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ACLS Book Flashcards

(102 cards)

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1
Q

What are the BCLS 4 steps?

A

1) check responsiveness - “are you alright” + scan for 5-10 sec
2) activate emergency response system + get AED
3) circulation - check pulse for 5-10sec
- – no pulse: CPR 30compression/2breathes
- – pulse: ONLY 1 breath/5-6sec
4) defibrillation - AED

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2
Q

If alone - how to do CPR?

A

1) call for help
2) bring AED
3) CPR THEN AED

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3
Q

What is the ACLS survey?

A

Airway
Breathing
Circulation
Ddx

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4
Q

How to monitor airway?

A

capnography

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5
Q

What to check for in “Airway” - ACLS?

A

check airway and monitor w/ capnography

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6
Q

What to do in “Breathing” - ACLS?

A

cardiac arrest - 100%

otherwise: >94% is sufficient

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7
Q

What to do in “Circulation” - ACLS?

A 
monitor CPR quality
-capnography is >10mmHg
-intra arterial pressure is >20mmHg
use of AED
IV/IO + drugs if needed
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8
Q

What are the 6 roles of a team?

A 
team leader
observer/recorder
compressor
airway
IV/IO/meds
monitor/defib
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9
Q

What are the 2 airway devices?

A

bag-mask

any advanced airway

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10
Q

How many ventilations during CARDIAC ARREST?

A

bag-mask: 30 compressions/2vents

any advanced airway: 1 vent/6-8secs

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11
Q

How many ventilations during RESPIRATORY ARREST?

A

ANY airway device: 1 vent/5-6secs

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12
Q

How to manage airway with suspected C-spine injury?

A

jaw thrust

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13
Q

What are 2 basic airway adjuncts?

A

oropharyngeal airway

nasopharyngeal airway

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14
Q

What should be confirmed before using oropharyngeal airway?

A

PATIENT IS UNCONSCIOUS - AVOID GAG REFLEX

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15
Q

How to insert OPA?

A

1) clear mouth
2) select PROPER OPA
3) insert OPA so it curves UP
4) rotate OPA so curve is pressing on top of the tongue
* moves tongue out of the way

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16
Q

What haps of OPA is too big?

A

trauma to laryngeal

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17
Q

What haps of OPA is too small?

A

push tongue and obstruct airway

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18
Q

When can you use NPA, when can you cannot?

A

yes: conscious, semiconscious
no: facial abrasions - cribiform fracture

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19
Q

How to insert NPA?

A

1) select size
2) lubricate
3) insert

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20
Q

When to use soft catheters for suctioning?

A

aspiration of THIN secretion from oropharynx and nasopharynx
pt has clenched teeth

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21
Q

When to use rigid catheters?

A

suctioning oropharynx with THICK matter

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22
Q

How to insert oropharyngeal suction?

A

1) measure- nothing LONGER than ear lobe to tip of nose and insert
2) suction + rotate

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23
Q

How to insert endotracheal tube section?

A

1) sterile technique
2) insert
3) suction attempts should NOT exceed 10 sec

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24
Q

Where can you place the AED pads?

A

anterolateral
anteroposterior
anterior - left infrascapular
anterior-right infrascapular

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25
What drugs are used for VF/VT?
``` Epinephrine Norepinephrine Vasopressin Amiodarone Lidocaine Mg sulfate Dopamine O2 ```
26
How much epinephrine should be given during VF/pulseness VT?
IV/IO 1mg q3-5min
27
What can you give instead of epinephrine? How many doses of epinephrine?
Vasopressin IV/IO 40units for 1-2 doses
28
How much Amiodarone can you give during VF/pulselss VT?
300mg bolus then 150mg
29
What are reversible causes of VF/pulseless VT?
``` Hypovolemia Hypoxia Hydrogen ion - acidosis Hypo/hyper kalemia Hypothermia Tension pneumothorax Tamponade, cardio Toxins Thrombosis, pulm Thrombosis, coronary ```
30
How many volts for monophasic and biphasic defibrillator?
Monophasic: 360 Biphasic: 120-200
31
When do you check for rhythm?
Q2min
32
What can you use instead of Amiodarone - VF/ pulselessVT?
Lidocaine 1-1.5mg/kg then 0.5-0.75mg q5-10min | Max: 3mg/kg
33
What to use if pt has torsades de pointes + long QT interval?
Mg sulfate 1) 1-2g +10mg saline 2) bolus q5-20min
34
When should try to improve CPR quality - physiological monitoring during CPR?
End tidal co2
35
How to administer drugs through IV?
Drug by bolus 20ml bolus of fluid Elevate extremity for 10-20sec
36
How much fluids for post cardiac arrest?
1-2L
37
How much epinephrine for post cardiac arrest?
0.1-0.5mcg/kg
38
How much dopamine after post cardiac arrest?
5-10mcg/kg/min
39
How much norepinephrine post cardiac arrest?
0.1-0.5mcg/kg/min
40
EKG: Narrow complex + rapid rate?
Hypovolemia
41
EKG: slow rate?
Hypoxia
42
EKG: small amplitude QRS?
Acidosis
43
EKG: tall and peaked T waves + Small P waves + wide QRS?
Hyperkalemia
44
EKG: low T waves + U waves + prolonged QT + wide QRS?
Hypokalemia
45
EKG: J waves?
Hypothermia
46
How to tx hyper kalemia?
Ca chloride Na bicarb Glucose + insulin +/- albuterol
47
How to tx hypokalemia?
Mg
48
EKG: narrow complex + slow rate?
Tension pneumothorax
49
How to tx tension pneumothorax?
Needle decompression | Tube throacostomy
50
EKG: narrow complex + rapid rate + no pulse? Tx?
Cardio tamopanode | Pericardiocentesis
51
EKG: narrow complex + rapid rate + no pulse + distended neck? Tx?
Thrombosis-lung | Fibrinolytic
52
Patients with coronary atheroscleorsis can have?
unstable angina NSTEMI STEMi
53
How much ASA should be given for ichemia?
160-325mg
54
What if pt has N&V -how to give ASA and how much?
300mg rectal suppositories
55
How much and often should you give nitro - MI?
1 tab/spray q3-5min
56
When is nitro and morphine contraindicated-MI?
hypotension from RV infarction
57
When should morphine be given -MI?
STEMI NOT in NSTEMI
58
MOA of morphine?
reduces catecholamine release venodilation decreases systemic vascular resistance
59
What drug is contraindicated with MI?
NSAID
60
When is ASA contraindicated-MI?
ASA allergy | GI bleeding
61
What are potential delays in hosp - MI?
Door to data --> to decision --> to drug
62
How long for fibrinolytic therapy -MI?
30min
63
How long for PCI-MI?
90min
64
IV nitro is used in MI for..?
relief of ischemic chest discomfort | improvement in pulmonary edem and HTN
65
How should IV nitro be given?
titrate and keep SBP >90
66
Criteria for symptomatic bradycardia?
HR is slow pt has sx sx are d/t slow HR
67
Bradycardia sx? Also sx for?
``` hypotension mental status chest pain HF unstable tachycardia ```
68
What is the dose for atropine IV - bradycardia?
1) 0.5mg bolus | 2) repeat q3-5min
69
What is the dose for dopamine and epinepherine IV - bradycardia?
2-10mcg/kg/min
70
What is bradycardia?
71
First line for bradycardia?
atropine
72
What to give pt before pacing-bradycardia?
parenteral benzo parenteral narcotic chronotropic infusion
73
What is the demand rate on the TCP-bradycardia?
60
74
Who should get TCP -EKG?
mobitz type II second deg AV block third degree bundle branch
75
When is cardioversion contraindicated in tachycardia?
sinus tachycardia - usually d/t fever, shock, etc
76
When should consult be obtained for tachycardia?
stable
77
When should someone get cadrioverted in tachycardia?
>150HR
78
What are the sx of tachycardia that indicates cardioversion?
hypotension shock altered mental status ischemic chest pain
79
EKG is narrow and regular - tachycardic?
50-100J
80
EKG is narrow and irregular-tachycardic?
120-200J biphasic | 200J monophasic
81
EKG is wide regular - tachycardic?
100J
82
How much adenosine IV for tachycardia?
1) 6mg IV push + NS flush | 2) 12mg if needed
83
When should procainamide/amiodarone/sotalol be considered in tachycardia?
wide QRS
84
How much procainamide- tachycardia?
20-50mg/min until needed | maintenance: 1-4mg/min
85
When is procinamide contraindicated?
prolonged QT or CHF
86
Amiodarone IV dose - tachycardia?
1) 150mg over 10min | maintenance 1mg/min for 6hrs
87
Sotalol IV dose- tachycardia?
100mg over 5min
88
If pt has CHF + tachycardia + wide QRS?
sotalol | NO procainamide
89
When do you use sychronized shocks?
unstable SVT unstable afib unstable aflutter unstable monomorphic tachycardia w/pulses
90
When do you use unsychornized shocks?
pulselesness | cannot differentiate between monomorphic and polymorphic VT in usntable pt
91
When to use 200J in synchronized cardioversion?
unstable SVT a flutter | unstable a fib
92
Unstable monomorphic VT -cardioversion?
100J
93
When is cardioversion contraindicated in tachycardia?
cx is fever, anemia, hypotension, blood loss, exercise
94
How much adenosine IV - tachycardia?
1) 6mg IV rapid + NS flush | 2) 12mg
95
What to do when pt has irregular wide complex tachycardia?
NO DRUGS
96
What to do if SVT does not respond to vagal maneuvers?
adenosine 6mg rapid IV push +20mL flush | then 12mg rapid IV push +20mL flush
97
What are potential delays for stroke tx?
``` 8D D-etectino D-ispatch D-eliverty D-oor D-ata D-ecision D-rug D-isposition ```
98
What is Cincinnati prehospital stroke scale?
facial droop arm drift abnormal speech
99
What is the time line for stroke pts?
10min of assessment of pt 25 min of neurological assessment of pt 25 min of CT scan 45min of CT scan interpretation
100
Who can have TPA for stroke?
w/in 3hrs
101
Who canNOT have TPA for stroke?
``` head trauma/stroke w/in 3 MO sx-hemmorrhage bleeding high BP: >185/>110 low platelet ct ```
102
What to NEVER GIVE after TPA?
anticoag or antiplatelet w/in 24hrs

ACLS (1 decks)

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