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ACLS Stuff Flashcards

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1
Q

What does the BLS Assessment entail? (4)

A
  1. Check Pt responsiveness
  2. Activate Code (blue/66)
  3. Check for breathing/pulse
  4. Start BVM and CPR if indicated
  • 30:2 (depth 6cm)
  • 1 breath every 6 seconds if pulse present
  • agonal gaps are not real breaths
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2
Q

How would you check Pt responsiveness on a prone patient?

A

Tap and shout “are you okay””

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3
Q

How long do you check for breathing/pulse?

A

5 - 10 secs

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4
Q

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

A
  • 30:2 (depth 6cm)
  • 1 breath every 6 seconds if pulse present
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5
Q

ABC(DE) primary assessment consists of?

A
  • Airway
  • Breathing
  • Circulation
  • Disability
  • Exposure
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6
Q

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

A

Patency/obstruction

  • ETT required? confirmed? secured?
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7
Q

Primary assessment: What do we check for breathing?

A

Check for Adequate ventilation and oxygenation via

  • ETCO2 and SpO2
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8
Q

Primary assessment: Exposures?

A
  • Trauma
  • Bleeding
  • Burns
  • Hypothermia
  • Medical alert braclets
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9
Q

Primary assessment: Disabilities

A
  • Neurological function
  • LOC
  • Pupil dilation
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10
Q

Primary assessment: What do we look for in circulation?

A
  • Effective CPR
  • Shockable rhythm? Defib vs cardioversion?
  • IV/IO?
  • ROSC?
  • Volume resuscitation?
  • Meds for rhythm or BP?
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11
Q

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

A
  1. Signs and symptoms
  2. Allergies
  3. Meds
  4. Past med history
  5. Last meal
  6. Events
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12
Q

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

A
  • Sudden onset or gradual?
  • Scene hazards?
  • Time of onset?
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13
Q

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

A
  • Illness/hospitalizations
  • Family hx
  • surgeries/immunization status
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14
Q

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

A
  • Breathing concerns
  • Fever, headaches
  • Tachypnea and tachycardia
  • Bleeding
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15
Q

Purpose of code 66?

A

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

  • prevent code blue
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16
Q

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

A

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

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

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17
Q

What are common rhythms of acute coronary syndrome support?

A
  • Sudden cardiac death
  • VTs
  • Hypotensive bradycardias
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18
Q

Difference between STEMI and NSTEMI?

A
  1. STEMI = (ST-Elevation Myocardial Infarction)
  2. NSTEMI (Non ST-Elevation MI)
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19
Q

How does acute coronary syndrome develop?

A
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20
Q

What does ABCDE describe for acute coronary syndrome?

A

Development of clots that lead to coronary issues.

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21
Q

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

A

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.
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22
Q

Suggested plan for ischemia/infarction?

A

Look at the diagram and get an idea of the workflow

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23
Q

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

A

SpO2 >= 90%

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24
Q

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

A

- 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)

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25
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
26
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
27
What is percutaneous coronary interventions?
Angioplasty with stent
28
2 types of stroke?
Ischemic and hemorrhagic
29
Ischemic stroke is caused by?
Occlusion of an artery
30
Hemorrhagic stroke is caused by?
Sudden Blood vessels rupture in the brain. - Avoid clot busters
31
Stroke plan? - hint determine if it thrombotic or hemorrhagic
32
Alteplase use?
Clot buster - fibrinolytic therapy
33
Drugs for bradycardia?
**- Atropine** Less commonly used: - Dopamine - Epinephrine
34
Traits for a symptomatic bradycardia?
HR < 50 bpm normally brady is < 60bpm
35
ECG Rhythms for bradycardia
- Sinus brady - First degree AV block - Second degree AV block (Mobitz I & II) -Third degree AV block
36
Does atropine work for mobitz II or 3rd degree heart blocks?
unlikely
37
Bradycardia is a sign of what?
**- Hypoxia** - Elevated ICP *- Check if its hypo or hypertension*
38
What helps a unstable bradycardia?
Transcutaneous pacing (stimulate contraction and rhythm) - must confirm electrical and mechanical capture
39
Things to consider for transcutaneous pacing?
Sedation of the pt Starting rate (should be 60-80)
39
Things to consider for transcutaneous pacing?
Sedation of the pt Starting rate (should be 60-80)
40
Bradycardia workflow
41
Which HR range should be cardioverted right away?
HR >= 150 BPM
42
Rhythms associated w/tachycardia?
Sinus tach A fib A flutter SVT Monomorphic VT Polymorphic VT Wide-complex tachy
43
Drug admin order for a tachycardia?
1. Vagal maneuver (if reg) 2. Adenosine (if reg) 3. Beta blockers or Calcium Channel blockers
44
Drugs usually associated w/Stable and wide QRS tachycardia?
- Procainamide (Wide tachy) - Amiodarone - Beta blockers or calcium channel blockers
45
Drug usually associated w/synchronized cardioversions?
Adenosine
46
Signs of respiratory distress? *edit*
- Increased HR - Increased RR - Decreased LOC (add more)
47
Signs of respiratory failure? *edit*
- Severely decreased LOC - Absent air movement (add more)
48
Respiratory arrest is also known as?
Apnea
49
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)
50
What does Amiodarone do?
Slows HR and reduces electrical activity in the heart. - For VF and VT
51
What is Adenosine is used to treat?
SVT; temporarily blocks electrical conduction in the AV node - Admin via intravenous bolus
52
Atropine use?
Treats Bradycardia by increasing HR
53
factors that prevent excessive ventilation?
- Increased intrathoracic pressure - Decreased venous return - Decreased CO - Cerebral vasoconstriction
54
Ask someone
55
Drugs for cardiac arrest
- Epinephrine every 3-5 mins (vasopressor) - Amiodarone (antiarrhythmic) - Lidocaine (antiarrhythmic) - Magnesium sulfate (torsades de pointes - ecg rhythm, ) - Dopamine - O2
56
What are indicators that a pt is in shock?
- If in VF/pVT - Agonal resp
57
Understand the workflow
58
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
59
How can hyperventilation be detrimental?
1. Increased intrathoracic pressure 2. Decrease venous return to the heart 3. Diminished CO
60
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.
61
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