ACLS Algorithm (Exam 2)

Question 1

initial management of ACLS

Answer 1

call EMS or code
high quality CPR
rapid defibrillation and ACLS
post cardiac arrest care

Question 2

pulse check should not take more than ____

Answer 2

10 seconds

Question 3

normal CPR vs. advanced airway

Answer 3

normal: 30 compressions then 2 breaths
advanced airway: 1 breath every 6 seconds

Question 4

high quality CPR

Answer 4

> 2 inches in depth
100-120 compressions/min
30:2
recheck rhythm every 2 mins

Question 5

vagal maneuver techniques

Answer 5

valsalva maneuver
diving reflex
coughing
gagging
carotid massage

Question 6

adenosine can be used to perform ____

Answer 6

stress test

Question 7

ACLS drugs

Answer 7

adenosine
amiodarone
procainamide
sotalol
lidocaine

Question 8

lidocaine in ACLS

Answer 8

IV boluses to resuscitate
then IV infusion after ROSC

Question 9

post cardiac arrest care

Answer 9

maintain MAP > 65 mmHg
correct underlying cause
target temperature management

Question 10

if MAP is < 64 mmHg

Answer 10

NS or LR, unless CI
vasopressors if not controlled with fluids

Question 11

issues that lead to target temperature management

Answer 11

cellular damage
excitatory neurotransmitter
anoxic brain injury
inflammatory mediators

Question 12

steps for target temperature management

Answer 12

1. initiation
2. maintenance
3. rewarming
4. normothermia

Question 13

initiation

Answer 13

start cooling immediately
analgesia/sedation
recognize/treat shivering

Question 14

maintenance

Answer 14

for 24 hours
close attention to BP, O2 sat, volume,
glucose, K+, seizures

Question 15

rewarming

Answer 15

begin 24 hours after induction
0.25 degrees/hr
watch BP, glucose, K+

Question 16

normothermia

Answer 16

avoid fevers

Question 17

inclusion criteria for target temperature management

Answer 17

witnessed OOH VF/pulseless VT
in hospital CA or OOH PEA/asystole
comatosed (need this)

Question 18

exclusion criteria for target temperature management

Answer 18

major head trauma
major surgery < 14 days
systemic infection/sepsis
clinically sig bleeding/risk
DNR/DNI
pregnant
age < 18 years

Question 19

complications of target temperature management (TTM)

Answer 19

shivering
hemodynamic instability
glucose control
potassium
infection

Question 20

target potassium for TTM

Answer 20

> 3.5 mEq/L

Question 21

bradyarrhythmia symptoms

Answer 21

dizziness
syncope
fatigue
confusion
HF exacerbation

Question 22

causes of bradyarrhythmia

Answer 22

vagal tone
myocarditis, MI, cardiac surgery
non-DHP CCB, BB, digoxin

Question 23

sinus bradycardia is common in

Answer 23

young, active adults

Question 24

culprit drugs in sinus bradycardia

Answer 24

beta blockers
CCBs
ivabradine

Question 25

long term treatment of sinus bradycardia

Answer 25

pacemaker

Question 26

1st degree heart block

Answer 26

prolonged PR interval

Question 27

2nd degree, mobitz I heart block

Answer 27

1:1 AV conduction progressively prolonged PR interval

Question 28

2nd degree, mobitz II heart block

Answer 28

"dropped" ventricular beats without PR prolongation

Question 29

3rd degree heart block

Answer 29

complete heart block no AV conduction

Question 30

management of bradyarrhythmias

Answer 30

assess for vasal vagal atropine 1 mg, q3-5mins up to 3 mg permanent implant pacemaker

Question 31

alternative drugs for bradyarrhythmias

Answer 31

epinephrine 2-10 mcg/min dopamine 2-10 mcg/kg/min transcutaneous/transvenous pacing