ACLS 2019 Cardiac Arrest Scenarios

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Questions and Answers

Name the ECG rhythms for a patient in cardiac arrest.

Vfib, pulseless ventricular Tachycardia (VT), Asystole, pulseless electrical activity (PEA).

What are the only 2 shockable rhythms?

VFib and Vtach.

What are the steps of the BLS initial survey?

Check responsiveness (ABC), activate emergency response and get AED/Defibrillator, check for breathing/pulse (NO MORE THAN 10 SECONDS), start CPR if no pulse, provide rescue breathing if pulse is present, and defibrillation.

What should be done if the patient presents without a pulse?

Chest compressions, hard and fast. Signup and view all the answers

What is the rate of chest compressions?

100-120 compressions per minute. Signup and view all the answers

What is the rate of rescue breaths?

1 breath every 5 seconds. Signup and view all the answers

What is the maximum time taken to check for a pulse?

10 seconds. Signup and view all the answers

What should be the quality of the chest compressions?

Hard and fast. Signup and view all the answers

Where is the appropriate hand placement for compressions?

Lower half of sternum. Signup and view all the answers

What is the CPR compression to breath ratio?

30:2. Signup and view all the answers

What is the appropriate depth of quality chest compressions?

2 inches. Signup and view all the answers

If the patient presents with a pulse, what is the appropriate course of action?

Rescue breathing ONLY at a rate of 1 breath every 5 to 6 seconds. Signup and view all the answers

What are 2 reasons to interrupt active CPR?

Pulse check (but less than 10 seconds) or AED arrival. Signup and view all the answers

What is the maximum pause time allowed during active CPR?

10 seconds. Signup and view all the answers

What should immediately follow a shock from AED/Defibrillator?

High quality CPR compressions. Signup and view all the answers

What is the effect of excessive ventilation and their associated symptoms?

Increased intra thoracic pressure decreases venous return to the heart, diminishes cardiac output, and causes gastric inflation. Signup and view all the answers

The primary ACLS survey includes __________.

ABCDE Signup and view all the answers

What are the steps for airway assessment?

Is it patent? Is advanced airway needed? Is the airway properly placed? Is it secured? Signup and view all the answers

How do you monitor airway placement?

Continuous Quantitative Waveform capnography. Signup and view all the answers

Breathing assessment steps include?

Assess ventilation and oxygenation adequacy, administer O2 PRN, monitor quantitative waveform capnography and oxyhemoglobin saturation. Signup and view all the answers

What are the steps for assessing circulation?

Monitor CPR quality, determine rhythm, assess if defibrillation/cardioversion is needed, establish IV/IO access, check glucose levels and vitals. Signup and view all the answers

What should be evaluated after circulation assessment?

Check for return of spontaneous circulation (ROSC), assess patient stability, determine if medications or volume are needed. Signup and view all the answers

Essential quality checks for CPR quality include?

Minimize interruptions and check pulse for less than 10 seconds. Signup and view all the answers

What does disability assessment involve?

Check for neuro function and assess responsiveness using AVPU. Signup and view all the answers

What does exposure assessment entail?

Removing clothing and assessing for obvious signs of trauma, bleeding, burns, or medical alert bracelet. Signup and view all the answers

What does the secondary assessment survey SAMPLE stand for?

Signs/Symptoms, Allergies, Medications, Past medical history. Signup and view all the answers

Study Notes

Cardiac Arrest ECG Rhythms

Common rhythms in cardiac arrest: Ventricular Fibrillation (Vfib), pulseless Ventricular Tachycardia (VT), Asystole, pulseless Electrical Activity (PEA).
Primary shockable rhythms: Vfib and Vtach.

BLS Initial Survey Steps

Assess responsiveness using the ABC method: Airway, Breathing, Circulation.
Activate emergency response and obtain an AED/Defibrillator.
Check for breathing and pulse within 10 seconds; initiate CPR if no pulse is detected or provide rescue breathing if pulse is present.

CPR and Chest Compressions

Perform chest compressions at a rate of 100-120 per minute.
Quality of chest compressions: must be hard and fast, aiming for a depth of 2 inches.
Maximum time allowed to check for a pulse is 10 seconds.
Compression to breath ratio for CPR is 30:2.
Appropriate hand placement for compressions is on the lower half of the sternum.
Follow AED shock immediately with high quality CPR.

Airway and Breathing Assessment

Airway assessment involves checking if it is patent, if advanced airway is needed, proper placement, and securing of the airway.
Monitor airway placement using continuous quantitative waveform capnography.
Breathing assessment: ensure adequate ventilation and oxygenation; administer 100% oxygen for cardiac arrest patients.

Circulation Assessment

Assess CPR quality and rhythm; attach AED/Defibrillator.
Establish IV/IO access and check glucose levels and vital signs; maintain minimum BP of 90 mmHg.
Evaluate whether Return of Spontaneous Circulation (ROSC) occurred and determine if the patient is stable or requires medications or volume.

Disability and Exposure Assessment

Disability assessment includes checking neuro function, responding to stimuli (AVPU scale).
Exposure assessment requires removing clothing to check for trauma, bleeding, burns, and medical alerts.

Secondary Assessment Survey

Utilize the SAMPLE method: Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading to the present illness/injury.

CPR Quality Checks

Minimize interruptions in CPR and limit pulse checks to less than 10 seconds; provide constructive feedback for ineffective compressions.

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Description

This quiz covers the essential rhythms and procedures in advanced cardiac life support (ACLS) for patients in cardiac arrest. It includes questions on ECG rhythms, shockable rhythms, and the BLS initial survey steps. Test your knowledge on ACLS guidelines from the 2019 standards.