ACLS Stuff Flashcards by Derrick Chuong

What does the BLS Assessment entail? (4)

Check Pt responsiveness
Activate Code (blue/66)
Check for breathing/pulse
Start BVM and CPR if indicated

30:2 (depth 6cm)
1 breath every 6 seconds if pulse present
agonal gaps are not real breaths

How well did you know this?

Not at all

Perfectly

How would you check Pt responsiveness on a prone patient?

Tap and shout “are you okay””

How well did you know this?

Not at all

Perfectly

How long do you check for breathing/pulse?

5 - 10 secs

How well did you know this?

Not at all

Perfectly

When you start BVM and CPR, what ratio of compressions and breaths do you give?

30:2 (depth 6cm)
1 breath every 6 seconds if pulse present

How well did you know this?

Not at all

Perfectly

ABC(DE) primary assessment consists of?

Airway
Breathing
Circulation
Disability
Exposure

How well did you know this?

Not at all

Perfectly

Primary assessment: what do you check on the airway assessment?

Patency/obstruction

ETT required? confirmed? secured?

How well did you know this?

Not at all

Perfectly

Primary assessment: What do we check for breathing?

Check for Adequate ventilation and oxygenation via

ETCO2 and SpO2

How well did you know this?

Not at all

Perfectly

Primary assessment: Exposures?

Trauma
Bleeding
Burns
Hypothermia
Medical alert braclets

How well did you know this?

Not at all

Perfectly

Primary assessment: Disabilities

Neurological function
LOC
Pupil dilation

How well did you know this?

Not at all

Perfectly

Primary assessment: What do we look for in circulation?

Effective CPR
Shockable rhythm? Defib vs cardioversion?
IV/IO?
ROSC?
Volume resuscitation?
Meds for rhythm or BP?

How well did you know this?

Not at all

Perfectly

What 6 things are apart of the secondary assessment [SAMPLE]?

Signs and symptoms
Allergies
Meds
Past med history
Last meal
Events

How well did you know this?

Not at all

Perfectly

What do we consider during the secondary assessment for: Events?

Sudden onset or gradual?
Scene hazards?
Time of onset?

How well did you know this?

Not at all

Perfectly

What do we consider during the secondary assessment for: Past med history

Illness/hospitalizations
Family hx
surgeries/immunization status

How well did you know this?

Not at all

Perfectly

What do we consider during the secondary assessment for: Signs and Symptoms?

Breathing concerns
Fever, headaches
Tachypnea and tachycardia
Bleeding

How well did you know this?

Not at all

Perfectly

Purpose of code 66?

Codes are called to intervene/prevent pt from becoming unstable.

prevent code blue

How well did you know this?

Not at all

Perfectly

Positions for a 6-person high performance team?
- team formation basically for optimal resuscitation

Res. triangle
- Compressor
- AED/monitor/defib
- Airway

Leadership roles
- team lead
- iv/io meds
- time/recorder

How well did you know this?

Not at all

Perfectly

What are common rhythms of acute coronary syndrome support?

Sudden cardiac death
VTs
Hypotensive bradycardias

How well did you know this?

Not at all

Perfectly

Difference between STEMI and NSTEMI?

STEMI = (ST-Elevation Myocardial Infarction)
NSTEMI (Non ST-Elevation MI)

How well did you know this?

Not at all

Perfectly

How does acute coronary syndrome develop?

How well did you know this?

Not at all

Perfectly

What does ABCDE describe for acute coronary syndrome?

Development of clots that lead to coronary issues.

How well did you know this?

Not at all

Perfectly

What is a good indicator that there is a coronary issue?
- aka symptomatic vs asymptomatic

Troponin

When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood.

How well did you know this?

Not at all

Perfectly

Suggested plan for ischemia/infarction?

Look at the diagram and get an idea of the workflow

How well did you know this?

Not at all

Perfectly

Therapies:
- What are oxygen goals for acute coronary syndrome?

SpO2 >= 90%

How well did you know this?

Not at all

Perfectly

What phrenological treatments are there for acute coronary syndrome
- what drugs are given?
- Give brief description

- Aspirin (stop clot formation)

- Nitroglycerin (reduce LV and RV preload via peripheral arterial and venous dilation)

- morphine (reduces chest pain if nitro can’t)

- Fibrinolytic therapy (clot busters)

How well did you know this?

Not at all

Perfectly

3 Indications for CPR

1. Unresponsiveness: If a person is unresponsive and not breathing normally, CPR should be started immediately. 2. Absence of Pulse: If a person is unresponsive and not breathing normally, check for a pulse. If there is no pulse, CPR should be started immediately. 3. Cardiac Arrest: If a person is experiencing cardiac arrest (a sudden loss of heart function), CPR should be started immediately

3 indications for BVM

1. Inadequate Breathing: If a person is breathing inadequately (e.g., gasping for air, breathing very slowly), a BVM may be used to assist with breathing until advanced medical care arrives. 2. Respiratory Arrest: If a person is in respiratory arrest (i.e., not breathing at all), a BVM should be used to provide artificial ventilation until advanced medical care arrives. 3. Anesthesia: During anesthesia, a BVM may be used to assist with breathing and maintain adequate oxygen levels in the body.1

What is percutaneous coronary interventions?

Angioplasty with stent

2 types of stroke?

Ischemic and hemorrhagic

Ischemic stroke is caused by?

Occlusion of an artery

Hemorrhagic stroke is caused by?

Sudden Blood vessels rupture in the brain. - Avoid clot busters

Stroke plan? - hint determine if it thrombotic or hemorrhagic

Alteplase use?

Clot buster - fibrinolytic therapy

Drugs for bradycardia?

**- Atropine** Less commonly used: - Dopamine - Epinephrine

Traits for a symptomatic bradycardia?

HR < 50 bpm normally brady is < 60bpm

ECG Rhythms for bradycardia

- Sinus brady - First degree AV block - Second degree AV block (Mobitz I & II) -Third degree AV block

Does atropine work for mobitz II or 3rd degree heart blocks?

unlikely

Bradycardia is a sign of what?

**- Hypoxia** - Elevated ICP *- Check if its hypo or hypertension*

What helps a unstable bradycardia?

Transcutaneous pacing (stimulate contraction and rhythm) - must confirm electrical and mechanical capture

Things to consider for transcutaneous pacing?

Sedation of the pt Starting rate (should be 60-80)

Things to consider for transcutaneous pacing?

Sedation of the pt Starting rate (should be 60-80)

Bradycardia workflow

Which HR range should be cardioverted right away?

HR >= 150 BPM

Rhythms associated w/tachycardia?

Sinus tach A fib A flutter SVT Monomorphic VT Polymorphic VT Wide-complex tachy

Drug admin order for a tachycardia?

1. Vagal maneuver (if reg) 2. Adenosine (if reg) 3. Beta blockers or Calcium Channel blockers

Drugs usually associated w/Stable and wide QRS tachycardia?

- Procainamide (Wide tachy) - Amiodarone - Beta blockers or calcium channel blockers

Drug usually associated w/synchronized cardioversions?

Adenosine

Signs of respiratory distress? *edit*

- Increased HR - Increased RR - Decreased LOC (add more)

Signs of respiratory failure? *edit*

- Severely decreased LOC - Absent air movement (add more)

Respiratory arrest is also known as?

Apnea

How do you manage resp. arrest/apnea?

- Avoid excessive ventilation - Deliver 1 breath every 6 seconds if pulse present and recheck every 2 mins. - Open airway (OPA, O2, head tilt, suction)

What does Amiodarone do?

Slows HR and reduces electrical activity in the heart. - For VF and VT

What is Adenosine is used to treat?

SVT; temporarily blocks electrical conduction in the AV node - Admin via intravenous bolus

Atropine use?

Treats Bradycardia by increasing HR

factors that prevent excessive ventilation?

- Increased intrathoracic pressure - Decreased venous return - Decreased CO - Cerebral vasoconstriction

Ask someone

Drugs for cardiac arrest

- Epinephrine every 3-5 mins (vasopressor) - Amiodarone (antiarrhythmic) - Lidocaine (antiarrhythmic) - Magnesium sulfate (torsades de pointes - ecg rhythm, ) - Dopamine - O2

What are indicators that a pt is in shock?

- If in VF/pVT - Agonal resp

Understand the workflow

Post Cardiac Arrest Care

- Still need to consider Hs & Ts - Manage the ABCs - Targeted Temp Management - Monitor EtCO2 – May be one of the first signs the patient is arresting again! - Treat hypotension (drugs or volume) - Neuroprognostication – Hypoxic-ischemic injury

How can hyperventilation be detrimental?

1. Increased intrathoracic pressure 2. Decrease venous return to the heart 3. Diminished CO

When do you cardiovert?

- Atrial fibrillation (AF), - Atrial flutter - Stable ventricular tachycardia; when medications have failed to convert the rhythm, or when the patient is becoming unstable and the rhythm must be immediately terminated.