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Flashcards in ACLS class notes Deck (67):
1

True or false: the IV that is in place to infuse drugs is also used to draw labs

True

2

What is the indication for NS vs LR?

LR for trauma
NS for medical codes

3

What is the primary antiarrhythmic used in a code?

Amiodarone

4

What is the dosage on amiodarone for the first, and successive doses?

300 mg
150 mg for each additional dose

5

What is the dosage on lidocaine for the first and successive doses?

1.0-1.5 mg/kg for first dose, 0.5 to 0.75 mg

6

What are the 5 H's?

Hypoxia
Hydrogen ions
Hypo/hyperkalemia
Hypothermia
***

7

What are the five T's?

***

8

What is the amount of oxygen (SpO2) that should be used on COPD patients?

94-99%

9

What is the max amount of ventilation during a code?

1 per 6 secs

10

What is the reasoning for pre-oxygenation?

3 breathes of oxygen prior to sucking all air out

11

What is the target body temperature with hypothermia? How long should this be maintained?

32-36 degrees C for 24 hours (different from book)

12

What is the first thing that is checked with a newly organized rhythm on the monitor?

Check pulse to assess for PEA

13

What is the SBP that is considered stable?

90 mmHg

14

What should be done if the SBP is only 70 mmHg?

Continue support with CPR

15

What is the normal response to prolonged hypothermia? What, then, must be monitored?

Inflammation. Thus need to monitor for fever, and manage appropriately.

16

What are the orders that need to be obtained post arrest?

ECG + basic labs

17

What are the two contraindications to ASA administration?

Enteric bleed within the last 2 weeks
Allergy

18

At what level of SpO2 should oxygen be given?

94% or less

19

What is the frequency of Nitro?

1 every 5 minutes, up to three doses

20

What are the contraindications to nitro?

Bradycardia

21

If RV infarction is present, should you use nitrates?

No

22

What EKG should be obtained if there shows an inferior lead STEMI? Why?

Right sides EKG, to evaluate for RV infarction

23

Should you use coated ASA?

No

24

What is the goal for fibrinolytics?

within 30 minutes of arrival in the ED

25

CXR should be obtained within what time frame after arrival to the ED?

30 minutes

26

What are the adjunctive treatment?

NTG
Heparin
Beta blocker

27

What is the goal PCI time?

Within 90 minutes of the onset of s/sx

28

What is the goal PCO2 level to achieve with CPR?

15-20 mmHg

29

What level of pCO2 indicates the ROSC?

30-45 mmHg

30

What is the difference between monophasic and biphasic shocks, in terms of the amount of energy involved?

Biphasic is steadily increased
Monophasic is full blast

31

What is the stepwise amount of joules given with biphasic?

120 J
150 J
200 J

32

What is the first dose of atropine given with bradycardia? How often should this be repeated? Max dose?

-0.5 mg bolus
-q 3-5 minutes
-Max 3 mg

33

What should be done if bradycardia is not causing s/sx?

Monitor and observe

34

What should be done if bradycardia is causing s/sx?

Give atropine

35

What should be done if atropine is ineffective in the first dose? What if that does not work?

Transcutaneous pacing, or dopamine/epi infusion.

Consult specialist

36

What is the first and second dose of adenosine?

6 mg loading dose

12 mg if unresponsive

37

What should be done if there is a persistent tachyarrhythmia is causing s/sx?

Synchronized cardioversion

38

What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is a wide QRS??

IV access + ECG, and adenosine

39

What should be done if there is a persistent tachyarrhythmia is NOT causing s/sx, and there is NOT a wide QRS?

IV access with vagal maneuvers, adenosine,

40

What should be done with hypotension post ROSC?

IV bolus + vasopressors + ECG

41

When should induced hypothermia be performed following ROSC?

Hypotension and is not responsive to commands

42

What is the indication for PCI?

STEMI or high suspicion of AMI

43

If there is not a suspicion for a STEMI, what should be done post ROSC?

Advanced critical care

44

Is there a max amount of epi that can be given?

No

45

HOw long should CPR intervals last?

2 minutes

46

What is the max atropine?

3 mg

47

What is the dopamine dose?

2-10 mcg / kg /min

48

What is the epi dose in bradycardia?

2-10 mcg/min

49

What is synchronized cardioversion used for?

SVTs

50

What is the dose of defibrillation for a narrow, regular rhythm?

50-100 J

51

What is the dose of defibrillation for a narrow, irregular rhythm?

120-200 J

52

What is the dose of defibrillation for a wide, regular rhythm?

100 J

53

What is the dose of defibrillation for a wide, irregular rhythm?

Defibrillation--no dose

54

What is the dosing on sotalol?

100 mg over 5 minutes

55

What is the maintenance dose of amiodarone?

1 mg/min q 6 hours

56

What should be done immediately after shocking with cardioversion if there is asystole?

Compressions

57

What are the 8 D's of stroke?

-Detection
-Dispatch
-Delivery
-Door
-Data
-Decision
-Drug
-Disposition

58

What is the timeframe of fibrinolytics for strokes?

3-4.5 hours

59

What is the amount of time needed for s/sx to appear with a stroke?

10 seconds

60

When should oxygen be given to stroke patients?

Less than 94% or unknown SpO2

61

What is the first lab that should be obtained with a stroke patient?

BG

62

Pronator drift should be assessed after how long?

10 seconds

63

What must a hospital have to be considered a stroke center?

CT

64

CT scan should be done within what timeframe once in the ED?

10 minutes

65

What are the three components of the cincinnati stroke scale?

-Facial droop
-Arm drift
-Abnormal speech

66

What are the three inclusion criteria for tPA?

-Ischemic stroke causing measurable deficits
-Onset of s/sx less than 3 hours ago
-Age over 18 years

67

Head trauma in what timeframe is a contraindication to tPA?

3 months