
Q

What is the goal for door to transfer?

A

30 minutes

41
Q

What is the timeframe to ship and drip patients?

A

12 hours from symptom onset, and 6 hours from start of fibrinolysis

42
Q

Within how many hours of symptom onset can fibrinolytic be given?

A

12 hours of symptom onset

43
Q

What are the three indications for IV nitro in STEMI patients?

A
  • Recurrent chest pain unresponsive to oral
  • pulmonary edema
  • HTN
44
Q

True or false: if a stroke patient presents with an arrhythmia and are stable, is it appropriate to watch it

45
Q

What are the goals for the following with a stroke:

  • See a physician
  • CT scan/neuro assessment
  • interpret CT
  • Initiate fibrinolytics
A
  • 10 minutes to see physician
  • 25 minutes to CT/neruo
  • Interpret CT in 45 mins
  • Fibrinolytics within 3 hours of symptoms onset
46
Q

How long after tPA should anticoagulants be avoided?

47
Q

what are the three components of the Cincinnati stroke scale?

A

Facial droop
Arm drift
Abnormal speech

48
Q

What is the BP cutoff for tPA?

49
Q

An arterial puncture within what timeframe is a contraindication to tPA?

50
Q

True or false: a h/o intracranial hemorrhage is a contraindication to tPA

51
Q

platelet count less than how many is a contraindication to tPA?

52
Q

Heparin received within what timeframe is a contraindication to tPA?

53
Q

What is the INR and PT cutoff for tPA?

A

INR = 1.7

PT over 15 seconds

54
Q

BG less than what is a contraindication to tPA?

55
Q

What are the four exclusion criteria for extended time for tPA (4.5 hour mark)?

A
  • Age over 80
  • Severe Stroke
  • Anticoagulant use
  • h/o both DM and prior ischemic stroke
56
Q

Below what rate is tachycardia usually not the cause of s/sx?

57
Q

What is the dose and rate for dopamine infusion for bradycardia?

A

2-20 mcg/kg/min

58
Q

What is the dose and rate for epi infusion for bradycardia?

A

2-10 mcg/min

59
Q

What is the treatment for narrow complex tachycardia in the stable patient?

A

Vagal maneuvers
Adenosine
Beta blockers or CCBs

60
Q

What is the treatment for unstable tachycardias? (wide or narrow)

A

Synchronized cardioversion

61
Q

What is the treatment for wide complex tachycardias in the stable patient?

A

Consider adenosine or anti-arrhythmic

62
Q

When is adenosine indicated for the treatment of wide complex tachycardias?

A

only if regular and monomorphic

63
Q

What is the dose and rate of infusion of sotalol?

A

100 mg (1.5 mg/kg over 5 mins)

64
Q

What is the IV rate of procainamide infusion? What is the max dose?

A

20-50 mg/min

17 mg/kg

65
Q

What are the side effects of procainamide (2)

A
  • Hypotension

- QRS duration increases over 50%

66
Q

What are the four major indications for synchronized cardioversion? (4)

A

Unstable:

  • A-fib
  • A-flutter
  • SVT
  • Regular monomorphic tach with pulses
67
Q

If you are unsure if an unstable patient has monomorphic or polymorphic VT, what should you do?

A

Unsynchronized cardioversion

68
Q

What is the correct dose of monophasic and biphasic electricity for unstable a-fib?

A 
Mono = 200 J
Bi = 120-200 J
69
Q

What is the dose of monophasic electricity for unstable VT with a pulse?

70
Q

What happens if you shock sinus tachycardia?

A

Increases the rate

71
Q

What are the two main pathophysiologic mechanisms of unstable tachycardia?

A
  • Decreased CO d/t fast

- Beating is ineffective

72
Q

When you are pacing a patient transcutaneously, where should you never assess for a pulse, and why?

A

Carotids, due to muscle contraction in that area

73
Q

True or false: Transcutaneous pacing is indicated even if the patient is hypothermic

74
Q

What is the effect of atropine doses of less than 0.5 mg?

A

Paradoxical decrease in HR

75
Q

Why must you be careful in using atropine in cases of an MI?

A

Increases myocardial oxygen demand

76
Q

What rhythms should atropine be avoided in, and skipped directly for pacing?

A

Mobitz type II or 3rd degree heart block

77
Q

How are bradycardias caused by mobitz type II and 3rd degree heart block treated?

A

TCP or beta adrenergic support

78
Q

What is the dose of monophasic electricity for unstable:

  • A-fib?
  • Monomorphic VT
  • SVT/atrial flutter
A

-a-fib = 200 J
-Mono VT = 100 J
SVT/a-flutter = 50-100 J

Surgery and other stuff (25 decks)

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