ACLS

Question 1

Rate of high quality CPR

Answer 1

100/min (at least)

Question 2

Ratio of breaths to compressions

Answer 2

30 to 2

Question 3

depth of adult compressions

Answer 3

1/2 AP depth of chest - 2inches

Question 4

depth of child compressions

Answer 4

1/3 AP depth of chest - 1.5inches

Question 5

avoid interruptions in compressions of more than?

Answer 5

10seconds

Question 6

how often should compressors be switched?

Answer 6

2 minutes

Question 7

why is a manual defibrillator preferred to AED?

Answer 7

decreases interruption of chest compressions

Question 8

when should rhythm be checked when using AED?

Answer 8

after 2 minute cycle of CPR

Question 9

when should pulse be checked with AED use?

Answer 9

only if organized rhythm is present

Question 10

Monophasic defibrillation strength

Answer 10

200-360joules

Question 11

biphasic defibrillation strength

Answer 11

120-200joules

Question 12

what strength is used if in doubt with defibrillation?

Answer 12

default of machine or 200 joules

Question 13

ventillation rates with no definitive airway

Answer 13

use BVM, 2 ventillations every 30 compressions

Question 14

ventillation rates with advanced airway

Answer 14

use ET, 1 ventillation every 6-8 seconds (8-10/min) without pausing compressions

Question 15

Ventillation rates with respiratory arrest

Answer 15

BVM or ET tube, 1 ventillation every 5-6 seconds (10-12/min)

Question 16

after advanced airway is place, are CPR cycles needed?

Answer 16

no

Question 17

Why are circumfrential ties around the neck avoided with ET tube?

Answer 17

to prevent obstruction of venous return to the brain

Question 18

suction attempts should not exceed?

Answer 18

10seconds

Question 19

Most reliable method of confirming and monitoring ET tube placement?

Answer 19

continuous quantitative waveform capnography

Question 20

what does continuout quantitative waveform capnography do?

Answer 20

monitors effectiveness of chest compressions during CPR

Question 21

What is effective CPR measured as?

Answer 21

PETCO2 >10mmHg

Question 22

What is ROSC measured as?

Answer 22

PETCO2 35-40mmHg

Question 23

What hsould pulse ox be held above?

Answer 23

94-99%

Question 24

epinephrine

Answer 24

first drug in any arrest rhythm (vasopressor)

Question 25

Amiodarone

Answer 25

antiarrhythmic (preferred over lidocaine), wide complex tachy, narrow complex tachycardia under expert consultation

Question 26

Vasopressin

Answer 26

one time only in place of 1st or 2nd dose of Epi (vasopressor)

Question 27

Atropine

Answer 27

0.5mg for all bradycardia rhythms before pacing unless IV not accessable (max 3mg)

Question 28

Adenosine

Answer 28

treatment of wide complex tachycardia if stable, regular and monomorphic, narrow SVT

Question 29

Chronotropic drug infusions

Answer 29

dopamine, epi drips as an alternative to pacing for symptomatic/unstable bradycardias

Question 30

Morphine

Answer 30

use with caution in unstable angina

Question 31

At what point should you consider adding drugs to the CPR cycle?

Answer 31

during cycles of CPR as soon as possible after rhythm check

Question 32

Hypotension

Answer 32

SBP \<90mmHg

Question 33

Treatment of HOTN

Answer 33

IV/IO bolus 1-2L NS or LR, inotropic or vasopressore (dopamine, epi drip)

Question 34

When should you consider therapeutic hypothermia

Answer 34

when the pt is not responsive to verbal commands

Question 35

What labs are needed for ROSC

Answer 35

VS, 12 lead EKG, CXR, ABG

Question 36

METs

Answer 36

medical emergency response teams

Question 37

RRTs

Answer 37

rapid response teams

Question 38

LR

Answer 38

lactated ringers

Question 39

Measures with presentation of stroke Pt

Answer 39

immediate CT for fibrinolytic therapy determination

Question 40

CSS

Answer 40

canadian stroke scale

Question 41

goals of ACS presentation

Answer 41

identify STEMI, relieve chest discomfort, prevent MACE, treat acute, life-threatening complications

Question 42

MACE

Answer 42

major adverse cardiac events

Question 43

Treatment of ACS

Answer 43

ABCs, O2, EKG, ASA, nitro, morphine

Question 44

when should EKG be done in ACS?

Answer 44

before O2 therapy if VSS, no resp distress, polse ox \>94%

Question 45

first step in evaluating PEA/asystole

Answer 45

scheck a second lead for asystole

Question 46

treatment of PEA/asystole

Answer 46

epi 1mg IV/IO every 3-5 minutes or vasopressin 40units IV/IO x1 in place of 1st or 2nd dose of epi

Question 47

H's and T's

Answer 47

hypovolemia, hypoxia, hydrogen ion, hypo/hyperkalemia, hypothermia, tension pneumo, tamponade, toxins, thrombosis (pulmonary/coronary)

Question 48

treatment of bradycardia

Answer 48

atropine 0.5mg IV/IO, beta adrenergic agonists (dopamine drip 2-10mcg/kg/min, Epi drip 2-10mcg/min)

Question 49

consider?. If no response to atropine in bradycardia

Answer 49

transcutaneous pacing, immediately if pacing is unstable with high degree heart block or when IV no available

Question 50

evaluation of tachycardia

Answer 50

pulse? No = CPR, yes = stable/unstable

Question 51

unstable tachycardia examples

Answer 51

narrow irregular (Afib), narrow regular (SVT,Aflutter), wide regular (monomorphic VT), wide irregular (torsades)

Question 52

cardioversion for Afib

Answer 52

120-200joules

Question 53

cardioversion for SVT/aflutter

Answer 53

50-100J

Question 54

cardioversion for monomorphic VT

Answer 54

100J, increase subsequent shocks

Question 55

types of stable tachycardia

Answer 55

Narrow (SVT), wide (Vtach)

Question 56

treatment of narrow stable tachycardia

Answer 56

EKG, vagal maneuvers, adeonosine 6mg, repeat at 12mg prn x2, BB or CCB, expert cosult

Question 57

treatment of wide stable tachycardia

Answer 57

EKG, adenosine if monomorphic and regular, antiarrhythmics (amiodarone 150mg in 50ml D5W over 10 minutes, maintenance of 1mg/min), expert consult