Cardiology

Question 1

What is the BLS adult algorithm?

Answer 1

1. unresponsive/not breathing/only gasping 2. activate the emergency response team and go get the defibrillator (or have 2nd person do this is available) 3. Check pulse. Definite pulse within 10 seconds? (3a. if yes give 1 breath Q5-6 sec. and recheck pulse Q2Min. ) 4. begin cycle of 30 compressions and 2 breaths 5. AED/defibrillator arrives/set it up 6. check rhythm. is it shockable? (7. if shockable give 1 shock and resume CPR immediately for 2 min) (8. if not shockable resume CPR immediately for 2 min. check rhythm every 2 min. continue until ALS providers take over or the victim starts to move.)

Question 2

What is the ACLS Cardiac Arrest Algorithim?

Answer 2

1. If someone appears to be having cardiac arrest shout for help/activate the emergency response 2. start CPR, give O2, attach monitor/defibrillator - check if rhythm is shockable 2A. if rhythm IS shockable (v-fib or v-tach) shock 3A. give CPR for 2 min, and get iv/io access 4A. check if rhythm is shockable, if yes shock 5A. CPR for 2 min, 1mg Epi Q3-5 min, consider advanced airway capnography 6A. check to see if the rhythm is shockable, if yes shock 7A. give CPR for 2 min, give Amioderone 300mg (second dose 150mg), treat reversible causes. 8A continue the cycle of rhythm check/shock - CPR/drugs until the person is pronounced dead or there is ROSC - return of spontaneous circulation, then go to post cardiac arrest care////// 2B. if rhythm is not shockable (Asystole/PEA) perform CPR for 2 min, gain IV/IO access, Epi. Q3-5 min, consider advanced airway capnography 3B.Check rhythm 4B. not shockable perform CPR 2 min, treat reversible causes 5B.continue the cycle of rhythm check - CPR/drugs until the person is pronounced dead or there is ROSC - return of spontaneous circulation, then go to post cardiac arrest care.

Question 3

What are the reversible causes that we are looking for during life support measures?

Answer 3

Hypovolemia (check B/P, give fluids), Hypoxia (check O2 sat., give O2), Hydrogen Ion - acidosis - (give O2?), Hypo - Hyperkalemia (blood test, fix hypo with K supplement, fix hyper with intravenous bicarbonate, calcium, and insulin given together with 50% dextrose may be appropriate- potentially), Hypothermia, Tension Pneumothorax, tamponade -cardiac, , toxins, thrombosis (pulmonary and coronary