ACLS Flashcards Preview

Paramedic - NREMT-P > ACLS > Flashcards

Flashcards in ACLS Deck (76)
Loading flashcards...
1

Post-Cardiac Arrest Cara

Temperature Management : between 32-36Celcius 89.6-95.2Farenheit for at least 24 hours
Oxygen: should titration of oxygen to lowest level possible to avoid oxygen toxicity. Approximately 94% oxygen or greater
Ventilation: start at 10/min and ventilate for capnography at around 35-45mmHg
Pressure: mean arterial pressure of at least 65mmHg is reasonable

2

Roles of Arrest

Airway
Compressor
Defibrillator
Team Leader
Medications
Time/Recorder

3

Team Member

Ask for new task or role if unable to perform assigned task because it is beyond level of experience
Suggest an alternative drug dose in a confident manner
Question a colleague who is about to make a mistake

4

Team Leader

Clearly define roles for each person
Ask new intervention be done if it is higher priority
Ask for ideas of diagnoses
Confirm what members do and be clear about instructions

5

If Unsure about a Pulse

Start CPR because it can be more harmful to not do it if it is needed

6

BLS Assesment

Check Respnsiveness
Shout for Help
Check Breathing and Pulse
Start CPR and Rescue Breathing
Attach Defibrilator

7

Coronary Perfusion pressure

Aortic relaxation "diastolic"
-relates with both myocardial blood flow and ROSC
-one study showed that ROSC did not occur unless a CPP 15mmHg or greater was achieved

8

Quality Compresion

At least 2 inches
Rate of 100-120
Allow full chest recoil

9

Depth of Compressions

More often too shallow but too deep >2.4 inches has shown to decrease survival rate in cardiac arrest due to injuries

10

High Quality CPR

Compress chest hard and fast
Allow complete chest recoil
Minimize interruptions less than 10 seconds
Avoid excessive ventilations
Switch compressor every two minutes

11

Capnography

If less than 10mmHg then reasses quality of CPR

12

H's and T's

Hypovolemia
Hypoxia
Hydrogen Ion
Hypo/hyperkalemia
Hypothermia
Tension Pneumo
Tamponade
Toxins
Thrombosis (coronary and PE)

13

Tidal Volume of Adult

8-10ml/kg

14

Respiratory

Respiratory Rate below 6/min is considered hypoventilation and requires ventilation assistance

15

Resp Distress

Abnormal Respiratory Rate

16

Resp Failure

Inadequate Oxygenation

17

Resp Arrest

Absent Breathing

18

Tidal Volume for Patient not breathing

6-7ml/kg will suffice enough to rise the chest

19

BVM

If ventilations are being properly delivered and are adequate, providers may differ from an advanced airway

20

Excessive Ventilation

Can increase thoracic pressure, decreases venous return to the heart and diminishes cardiac output

21

Common Airway Obstruction

Loss of tone in the throats muscles. When the tounge falls to the back of the throat

22

Airway Obstruction

If obstructed and resp arrest occurs, start CPR and check mouth after every two minutes when going to give ventilations and remove with fingers if clearly visible

23

BVM device

Delivers approximately 600ml of volume and should see chest rise over 1 second

24

Suctioning

Suction force of 80-120mmHg is nescessary
Soft: used for mouth or nose and et deep suction
Ridged: suction oropharynx and thick secretions

25

Suction Measure

Ridged is the same as an OPA and the Soft is measured from nose, around ear to xiphoid process
Should not exceed more than 15 seconds

26

ACS Algorithm

Symptoms of ischemia=> abc's 12 lead => titration oxygen if less than 90%, give 160-325 aspirin, nitoglycerine, morphine if pain not relieved by nitro

27

Reperfusion Goals

Door to Ballon 90minutes
Door to Needle (fibronolysis) 30 minutes

28

Chest Discomfort of Ischemia

-Uncomfortable Pressure, fullness, squeezing, pain in center of chest lasting several minutes
-Chest discomfort spreading to shoulders, neck, one or both arms or jaw
-Chest discomfort spreading to back or between shoulder blades
-Unexplained SOB with or without chest discomfort

29

Aspirin

Dose: 160-325mg causes near immediate and total inhibition of thromboxone
IF Pt has not taken aspirin, has allergies, or recent GI bleed

30

Nitroglycerine

Reduces ischemic chest discomfort
Cause reduction in LV and RV preload through peripheral arterial and venous dilation
1 spray, or dose, 400mcg every 3-5 minutes for ongoing symptoms
Total of three doses
BP > 90mmHg Systolic and HR IS 50-100/min