Advanced life support

Question 1

How to do Chest compressions

Answer 1

• Centre of the chest
• Compress5-6cm
• Compress at a rate of 100-120
• Allow full recoil
• Firmsurface

Question 2

What is the step wise approach to achieving an open airway for adequate oxygenations

Answer 2

positon (looking for signs of life)
Manoeuver (Head tilt, chin lift)
adjunct (OPA, NPA)
supraglotic airway (IGEL)
intubation 
ciricothyrioclotmy

Question 3

What are the shockable rhythms

Answer 3

Ventricular Fibrillation

Pulseless Ventricular Tachycardia

Question 4

What are the non shockable rhythms

Answer 4

Aystole

PEA

Question 5

What drug should you give if PT is VF/VT?

Answer 5

• PersistentVF/pVT
• After 3rd shock
• Adrenaline 1mgin10ml-1:10,000
(Consider contra- indiciations)

Question 6

How often can you give Adrenaline 1mgin10ml-1:10,000

Answer 6

Every 3 minutes

Question 7

What are the contraindications of Adrenaline 1mgin10ml-1:10,000

Answer 7

Contra-indication– Hypothermic patients

Question 8

How is Adrenline 1 mg in 10ml-1:10,000 given to pt

Answer 8

IV

IO

Question 9

What should you give after admistering Adrenline 1 mg in 10ml-1:10,000

Answer 9

20ml flush

Question 10

What are the benfits of adrenline?

Answer 10

• Smooth muscle relaxation in the airways
• Cause vasodilation of the coronary arteries
• Contraction smooth muscle in arterioles
• Increased peripheral resistance

Question 11

What to adminster after the 3rd shock if it is still not successful

Answer 11

Amiodarone 300mg

Question 12

What dose do you adminster of amiodrone after the 5th shcok

Answer 12

150mg in 5ml

Question 13

what to adminster as soon as you have iv/io access un a non shockable rhythm?

Answer 13

Adreniline 1mg in 10ml– 1:10,000

Repeat every 3-5 minutes

Question 14

What are the 4 h’s of reversiable causes

Answer 14

•Hypoxia
•Hypothermia
• Hypo/Hyper Kalaemia /
Metobolic
• Hypovolaemia

Question 15

What is hypoxia ?

Answer 15

Low oxygen levels in the blood

Question 16

How to reverse hypoxia in cardiac arrest

Answer 16

» Patent airway
» Adequately ventilated lungs
» Maximal possible inspired oxygen

Question 17

What is hypovolaemia ?

Answer 17

Decreseas in blood volume due to severe haemorrhage

truma, gastrointestinal bleeding or rupture of an aoritc aneurysm

Question 18

how to correct hypovolaemia in a cardiac arrest

Answer 18

» Stop the haemorrhage
» Fluid Therapy:
» <90 mmHg + impaired perfusion
» 250ml 0.9% NacL

Question 19

Hyperkalaemia

Answer 19

elevated level of potassium - kidney failure

Question 20

Hypokalaemia

Answer 20

low level of potassium

- vomiting, diarrhoea, dialysis

Question 21

Hypocalcaemia

Answer 21

low calcium levels

- kidney failure

Question 22

Hypoglycaemia

Answer 22

low blood sugar levels

Question 23

what is HYPOTHERMIA

Answer 23

when the core body temperature is below 30 degress

Question 24

what to do if your pt is hypothermic and in cardiac arrest

Answer 24

• Limit defibrillation attempts to three (delivered at maximum defibrillator output)
• Limit IV medications

Question 25

what are the 4 t's

Answer 25

* Tamponade * Tension Pneumothorax * Thrombosis * Toxins

Question 26

what is a THROMBOSIS

Answer 26

Blood clot » Acute coronary syndrome or ischaemic heart disease - urgent coronary angiography » Massive pulmonary embolism - fibrinolytic treatment

Question 27

what is a Tension pneumothorax

Answer 27

Tension pneumothorax is accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart.

Question 28

how to reverse a Tension pneumothorax

Answer 28

Needle thoracentesis or thoracostomy

Question 29

what is a cardiac tamponde

Answer 29

Fluid in the pericardium resulting in compression of the heart Difficult to diagnose Cardiac arrest after penetrating chest trauma is highly suggestive

Question 30

what are the reasons someone could be in cardiac arrest due to toxins

Answer 30

» Accidental or deliberate ingestion of therapeutic or toxic substances » History indicated » Opioid overdos

Question 31

how can you reverse cardiac arrest if its a opioid overdose

Answer 31

Naloxone

Question 32

when would you not achive rosc on scene

Answer 32

if their is an untreatable reversable cause or need for medcial interventions

Question 33

when would you not start cpr

Answer 33

``` • DNACPR • Finalstagesofterminalillness • 15minutessinceonset • NobystanderCPR • Asystolefor>30seconds • Asystolefor>20minutesdespiteALS • Exclusion: Pregnancy,Drowning, Hypothermia or Poisoning, • Decapitation • Massivecranialandcerebral deconstruction • Hemicortectomyorsimilarmassiveinjury • Decompositionandputrefaction • Incineration • Hypostasis • Rigormortis ```

Question 34

if its a pediactric in cardiac arrest what do you do before starting cpr

Answer 34

5 rescue breaths, becuase they could be in respiratorty arrest

Question 35

what is the rate of cpr for a peadiatrics

Answer 35

15:2