ACLS Flashcards
Cardiac arrest happens when…
unable to generate adequate cardiac output to support oxygen demands of tissue
4 rhythms of cardiac arrest
VF, pVT, PEA, asystole
Which rhythms are shockable?
VF, pVT
Which rhythms are not shockable?
PEA, asystole
Survival in cardiac arrest depends on what?
BLS and/or ACLS
Only proven survival benefit
Good quality chest compressions and defibrillation
Immediate goal of cardiac arrest
ROSC (return of spontaneous circulation)
ACLS algorithm: Step 1
Start CPR if the patient has no pulse; give 100% O2 via a mask and hook them up to a monitor and/or defibrillator
ACLS algorithm: Step 2
After 2 minutes of CPR, determine if the rhythm is shockable
ACLS algorithm: Step 3a if the patient is in VF or pVT arrest
Shock for the first time, then do CPR for another 2 minutes
Get IV/IO access if not already done
ACLS algorithm: Step 4a if the patient is in VF or pVT arrest
Assess rhythm after 2 minutes of CPR; if it’s shockable, shock for the second time, then administer epinephrine q2-5 minutes and consider advanced airway, capnography
ACLS algorithm: Step 5a if the patient is in VF or pVT arrest
Assess rhythm again; if it’s shockable, shock for the third time, then you can administer lidocaine or amiodarone and treat underlying causes
If at any point the patient goes into PEA/asystole, don’t shock, give epinephrine and continue CPR
ACLS algorithm: Step 3b if the patient is in PEA or asystole
DO NOT SHOCK, administer epinephrine as soon as feasible (q3-5 mins) and get IV/IO access
ACLS algorithm: Step 4b if the patient is in PEA or asystole
After 2 minutes of CPR, determine if the rhythm is shockable
No: CPR x2 minutes, treat reversible causes
Yes: shock, administer epinephrine q3-5 minutes or amiodarone or lidocaine
Epinephrine MoA
Vasoactive agent: enhances organ perfusion by increasing arterial and aortic diastolic pressures resulting in increases in coronary and cerebral perfusion pressures
Epinephrine indications for ACLS
All 4 rhythms: VF, pVT, asystole, PEA
Epinephrine dosing
1mg/kg IV/IO
Antiarrhythmics used in ACLS
Amiodarone, lidocaine, magnesium
Antiarrhythmics MoA
Potentially normalizes abnormally depolarizing and conduction myocardial cells
Amiodarone indications
VF, pulseless VT, stable VT with pulse
Amiodarone: caution in…
Bradycardia and hypotension
Amiodarone has the potential to cause what?
QTc prolongation
Lidocaine indication
Same as amiodarone: VF, pVT, stable VT with pulse
When is lidocaine used?
Alternate to amiodarone, so use if it’s not available or TdP due to minimal risk of QT prolongation
