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Cardiology > ACLS > Flashcards

ACLS Flashcards

1
Q

Name the 5 H’s in ACLS

A

Hypovolemia, Hypoxia, H+ ions (acidosis), Hypo-/Hyperkalemia, Hypothermia

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2
Q

Name the 5 T’s in ACLS

A

Toxins, Tamponade (cardiac), Tension Pneumo, Thrombosis (pulmonary), Thrombosis (coronary)

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3
Q

What is hypovolemia, how is it treated?

A

Loss of fluid volume in circa system (can be a major contributing factor to cardiac arrest)
treated with fluid challenge or bolus

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4
Q

What is hypoxia, how is it treated?

A

inadequate O2 supply

High flow O2

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5
Q

What is acidosis (H+) and how is it treated?

A

ABG will determine if person is in respiratory acidosis - but you can prevent by providing adequate ventilation
You can prevent metabolic acidosis by giving sodium bicarb

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6
Q

Major sign of hyperkalemia on EKG is what?

How do we treat?

A

tall peaked T waves
widening of the QRS may be seen
Treat with sodium bicarb**
(other treatments include calcium chloride, kayexalate, dialysis)

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7
Q

Major sign of hypokalemia on EKG is what?

How do we treat?

A

flattened t wave, prominent U wave, possible widened QRS

Controlled infusion of diluted potassium

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8
Q

Hypothermia - core temp should be raised above what asap

A

86F (30C)

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9
Q

Some common causes of accidental OD are what?

A

tricyclics, digoxin, betablocker, calcium channel blockers

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10
Q

What is cardiac tamponade?
EKG and physical exam show what?
How is it treated?

A

fluid accumulates in the pericardium, resulting in ineffective pumping
narrow QRS and rapid heart rate, JVD, no pulse or difficulty finding pulse, muffled heart sounds
pericardiocentesis

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11
Q

What is a tension pneumo?
EKG and physical exam findings?
Treatment?

A

Air enters pleural space and cannot escape, buildup of tension that causes shift in intrathoracic structure
EKG- narrow QRS and slow heart rate
Physical - JVD, tracheal deviation, unequal breath sounds, difficult ventilation, no pulse with CPR
Needle decompression

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12
Q

What is a coronary thrombosis?
EKG and physical exam findings?
Treatment?

A

Occlusion or blockage of blood flow within a coronary artery caused by a clot
EKG - ST changes, T inversion, Q waves
Physical exam - elevated cardiac markers on lab
Treat with fibrinolytics, stents

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13
Q

What is a pulmonary thrombosis? (PE)
EKG and physical exam findings?
Treatment?

A

Blockage of main artery of lung
EKG- narrow QRS and rapid heart rate
Physical - no pulse with CPR, distended neck veins, positive d-dimer
Treatment - surgical (pulmonary thrombectomy and fibrinolytic therapy

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14
Q

Algorithm for asystole / PEA

A

Start CPR, O2, monitor
analyze … shockable? no —
CPR 2 mins, IV/IO access, Epi (1mg every 3-5), advanced airway, capnography
2 mins up .. analyze .. shockable? no —-
CPR 2 mins, treat H’s T’s
2 mins up.. analyze .. shockable? no —
CPR 2 mins, Epi 1 mg

repeat

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15
Q

Algorithm for pulseless VF/VT

A

Start CPR, O2, monitor
analyze .. shockable? yes –
SHOCK
CPR 2 mins, IV/IO access
2 mins up .. shockable? yes –
SHOCK
CPR 2 mins, Epi (1 mg every 3-5), advanced airway, capnography
2 mins up … analyze .. shockable? yes –
SHOCK
CPR 2 mins, Amiodarone 300 mg (1st dose) 150 mg (2nd dose)
2 mins up .. analyze .. shockable? yes –
SHOCK
CPR 2 mins, Epi 1mg
2 mins up .. analyze .. shockable? yes –
SHOCK

repeat

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16
Q

Algorithm for bradycardia with a pulse

A

heart rate monitor and observe
Symptomatic —–> Atropine .5 mg bolus, every 3-5, up to 3 mg
If ineffective: transcutaneous pacing OR dopamine drip 2-10 mcg/kg/mn OR Epi drip 2-10 mcg/min

Consider expert consultation, transvenous pacing

17
Q

Algorithm for tachycardia with a pulse

A

heart rate >150

maintain airway - O2 - cardiac monitor BP SPO2

Asymptomatic —>
Wide QRS? YES - IV, 12 lead, adenosine only if regular/monomorphic, antiarrythmic infusion,
Wide QRS? NO - IV, 12 lead, vagal maneuver, adenosine if regular, B Blocker, Ca channel blocker

Symptomatic —> Synchronized cardioversion, consider sedation (versed 1-5 mg), adenosine if regular narrow complex

18
Q

What is the dose of Epi in cardiac arrest?

A

1 mg every 3-5 mins

19
Q

What is the dose of vasopressin in cardiac arrest?

A

40 units - can replace first or second dose of epi

20
Q

What is the dose of amiodarone in cardiac arrest?

A

1st dose - 300 mg

2nd dose - 150 mg

21
Q

Shock energy of a biphasic defibrillator?

A

120-200 J

22
Q

Shock energy of a monophasic defibrillator?

A

360 J

23
Q

Atropine dose for bradycardia?

A

0.5 mg bolus, repeated every 3-5 mins for a max dose of 3 mg

24
Q

Dopamine IV infusion for bradycardia?

A

2-10 mcg/kg/min

25
Q

Epi IV infusion for bradycardia?

A

2-10 mcg/mn

26
Q

Adenosine dose for tachycardia?

A

1st dose: 6 mg RAPID push followed by NS flush

2nd dose: 12 mg RAPID push followed by NS flush

27
Q

Amiodarone dose for tachycardia?

A

first dose: 150 mg over 10 mins (in 100 mL)
repeat if VT recurs
maintenance infusion of 1 mg/min for first 6 hours

Cardiology (4 decks)

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