Overview of ACLS Flashcards

1
Q

What are the 4 assessments in the systematic aproach?

A
  1. Initial Assessment (visualization and scene safety)
  2. BLS Assessment
  3. Primary Assessment (A,B,C,D,E)
  4. Secondary Assessment (SAMPLE, Hs & Ts)
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2
Q

If the patient appears unconscious, which assessment do you do initially?

A

BLS Assessment

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3
Q

If the patient appears conscious, which assessment do you do initially?

A

Primary Assessment

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4
Q

You have an unconscious patient with a pulse. What is the order of assessments?

A

BLS Assessment, then Primary Assessment, then Secondary Assessment

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5
Q

You have an unconscious patient with no pulse. What is the order of assessments?

A

Start CPR, check rhythm and shock if indicated, repeat every 2 minutes, then do the Primary Assessment, then the Secondary Assessment

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6
Q

You have a conscious patient. What is the order of assessments?

A

Primary Assessment, then Secondary Assessment

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7
Q

What are some key features of high-quality CPR?

A
  1. Compress at a depth of 5cm(2inch) and at a rate of 100-120bpm
  2. Ratio of 30:2 or other advanced protocol
  3. Allow for complete chest recoil
  4. Switch compressors every 2 minutes, taking no longer than 5 seconds
  5. Minimize interruptions in compressions to 10 seconds or less
  6. Avoid excessive ventilation
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8
Q

What are the steps of the BLS Assessment?

A
  1. Check responsiveness
  2. Activate emergency response system and get AED or defibrillator
  3. Check for breathing and pulse (5-10 seconds)
  4. If no pulse, start CPR. If there is a pulse, start rescue breathing and check pulse every 2 mins
  5. Defibrillate and follow each shock immediately with CPR
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9
Q

What are the steps of the Primary Assessment?

A

Airway, Breathing, Circulation, Disability, Exposure

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10
Q

What questions are you asking when assessing Airway in the Primary Assessment?

A

Patent?

Need for advanced airway?

Confirmed proper placement?

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11
Q

How do you confirm placement of an advanced airway?

A

Capnography

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12
Q

What questions are you asking when assessing Breathing in the Primary Assessment?

A

Are ventilation and oxygenation adequate?

Are capnography and oxyhemoglobin saturation monitored?

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13
Q

How do you monitor adequacy of ventilation and oxygenation?

A

Chest rise, cyanosis, capnography, oxygen saturation

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14
Q

What questions do you ask when assessing Circulation in the Primary Assessment?

A

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?

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15
Q

What do you assess for Disability in the Primary Assessment?

A

Neurologic function, responsiveness, level of consciousness, pupil dilation
(AVPU - alert, voice, painful, unresponsive)

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16
Q

How do you assess for Exposure in the Primary Assessment?

A

Remove clothing for physical exam, look for obvious signs of trauma, bleeding, burns, markings, or medical alert bracelets

17
Q

What are the components of the Secondary Assessment?

A

Differential diagnosis, focused medical history, searching for underlying causes (SAMPLE, H’s & T’s)

18
Q

What does SAMPLE stand for in the Secondary Assessment?

A

Signs and Symptoms

Allergies

Medications

Past Medical History

Last Meal Consumed

Events

19
Q

What are the H’s & T’s in the Secondary Assessment?

A

H: hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia

T: tension pneumothorax, tamponade, toxins, thrombosis (pulmonary/coronary)

20
Q

What are the 2 most common causes of PEA?

A

Hypovolemia and Hypoxia

21
Q

What are the signs of hypovolemia?

A

Initially: sinus tachycardia, increased diastolic, decreased systolic

As volume loss continues: blood pressure undetectable, rapid rates continue

22
Q

What should be considered for PEA with sinus tachycardia?

A

Volume infusion