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Advanced Life Support > qwerqwer > Flashcards

qwerqwer Flashcards

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1
Q

PEA

A

Pulseless Electrical Activity

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2
Q

Two MOST common underlying and potentially reversible causes of PEA

A
  • Hypovolemia
  • Hypoxia—absence of enough )2j in the cells and
    tissues to maintain homeostasis
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3
Q

ROSC

A

Return Of spontaneous Circulation

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4
Q

Hypovolemia produces WHAT classic physiologic response

A

Sinus Tachycardia—rapid, narrow complex

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5
Q

What does hypovolemia typically do to
1. Systolic BP
2. Diastolic BP

A
  1. Decreases SBP
  2. Increases DBP
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6
Q

Two major/common causes of hypovolemia

A
  1. Occult internal hemorrhage
  2. Dehydration
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7
Q

IHCA

A

In-house cardiac arrest

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8
Q

pVT

A

Pulseless Ventricular Tachycardia

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9
Q

ACS

A

Acute Coronary Syndrome

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10
Q

What ACS drugs are initially used to relieve ischemic discomfort, dissolve clots, and inhibit thrombin and platelets

A
  • Oxygen
  • Aspirin
  • Nitroglycerin
  • Opiates (e.g. morphine)
  • Fibrinolytic therapy
  • Heparin (unfractionated-low-molecular weight)
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11
Q

STEMI chain of command

A
  • Recognize ACS symptoms
  • Activating/Notifying EMS
  • Providing CPR if needed, providing early defib with AED
  • Providing coordinated system of care among EMS and
    hospital
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12
Q

What disease is underlying reason for many clinical syndromes, resulting in varying degrees of artery occlusion

A

Coronary Atherosclerosis

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13
Q

What ECG interpretation indicates an MI (myocardial infarction)

A

ST elevation

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14
Q

2 examples of adjunct therapies

A
  • Nitroglycerin
  • Heparin
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15
Q

What are two of the most important points to be aware for STEMI need?

A
  • The EG=CG is essential
  • STEMI patients don’t need evidence of elevated cardiac markers to decide to administer fibrinolytic therapy, or perform coronary angiography with interventions (angioplasty, stenting).
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16
Q

For ACS response, hospital intervention should occur when

A

Less than 10 minutes

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17
Q

Major ischemia or infarction symptoms include:

A
  • Chest pain
  • Shoulder pain
  • Dyspnea
  • Nausea
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18
Q

What is the most common symptom of myocardial ischemia and infarction

A

Retrosternal chest discomfort….Patient may perceive discomfort as tightness or pressure

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19
Q

What should a person do before arrival of first responders with presentation of ACS symptoms

A

Chew aspirin (162-325 mg non-enteric coated) if no contraindications

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20
Q

During EMS assessment, what should be done IMMEDIATELY upon ECG determination of ST-elevation

A
  • Notify hospital of results of ECG
  • Note time of onset
  • Note first medical contact
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21
Q

Assessing ABS’s includes:

A
  • Monitoring vit signs and cardiac rhythms
  • Being prepared to provide CPR
    Using a defibrillator if needed
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22
Q

What are the parameters for administering nitroglycerin to reduce ischemic chest discomfort

A
  • Give 1 s/l or translingual dose every 3 to 5 minutes for
    a maximum of 3 doses
  • Give only if SPP > 90, or if SPB is no lower than 30
    below baseline (if known)
  • HR is 50-100
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23
Q

Nitroglycerin, being a venous dilator, caution should be taken in patients with inadequate ventricular pre-load. What are these situations

A
  • Inferior wall and RV infarct
  • Hypotension, Bradycardia, Tachycardia
  • Recent phosphodiesterase inhibitor use…..sildenafil,
    vardenafil, tadalafil (all erectile dysfunctional drugs)
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24
Q

Is morphine a venodilator

A

YES

25
Q

For STEMI diagnosed hospitalizations, other than ASA, do not administer other non-0steroid anti-inflammatory drugs. WHY

A
  • Increased risk of death
  • Reinfarction
  • Hypertension
  • HF
  • Myocardial rupture
26
Q

What is the ONLY way to identify a STEMI

A

12-Lead ECG

27
Q

What time frame should labs, chest x-ray be conducted once patient arrives at the ED

A

30 minutes

28
Q

What are the goals of reperfusion for STEMI patients

A
  • PCI (percutaneous coronary intervention)…should
    begin within 90 minutes from medical contact to
    balloon inflation
  • Fibrinolytic administration should begin within 30
    minutes of patient’s arrival in ED
29
Q

If oxygen saturation i <90% , what intervention is needed

A

Start O2 at 4 Lpm and titrate

30
Q

What is the most serious drawback of using morphine n ACS patients

A

Morphine decreases the absorption of oral antiplatelet medications

31
Q

NSTE-ACS

A

Non ST-Elevation Acute Coronary Syndrome
-Unstable angina
-Non ST-Elevation MI

32
Q

T or F

More than one ECG is necessary to confirm ACS

A

TRUE

33
Q

How is early perfusion therapy achieved with patients with STEMI

A
  • Primary PCI
  • Fibrinolytics
34
Q

A patient with a STEMI should be treated how long after onset of symptoms

A

Within 12 hours

35
Q

Delay therapy during inpatient evaluation may occur in 4 ways, referred to as the 4 D’s. What are the 4 D’s

A
  1. In-hospital evaluation
  2. Door to Data (ECG)
  3. Data to Decision
  4. Decision to Drug (PCI)
36
Q

What are the drugs used for treatment of strokes

A
  • Alteplase
  • Glucose (D10/D50)
  • Labetalol
  • Nicardipine
  • Cilnidipine
  • Aspirin
37
Q

What are the two types of strokes

A
  • Ischemic (blockage)
  • Hemorrhagic (bleeding)
38
Q

Which type of stroke is eligible for fibrinolytic therapy

A

Ischemic

39
Q

What percentage of strokes are ischemic

A

87%

40
Q

What percentage of strokes are hemorrhagic

A

13%

41
Q

What are the 8 D’s of a stroke

A
  1. Detection
  2. Dispatch
  3. Delivery
  4. Door
  5. Data
  6. Decision
  7. Drug device
  8. Disposition
42
Q

EVT

A

Endovascular Thrombectomy

43
Q

LVO

A

Large Vessel Occlusion

44
Q

What is TIME ZERO

A

The last time the patient was seen to be normal

45
Q

What SpO2 level would supplemental O2 be administered to possible stroke patient

A

94% or less

46
Q

What are the 3 physical findings identifying a stroke outline by the CPSS (Cincinnati prehospital stroke scale)

A
  1. Facial droop
    -Can patient smile/show teeth
  2. Arm drift
    -Pt close eyes, arms out with palms up for 10 seconds
  3. Abnormal speech
    -Have patient say, “you can’t teach an old dog new
    tricks”
47
Q

CPSS has a probability of what percentage of identifying stroke pre-hospital evaluated

A

72%

48
Q

When using the CPSS tool, how many indicators must be present for a probability of 72% stroke?

A

1 out of 3

49
Q

What is the highest level designation for a stroke center?

A

Level 4

50
Q

ASRH

A

Acute
Stroke
Ready
Hospital

51
Q

Is an ASRH (acute stroke ready hospital) usually rural or urban

A

Rural

52
Q

What is the hospital designation for the HIGHEST level of stroke care

A

CSC (Comprehensive Stroke Center)

53
Q

In what timeframe should a possible stroke patient be assessed when arriving at the ED

A

10 minutes

54
Q

What is the timeframe for the DOOR TO NEEDLE intervention for stroke patients

A

60 minutes

55
Q

Is ALTEPLASE an effective intervention for a HEMORRHGE diagnosed stroke

A

No (alteplase is only effective on ischemic strokes

56
Q

INR/PTT results should be available to the ED within what timeframe

A

No longer than 30 minutes

57
Q

For possible stroke patients, is it ok to delay obtaining a CT/MRI for obtaining an ECG

A

No

58
Q

PENUMBRA

A

Reversibly injured brain tissue around the ischemic core, which is the target area of repair for an ischemic stroke. Rescue of the Penumbra is the goal to treatment of an ischemic stroke

59
Q
A

Advanced Life Support (1 decks)

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