ACLS Concepts Flashcards
1
Q
What is agonal breathing?
A
2
Q
What is an agonal rhythm, should you initiate CPR?
A
3
Q
Chest compression fraction?
A
4
Q
6-person High Performance Team
A
- Team Leader
–Doesn’t necessarily perform the tasks, but rather assigns roles to team members, makes decisions, provides feedback, and is responsible for roles not assigned
- Compressor (first priority)
–Alternates with AED person every 5 cycles (or two minutes), or when fatigue sets in
- AED/Monitor/Defibrillator (second priority)
–Obtains & operates the defibrillator, places the monitor so the team leader can see it, and rotates with the compressor
- Airway (third priority)
–Ventilates and intubates (if appropriate)
- IV/IO/Medications
–Establishes access and pushes the drugs
- Timer/recorder
–Records the times of interventions & medications, announces when the next drug is due, and records the frequency and duration of interruptions in compressions
5
Q
Difference between Cardiac Arrest Teams & Rapid Response Teams?
A
6
Q
What are the Rapid Response Team (Medical Emergency Team) Components?
A
7
Q
What are team dynamics (8)?
A
- Have clear roles
- The most important role of a team member is being proficient in skills according to your scope of practice - Know your limits
- Have constructive intervention
- Share knowledge
- Avoid “fixation error” - Summarize & re-evaluate
- Have “closed loop” communication
- Give clear messages
- Have mutual respect
8
Q
What are systems of care?
A
9
Q
Out of Hospital (OHCA) Chain of Survival
A
10
Q
BLS Assessment (RACD)
A
11
Q
Lone Rescuers
A
12
Q
Initial Steps On Conscious Patients
A
13
Q
What The Primary Assessment (ABCDEs) Consists Of
A
- Airway
- Check patency and consider advanced airway placement - Breathing
- Consider supplementary oxygen & advanced airway placement, monitor oxygenation & ventilation, and avoid excessive ventilation - Circulation
- Assessing the pulse, ECG, BP (stable vs. unstable), CPR effectiveness, temperature & glucose, the need for fluid and drug administration, and the need for cardioversion/defibrillation - Disability
- Check for neurologic function
- Responsiveness, level of consciousness, and pupil dilation)
- AVPU (Alert, Voice, Painful, Unresponsive) - Exposure
- Remove the patient’s clothing to perform a quick physical exam
- Look for obvious signs of trauma, bleeding, burns, unusual markings, or medical alert bracelets
14
Q
Initial Steps On Conscious Patients (ABCDEs)
A
So remember, if you encounter a conscious patient, just say, “Let’s place some oxygen and monitors on the patient, and start an IV.”
15
Q
Secondary Assessment
A
16
Q
7 H’s of Pulseless Arrest
A
17
Q
5 T’s of Pulseless Arrest
A
- Tamponade (cardiac tamponade)
–Cardiac tamponade occurs when fluid accumulation within the pericardial sac compresses the heart - Thrombosis (coronary and pulmonary)
–In patients with cardiac arrest due to presumed or known PE, it is reasonable to administer fibrinolytics - Tension pneumothorax
- Trauma
–Can obviously lead to hypotension and exsanguination - Toxins (drug overdose)
–Can lead to a prolonged QT interval on the ECG
18
Q
Treatment for a drug overdose?
A
19
Q
First step - Severe Choking In A Responsive Infant
A
20
Q
Second Step - Severe Choking In A Responsive Infant
A
21
Q
Severe Choking In Unresponsive Patients
A
22
Q
After the Obstruction is Relieved
A
23
Q
Drowning Protocol
A
24
Q
Colorimetric Capnography
A
25
Breathing Rates In ACLS - Compressions vs. no Compressions
26
Breathing Rates in ACLS - Intubated vs. Mask Ventilated
27
Breathing Rate Summary in ACLS
28
Breathing Protocol
29
Intravenous (IV) vs. Intraosseous (IO) vs. Endotracheal (ETT) Access
30
Best place for intraosseous access?
31
ETT access protocol for delivering emergency drugs?
32
Possible ETT drugs?
33
Chest compressions
34
Chest compression technique
35
High Quality CPR Pneumonic
36
One hand CPR Technique
37
“Two Finger” CPR Technique
38
“Thumb Encircling” CPR Technique
39
CPR in Mask Ventilated (Not Intubated) Patients
40
“Cycles” Of CPR In Mask Ventilated Patients
41
CPR in Intubated Patients
42
CPR Summary Based on the Ventilation Technique
43
Goals for Chest Compressions
44
Chest Compression Priority
45
Continuous Chest Compressions
46
Chest Compression Fraction
47
Lay Rescuer vs. Highly Trained CPR Delivery
48
When to Withhold CPR
49
CPR Protocol When Defibrillating
50
When can ECMO be implemented for cardiac arrest?
51
Ablities of AED pads?
52
Limitations of AED pads?
53
Difference between "semi-automated" and "fully-automated" Automated External Defibrillator (AED)?
54
AED Protocol
55
A manual defibrillator can do everything an AED can, and has the following “extra” abilities:
56
Which is preferred, a manual defibrillator or AED?
57
Controlling the Manual Defibrillator
58
Three modes of the manual defibrillator?
59
Pacing With The Manual Defibrillator
60
Monophasic vs. Biphasic Defibrillators
61
“Sync” Button for Synchronized Cardioversion
62
Indications for Synchronized Cardioversion
63
How to Perform Synchronized Cardioversion - Pad placement
64
How to Perform Synchronized Cardioversion - Steps after pad placement
65
Indications for Defibrillation (Unsynchronized Cardioversion)
66
Defibrillation (Unsynchronized Cardioversion) is **not** indicated in these situations
67
How to Perform Defibrillation - Pad placement
68
How to Perform Defibrillation - Steps after pad placement
69
Biphasic Defibrillator Energy Doses
70
Anterior-Anterior Pad Placement
| (Also Known as “Anterior-Lateral/Apex” Placement)
71
Posterior, Left Anterior Pad Placement
72
Posterior, Right Anterior Pad Placement
73
Pad Placement for an AED - Most common
74
Pad Placement for an AED - Second option
75
Prefferred Placement for Transcutaneous Pacing
76
Pad Placement for Transcutaneous Pacing - Second option
77
Placement for Defibrillation &
Cardioversion of Ventricular Tachycardia
78
Which Pad Placement is Best for Defibrillation and Cardioversion of Ventricular Tachycardia?
79
Pad Placement for Cardioversion of Atrial Rhythms
80
Pad Placement for Cardioversion of Atrial Rhythms - Second option
81
Paddle Placement For Adults - Most common
82
Paddle Placement For Pediatric Patients
83
Purpose of Electrode Gel For Defibrillation Paddles
84
Anterior-Anterior Placement is recommended for, but could also be used for?
85
Posterior, Left Anterior Placement is recommended for, but also could be used for?
86
Posterior, Right Anterior Placement recommended for?
87
Pediatric Manual Defibrillator Pads used for what age? Why?
88
What age are Pediatric AED Pads indicated for?
89
What is a Pediatric AED Pads & Pediatric Dose Attenuator?
90
Adult AED Pads indicated for what age?
91
Defibrillator Pads for Pediatrics
92
Defibrillator Safety
93
Defibrillator Safety - What to do if patient is wet?
94
Defibrillator Safety - What can happen if pads are placed to close together?
95
The time from arrival to the first shock should be?
96
Patients who achieve ROSC after cardiac arrest may develop post-cardiac arrest syndrome, which may include:
97
First goal of Post Resuscitation Care
98
Second goal of Post Resuscitation Care
99
Third goal of Post Resuscitation Care
100
Fourth goal of Post Resuscitation Care
101
Targeted Temperature Management (TTM)
102
An appropriate amount of time should pass before assessment of neurologic status after TTM, how long?
103
Methods of Initiating TTM
104
Oxygenation & Ventilation After ROSC
105
Cardiovascular Care After ROSC
106
Post Arrest Resuscitation Guidelines - Blood pressure and temperature management
107
Post Arrest Resuscitation Guidelines - Labs and diagnosement tests
108
Prophylactic Antiarrhythmic Therapy After ROSC
1. Lidocaine
2. Beta blockers
109
Overall Resuscitative Efforts - Terminating or prolonging?
110
Resuscitation in Hypothermic Patients
111
Resuscitation in Hypothermic Patients from drowning in icy water?
112
What to Say in the Algorithms
113
Drug therapy for bradycardia
114
Drug therapy for SVT
1. Adenosine
- 6mg initial bolus followed with saline flush
2. Sotalol
- 1.5mg/kg or 100mg
3. Calcium Channel Blockers (Cardizem, etc)
4. Amiodarone and Procainamide\*
\*Not part of ACLS algorithym but can be used in rare forms of SVT originating in myocardium
115
How does adenosine work and what is the recommended dose?
116
How does sotalol work, and what is the recommended dose?
117
How does calcium channel blockers work?
118
Indication for Amiodarone and Procainamide
119
Afib/atrial flutter treatment in ACLS
120
Adenosine for Afib or Atrial Flutter?
121
Indication for epinephrine, dose?
Epinephrine For Pulseless Rhythms
122
Indications for Amiodarone
123
Amiodarone Dosing Situations
124
Procainamide indications and dosing?
125
Amiodarone & Procainamide Summary
126
Magnesium indication and dosing?
127
Steroids and Arrest
