Overview of ACLS Flashcards
What are the 4 assessments in the systematic aproach?
- Initial Assessment (visualization and scene safety)
- BLS Assessment
- Primary Assessment (A,B,C,D,E)
- Secondary Assessment (SAMPLE, Hs & Ts)
If the patient appears unconscious, which assessment do you do initially?
BLS Assessment
If the patient appears conscious, which assessment do you do initially?
Primary Assessment
You have an unconscious patient with a pulse. What is the order of assessments?
BLS Assessment, then Primary Assessment, then Secondary Assessment
You have an unconscious patient with no pulse. What is the order of assessments?
Start CPR, check rhythm and shock if indicated, repeat every 2 minutes, then do the Primary Assessment, then the Secondary Assessment
You have a conscious patient. What is the order of assessments?
Primary Assessment, then Secondary Assessment
What are some key features of high-quality CPR?
- Compress at a depth of 5cm(2inch) and at a rate of 100-120bpm
- Ratio of 30:2 or other advanced protocol
- Allow for complete chest recoil
- Switch compressors every 2 minutes, taking no longer than 5 seconds
- Minimize interruptions in compressions to 10 seconds or less
- Avoid excessive ventilation
What are the steps of the BLS Assessment?
- Check responsiveness
- Activate emergency response system and get AED or defibrillator
- Check for breathing and pulse (5-10 seconds)
- If no pulse, start CPR. If there is a pulse, start rescue breathing and check pulse every 2 mins
- Defibrillate and follow each shock immediately with CPR
What are the steps of the Primary Assessment?
Airway, Breathing, Circulation, Disability, Exposure
What questions are you asking when assessing Airway in the Primary Assessment?
Patent?
Need for advanced airway?
Confirmed proper placement?
How do you confirm placement of an advanced airway?
Capnography
What questions are you asking when assessing Breathing in the Primary Assessment?
Are ventilation and oxygenation adequate?
Are capnography and oxyhemoglobin saturation monitored?
How do you monitor adequacy of ventilation and oxygenation?
Chest rise, cyanosis, capnography, oxygen saturation
What questions do you ask when assessing Circulation in the Primary Assessment?
Are compressions effective?
What is the rhythm?
Is defibrillation or cardioversion indicated?
Has IV/IO access been established?
Is there ROSC?
Are any medications needed for rhythm or blood pressure?
Does the patient need fluid resuscitation?
What do you assess for Disability in the Primary Assessment?
Neurologic function, responsiveness, level of consciousness, pupil dilation
(AVPU - alert, voice, painful, unresponsive)
How do you assess for Exposure in the Primary Assessment?
Remove clothing for physical exam, look for obvious signs of trauma, bleeding, burns, markings, or medical alert bracelets
What are the components of the Secondary Assessment?
Differential diagnosis, focused medical history, searching for underlying causes (SAMPLE, H’s & T’s)
What does SAMPLE stand for in the Secondary Assessment?
Signs and Symptoms
Allergies
Medications
Past Medical History
Last Meal Consumed
Events
What are the H’s & T’s in the Secondary Assessment?
H: hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia
T: tension pneumothorax, tamponade, toxins, thrombosis (pulmonary/coronary)
What are the 2 most common causes of PEA?
Hypovolemia and Hypoxia
What are the signs of hypovolemia?
Initially: sinus tachycardia, increased diastolic, decreased systolic
As volume loss continues: blood pressure undetectable, rapid rates continue
What should be considered for PEA with sinus tachycardia?
Volume infusion
