Podcast
Questions and Answers
Which class of medications commonly given to patients with acute coronary syndromes may be adversely affected by morphine administration?
Which class of medications commonly given to patients with acute coronary syndromes may be adversely affected by morphine administration?
What is a benefit of morphine when given for the management of acute coronary syndromes?
What is a benefit of morphine when given for the management of acute coronary syndromes?
Which ECG finding is suggestive of high-risk non-ST segment elevation acute coronary syndromes?
Which ECG finding is suggestive of high-risk non-ST segment elevation acute coronary syndromes?
How would you classify the electrocardiographic findings with ST-segment elevation of 2mm in leads II, III, and aVF?
How would you classify the electrocardiographic findings with ST-segment elevation of 2mm in leads II, III, and aVF?
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What happens when teams rapidly assess and intervene when patients have abnormal vital signs?
What happens when teams rapidly assess and intervene when patients have abnormal vital signs?
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What is the goal for first medical contact-to-balloon inflation time for a patient receiving PCI?
What is the goal for first medical contact-to-balloon inflation time for a patient receiving PCI?
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What is the longest acceptable emergency department door-to-needle time when fibrinolysis is the intended reperfusion strategy?
What is the longest acceptable emergency department door-to-needle time when fibrinolysis is the intended reperfusion strategy?
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What is the time goal for completing a fibrinolytic checklist once the patient arrives in the emergency department?
What is the time goal for completing a fibrinolytic checklist once the patient arrives in the emergency department?
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What is the recommended time window after symptom onset for early fibrinolytic therapy or direct catheter-based reperfusion for patients with STEMI and no contraindications?
What is the recommended time window after symptom onset for early fibrinolytic therapy or direct catheter-based reperfusion for patients with STEMI and no contraindications?
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What will your first actions include if a patient shows symptoms suggestive of MI within the first 10 minutes?
What will your first actions include if a patient shows symptoms suggestive of MI within the first 10 minutes?
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When considering oxygen saturation for a patient with HR 120/min, BP 135/88, RR 23, O2 87%, what is your course of action?
When considering oxygen saturation for a patient with HR 120/min, BP 135/88, RR 23, O2 87%, what is your course of action?
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What additional questions help you determine next steps in patient treatment?
What additional questions help you determine next steps in patient treatment?
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What treatment can you repeat as long as it is not contraindicated by vital signs?
What treatment can you repeat as long as it is not contraindicated by vital signs?
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What is your interpretation of the patient's EKG tracing with STEMI in V2-6?
What is your interpretation of the patient's EKG tracing with STEMI in V2-6?
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What is the most probable treatment with the possible diagnosis of STEMI?
What is the most probable treatment with the possible diagnosis of STEMI?
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What is the goal for PCI when treating a patient?
What is the goal for PCI when treating a patient?
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Which action is part of the secondary assessment of a conscious patient?
Which action is part of the secondary assessment of a conscious patient?
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What is the most common type of stroke?
What is the most common type of stroke?
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What is the recommended time window after symptom onset for early fibrinolytic therapy or direct catheter-based reperfusion for patients with STEMI and no contraindications?
What is the recommended time window after symptom onset for early fibrinolytic therapy or direct catheter-based reperfusion for patients with STEMI and no contraindications?
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What validated, abbreviated out-of-hospital neurologic evaluation tool contains 3 components: facial droop, arm drift, and abnormal speech test?
What validated, abbreviated out-of-hospital neurologic evaluation tool contains 3 components: facial droop, arm drift, and abnormal speech test?
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What is the estimated probability of the CPSS with 1 abnormal finding when scored by prehospital providers?
What is the estimated probability of the CPSS with 1 abnormal finding when scored by prehospital providers?
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Which stroke severity tool helps EMS differentiate large vessel occlusion stroke from non-large vessel occlusion stroke?
Which stroke severity tool helps EMS differentiate large vessel occlusion stroke from non-large vessel occlusion stroke?
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What is the primary advantage of using a stroke severity tool?
What is the primary advantage of using a stroke severity tool?
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During CPR, CCF should be at least ______% and ideally greater than _____%.
During CPR, CCF should be at least ______% and ideally greater than _____%.
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What is an advantage of EMS alerting the receiving facility of the impending arrival of a patient with suspected acute ischemic stroke?
What is an advantage of EMS alerting the receiving facility of the impending arrival of a patient with suspected acute ischemic stroke?
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What is the time goal for neurologic assessment by the stroke team or designee and non-contrast computed tomography or MRI performed after hospital arrival?
What is the time goal for neurologic assessment by the stroke team or designee and non-contrast computed tomography or MRI performed after hospital arrival?
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What is the time goal for initiation of fibrinolytic therapy in appropriate patients without contraindication after hospital arrival?
What is the time goal for initiation of fibrinolytic therapy in appropriate patients without contraindication after hospital arrival?
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What is the door-to-needle time goal for 85% or more of acute ischemic stroke patients treated with IV thrombolytics?
What is the door-to-needle time goal for 85% or more of acute ischemic stroke patients treated with IV thrombolytics?
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What is the door-to-device time goal for direct arriving patients with acute ischemic stroke treated with endovascular therapy?
What is the door-to-device time goal for direct arriving patients with acute ischemic stroke treated with endovascular therapy?
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Evidence suggests that there is a higher likelihood of good to excellent functional outcome when alteplase is given to adults with an acute ischemic stroke within what time frame?
Evidence suggests that there is a higher likelihood of good to excellent functional outcome when alteplase is given to adults with an acute ischemic stroke within what time frame?
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What is the maximum time from last known normal when endovascular therapy can be performed?
What is the maximum time from last known normal when endovascular therapy can be performed?
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What is the maximum time from last known normal when intra-arterial thrombolysis for select patients can be used for treatment?
What is the maximum time from last known normal when intra-arterial thrombolysis for select patients can be used for treatment?
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Identify the SBP threshold for withholding fibrinolytic therapy to otherwise eligible patients with acute ischemic stroke.
Identify the SBP threshold for withholding fibrinolytic therapy to otherwise eligible patients with acute ischemic stroke.
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What is the DBP threshold for withholding fibrinolytic to otherwise eligible patients with acute ischemic stroke?
What is the DBP threshold for withholding fibrinolytic to otherwise eligible patients with acute ischemic stroke?
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Which action is not part of the acute stroke pathway?
Which action is not part of the acute stroke pathway?
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What BG should trigger the administration of IV or subQ insulin for a patient with acute ischemic stroke?
What BG should trigger the administration of IV or subQ insulin for a patient with acute ischemic stroke?
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What additional assessment and stabilization activities should be completed for a patient presenting with sudden left arm weakness and left-sided paralysis?
What additional assessment and stabilization activities should be completed for a patient presenting with sudden left arm weakness and left-sided paralysis?
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What needs to be completed for this patient within 20 mins after hospital arrival?
What needs to be completed for this patient within 20 mins after hospital arrival?
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What are some of the general questions you need to ask a patient presenting symptoms?
What are some of the general questions you need to ask a patient presenting symptoms?
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Is this patient a potential candidate for fibrinolytic therapy if the neuroimaging interpretation suggests an acute ischemic infarction without signs of hemorrhage or mass lesions?
Is this patient a potential candidate for fibrinolytic therapy if the neuroimaging interpretation suggests an acute ischemic infarction without signs of hemorrhage or mass lesions?
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What actions should the hospital staff take to determine whether the patient is a candidate for fibrinolytic therapy?
What actions should the hospital staff take to determine whether the patient is a candidate for fibrinolytic therapy?
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Is this patient still a candidate for fibrinolytic therapy if the patient's neurologic function is rapidly improving?
Is this patient still a candidate for fibrinolytic therapy if the patient's neurologic function is rapidly improving?
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Because the patient is no longer a candidate for fibrinolytic therapy, what are your next steps for him?
Because the patient is no longer a candidate for fibrinolytic therapy, what are your next steps for him?
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What tidal volume typically maintains normal oxygenation and elimination of carbon dioxide?
What tidal volume typically maintains normal oxygenation and elimination of carbon dioxide?
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What is the term for the rise in arterial carbon dioxide levels typically associated with respiratory failure?
What is the term for the rise in arterial carbon dioxide levels typically associated with respiratory failure?
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How much tidal volume must you provide with a bag mask device to produce visible chest rise for an adult patient in respiratory arrest?
How much tidal volume must you provide with a bag mask device to produce visible chest rise for an adult patient in respiratory arrest?
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What device on a resuscitation bag mask device may prevent sufficient tidal volume in patients with poor lung compliance?
What device on a resuscitation bag mask device may prevent sufficient tidal volume in patients with poor lung compliance?
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Patients with perfusing rhythms should receive ventilation once every _____ seconds.
Patients with perfusing rhythms should receive ventilation once every _____ seconds.
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What is the most effective way to deliver bag mask ventilation?
What is the most effective way to deliver bag mask ventilation?
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How long should the second rescuer squeeze the bag mask device when providing 2 rescuer ventilation?
How long should the second rescuer squeeze the bag mask device when providing 2 rescuer ventilation?
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When performing the jaw thrust maneuver on patients with suspected cervical spine injury, where should you place your fingers?
When performing the jaw thrust maneuver on patients with suspected cervical spine injury, where should you place your fingers?
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When you use a bag mask device you should deliver 500- _______ mL tidal volume.
When you use a bag mask device you should deliver 500- _______ mL tidal volume.
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In which of the following patients can nasopharyngeal airways be used?
In which of the following patients can nasopharyngeal airways be used?
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Select the first step in the use of an oropharyngeal airway.
Select the first step in the use of an oropharyngeal airway.
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What is a potential complication of inserting an oropharyngeal airway?
What is a potential complication of inserting an oropharyngeal airway?
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The length of a correctly sized nasopharyngeal airway is the same as the distance from the tip of the patient's nose to the _____?
The length of a correctly sized nasopharyngeal airway is the same as the distance from the tip of the patient's nose to the _____?
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What is a potential complication using a nasopharyngeal airway that is too long?
What is a potential complication using a nasopharyngeal airway that is too long?
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What is the most serious potential complication of nasopharyngeal airway insertion into a patient with facial trauma?
What is the most serious potential complication of nasopharyngeal airway insertion into a patient with facial trauma?
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What is the max length of suction catheter that should be inserted into the patient's oropharynx beyond the tongue?
What is the max length of suction catheter that should be inserted into the patient's oropharynx beyond the tongue?
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What is the most reliable method of confirming and monitoring correct placement of an ET tube?
What is the most reliable method of confirming and monitoring correct placement of an ET tube?
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What is the recommended ventilation rate for an adult in cardiac arrest with an advanced airway device in place?
What is the recommended ventilation rate for an adult in cardiac arrest with an advanced airway device in place?
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What initial actions should be taken for a patient who loses consciousness upon arrival at the ED after experiencing severe shortness of breath?
What initial actions should be taken for a patient who loses consciousness upon arrival at the ED after experiencing severe shortness of breath?
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What should your initial actions include if the patient is unresponsive and not breathing but has a strong pulse?
What should your initial actions include if the patient is unresponsive and not breathing but has a strong pulse?
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What is the recommended rate for rescue breaths for a patient in respiratory distress?
What is the recommended rate for rescue breaths for a patient in respiratory distress?
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Which signs and symptoms indicate symptomatic bradycardia?
Which signs and symptoms indicate symptomatic bradycardia?
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What is the interpretation of PR intervals being uniform but random QRS dropped?
What is the interpretation of PR intervals being uniform but random QRS dropped?
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What is the interpretation of having more P waves than QRS with an absence of relationship between the P wave and QRS?
What is the interpretation of having more P waves than QRS with an absence of relationship between the P wave and QRS?
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What is the definition of bradycardia?
What is the definition of bradycardia?
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Study Notes
Acute Coronary Syndromes (ACS) and Treatment
- Morphine administration can negatively affect oral antiplatelet medications used during acute coronary syndromes.
- Morphine provides central nervous system analgesia, beneficial for managing acute coronary syndromes.
- A 12-lead ECG revealing dynamic T-wave inversion indicates high-risk non-ST elevation acute coronary syndromes.
- ST-segment elevation of 2mm in leads II, III, and aVF on ECG classifies as STEMI (ST-Elevation Myocardial Infarction).
- Rapid assessment and intervention for abnormal vital signs reduce in-hospital cardiac arrest rates.
Timeliness in Acute Care
- The goal for first medical contact to balloon inflation time for PCI (Percutaneous Coronary Intervention) is 90 minutes.
- Acceptable emergency department door-to-needle time for fibrinolysis is 30 minutes.
- Completion of a fibrinolytic checklist should occur within 10 minutes upon patient arrival in the emergency department.
- Early fibrinolytic therapy or direct catheter-based reperfusion should be initiated within 12 hours of symptom onset for STEMI patients.
Initial Patient Management
- In cases of MI symptoms, actions include prehospital notification, aspirin administration, cardiac assessment, and obtaining an ECG.
- For oxygen saturation below 90%, start oxygen therapy at 4L.
- Patient responses regarding symptom onset, medications, and allergies are vital for determining next steps.
- Sublingual nitroglycerin may be repeated every 3-5 minutes if not contraindicated.
Stroke Assessment and Management
- Cincinnati Prehospital Stroke Scale evaluates stroke risk with components like facial droop and abnormal speech tests, yielding a 72% probability of identifying a stroke with one abnormal finding.
- Acute ischemic stroke treatment protocols stress timely assessments: neurologic assessment within 20 minutes, initiation of fibrinolytic therapy within 45 minutes.
- The maximum time from the last known normal for endovascular therapy is 24 hours.
Respiratory Management
- A tidal volume of 6-8 mL/kg is crucial for maintaining adequate oxygenation and carbon dioxide elimination.
- Signs of respiratory distress include increased respiratory rate and low oxygen saturation.
- Hypercapnia refers to elevated arterial carbon dioxide levels associated with respiratory failure.
- Effective bag-mask ventilation utilizes a 2-person technique for optimal delivery.
Airway Management
- The first step for using an oropharyngeal airway is clearing the mouth and pharynx.
- Complications can arise from improper airway insertion, such as pushing the tongue back or misplacement into the cranial cavity.
- Nasopharyngeal airways are suitable for unconscious or semi-conscious patients; correct length corresponds to the distance from nose to earlobe.
Cardiac Rhythms and Interventions
- Symptomatic bradycardia presents with symptoms such as chest pain and altered mental status.
- Types of heart block include second-degree type II, characterized by dropped QRS complexes, and third-degree AV block, showing more P waves than QRS without a relationship.
- Low oxygen saturation (SpO2) in patients warrants rescue breaths every 6 seconds to ensure adequate ventilation.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge with ACLS 2021 flashcards. This quiz focuses on key medications and their effects in managing acute coronary syndromes. Each question aids in understanding critical care practices and pharmacology relevant to emergency response.
