Rapid Response And Code Management Flashcards

1
Q

Types of arrest

A

Respiratory:
Not breathing

Cardiac:
No pulse

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2
Q

Members of code team

A

Leader
RN role
Anesthesiologist or CRNA
Nursing supervisor
RT pharmacy

UAP/Chaplain/Lab

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3
Q

Members of code team (what they do)

Leader

RN roles

A

Leader:
-ACLS RN or MD

RN roles:
-documentation/time keeper
-medications
-start IV
-coordinate use of crash cart & defibrillator

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4
Q

Members of code team (what they do)

Anesthesiologist/CRNA

Nursing supervisor

RT

A

Anesthesiologist/CRNA
-advanced airway

Nursing supervisor
-crowd control and assist

RT
Ventilations/assist w/ intubation

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5
Q

Crash cart supplies

A

Intubation kit
Backboard
Monitor/defibrillator
IV equipment
ACLS meds
Suction
O2 ambu bag
Code sheets
NGT/chest tube/gloves/central line/ABG kits

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6
Q

CPR steps

A

1st assess responsiveness (if none call for help)

2nd assess presence of pulse
(Absent=CPR)
(Present but agonal or no breathing= rescue breaths)

(Check pulse every 2 mins not longer than 10 secs)
2:30 ratio

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7
Q

ACLS

What to use until intubation

Compressions to breaths ratio when intubated

How to confirm intubation
How to confirm intubation after code

A

Airway bag valve mask
ETT w/ 100% O2
-dont stop compressions for ventilations if intubated

Placement:
-bilateral breath sounds
-CO2 detector
-waveform capnography

After code: CXR

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8
Q

ACLS circulation

-compression depth and rate
Attach what
When to identify rhythm on defibrillator

A

100-120 at 2 inch depth

Attach monitor/defibrillator

Identify rhythm during pulse check

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9
Q

Assess for reversible causes: H and T’s

5 H’s

A

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo or hyperkalemia
Hypothermia

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10
Q

Assess for reversible causes: H and T’s

6 T’s

A

Tension pneumothroax
Tamponade
Toxins (drug OD)
Thrombus-pulmonary
Thrombus-cardiac
Trauma

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11
Q

Rapid response vs code

A

RR:
-prevent arrest

Code:
no pulse

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12
Q

Difference between cardiovert vs defirbillation

A

C:
Weird rhythm need back to NSR

D:
Vfib or pulseless VT

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13
Q

Monophasic vs biphasic defibrilation

-how many joulse
Yell all clear

A

monophasic: 360 joules

Biphasic: 200 joules (can go higher)

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14
Q

Where are pads placed for cardioversion and defibrillations

A

Anterior chest
Left lateral chest wall

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15
Q

When to resume CPR after shock delivered in defibrillation

A

Immediate after for 2 minutes
(next pulse/rhythm check)

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16
Q

Cardioversion

Synchronized with what?
What rhythms can we cardiovert?
What setting do we change on the monitor?

A

Synchronized w/ rhythm

Cardiovert unstable rhytms w/ a pulse:
-afib & aflutter
-SVT
-vtach w/ pulse

Change setting from Defib to synchronous (puts it synchronized with R wave)

17
Q

Cardio version

-meds to give
-joules usually set to?
Yell what
What is a risk of cardioversion

A

Moderate/conscious sedation

50-100 joules

Yell all clear

Risk for R on T phenomenon (causes vfib)

18
Q

AED

-what age can get an AED

What not to do with the pads

A

Over 1yoa

Dont place over pacemaker or AICD

19
Q

AICD (automated impantable cardioverter defibrillator)

Delivers shock directly where?
Location of device
Dont place what over site

A

Directly to heart muscle

Location:
Upper chest
Abdomen

Dont place pads over site

20
Q

Transcutaneous cardiac pacing

Indications

Set mode to what
Hr set to what
Set output of mA until what
What to give for discomfort?

A

Symptomatic bradycardia

Set mode: demand

Set rate: 70-80

Set output mA until capture
(increase until pacer recognizes heart and works)

Sedation/analgesic

21
Q

Treatments of symptomatic bradycardia

A

Atropine

Transcutaneous pacer

22
Q

How often to switch compressions

What L to set bag ETT on wall

23
Q

Meds to lower blood pressure

A

Nicardipine
Nipride
Nitroglycerin

24
Q

Post CODE care: return of spontaneous circulation (ROSC)

ETCO2 at what
Continue monitor what
Maintain airway how?
Labs
Foley
IV access (need central line for what)

A

ETCO2: 35-45

Monitor ECG continuous

ETT secured

Central line if using vasopressors

25
Q

Post CODE care: return of spontaneous circulation (ROSC)

Titrate meds to maintain hemodynamic stability

A

SBP > 90
MAP >65
HR >60

26
Q

Therapeutic hypothermia after cardiac arrest:

TTM (targeted temperature management)
-what its used to treat
-body temp wanted (for how long)
Control what
Monitor for what

A

Hypothermia after cardiac arrest (Vfib, pulseless VT)

32-36C for 24hrs

(Control shivering with sedation)

Monitor:
Arrhythmias
Hyperglycemia
Bleeding/infection
Metabolic/electrolyte issues

27
Q

Therapeutic hypothermia after cardiac arrest:
TTM (targeted temperature management)

What to do after the 24hours of maintaining 32-36C?
Monitor for what

A

Rewarm slowly:
-0.25-0.5C/hr

Monitor:
Vasodilation/Hypotension
Shock

28
Q

Complication with TTM 5

A

Hyperglycemia
Electrolyte imbalance
Bradycardia
Infection/Bleeding