Podcast
Questions and Answers
Check the pulse for no more than ____ seconds, but for at least ____ seconds.
Check the pulse for no more than ____ seconds, but for at least ____ seconds.
10, 5
Chest compressions should be done at this range per minute: ____ - ____.
Chest compressions should be done at this range per minute: ____ - ____.
100-120
Compression depth for children and adults should be ____ inches (no more than 2.4 in).
Compression depth for children and adults should be ____ inches (no more than 2.4 in).
2
Minimize interruptions during CPR to less than ____ seconds.
Minimize interruptions during CPR to less than ____ seconds.
What technique relieves airway obstruction in an unresponsive victim where trauma is not suspected?
What technique relieves airway obstruction in an unresponsive victim where trauma is not suspected?
What is used if head or neck injury is suspected to open the airway?
What is used if head or neck injury is suspected to open the airway?
What is the ratio of chest compressions to breaths during CPR?
What is the ratio of chest compressions to breaths during CPR?
When an advanced airway is in place, give 1 breath every ____ seconds during CPR.
When an advanced airway is in place, give 1 breath every ____ seconds during CPR.
What treatment is considered the choice in a responsive choking adult?
What treatment is considered the choice in a responsive choking adult?
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?
PETCO2 minimum level during CPR should be at least ____.
PETCO2 minimum level during CPR should be at least ____.
What are the two shockable rhythms?
What are the two shockable rhythms?
What are the two non-shockable rhythms?
What are the two non-shockable rhythms?
Epinephrine dose and frequency during CPR, and symptomatic bradycardia is ____ mg every ____ minutes.
Epinephrine dose and frequency during CPR, and symptomatic bradycardia is ____ mg every ____ minutes.
Monophasic pulseless VTach or VFib should be shocked with ____ J.
Monophasic pulseless VTach or VFib should be shocked with ____ J.
Start with ____ J defibrillation in biphasic VFib or pulseless VTach.
Start with ____ J defibrillation in biphasic VFib or pulseless VTach.
What is the antiarrhythmic drug of choice for pulseless VTach or VFib?
What is the antiarrhythmic drug of choice for pulseless VTach or VFib?
Initial amiodarone dose for pulseless VTach or VFib is ____ mg.
Initial amiodarone dose for pulseless VTach or VFib is ____ mg.
The second dose amount for amiodarone if needed for pulseless VTach or VFib is ____ mg.
The second dose amount for amiodarone if needed for pulseless VTach or VFib is ____ mg.
Max amiodarone dose is ____ mg.
Max amiodarone dose is ____ mg.
What are the 5H reversible causes of cardiac arrest?
What are the 5H reversible causes of cardiac arrest?
What are the 5T reversible causes of cardiac arrest?
What are the 5T reversible causes of cardiac arrest?
What does ROSC stand for?
What does ROSC stand for?
When a patient goes to ROSC, begin fluid bolus of normal saline to achieve minimum systolic BP of ____.
When a patient goes to ROSC, begin fluid bolus of normal saline to achieve minimum systolic BP of ____.
What are two medications that can be infused during ROSC for hypotension?
What are two medications that can be infused during ROSC for hypotension?
Door to balloon time for known post-code STEMIs should be within ____ minutes.
Door to balloon time for known post-code STEMIs should be within ____ minutes.
Door to needle time for fibrinolytic therapy for ACS should be within ____ minutes.
Door to needle time for fibrinolytic therapy for ACS should be within ____ minutes.
What is the treatment for asymptomatic bradycardia?
What is the treatment for asymptomatic bradycardia?
What is the first-line treatment for symptomatic bradycardia?
What is the first-line treatment for symptomatic bradycardia?
What is the next step if atropine doesn't work for symptomatic bradycardia?
What is the next step if atropine doesn't work for symptomatic bradycardia?
What are two medications to consider for infusion in those with symptomatic bradycardia?
What are two medications to consider for infusion in those with symptomatic bradycardia?
What are vagal maneuvers used for?
What are vagal maneuvers used for?
What is the first-line treatment for stable supraventricular tachycardia that is symptomatic?
What is the first-line treatment for stable supraventricular tachycardia that is symptomatic?
First adenosine dose for stable regular narrow complex symptomatic tachycardia is ____ mg.
First adenosine dose for stable regular narrow complex symptomatic tachycardia is ____ mg.
Second adenosine dose for stable symptomatic narrow complex tachycardia if the first dose doesn't work is ____ mg.
Second adenosine dose for stable symptomatic narrow complex tachycardia if the first dose doesn't work is ____ mg.
What is first-line treatment for unstable supraventricular tachycardia?
What is first-line treatment for unstable supraventricular tachycardia?
What medication is infused 150mg/10 minutes for VTach with a pulse?
What medication is infused 150mg/10 minutes for VTach with a pulse?
What is the first-line treatment for unstable VTach with a pulse?
What is the first-line treatment for unstable VTach with a pulse?
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Study Notes
CPR and Basic Life Support
- Pulse check duration: check for no more than 10 seconds, but for at least 5 seconds.
- Compression rate: aim for 100-120 compressions per minute during CPR.
- Compression depth for adults and children: maintain at 2 inches (maximum of 2.4 inches).
- Interruptions during CPR: minimize to less than 10 seconds.
Airway Management Techniques
- Head tilt-chin lift: use to relieve airway obstruction in unresponsive victims without suspected trauma.
- Jaw thrust: method employed when a head or neck injury is possible, to open the airway.
CPR Compression to Breath Ratios
- Chest compressions to breaths ratio: maintain a ratio of 30:2.
- If advanced airway in place, administer 1 breath every 6 seconds.
Choking Emergency Responses
- Use the Heimlich maneuver for responsive choking adults; if unresponsive, begin CPR.
Monitoring and Equipment
- Continuous waveform capnography: most reliable for confirming ET tube placement and ensuring adequate chest compressions.
- Minimum PETCO2 level during CPR: should be above 10 mmHg; if not, reassess compressions.
Cardiac Arrest Rhythms
- Two shockable rhythms: Pulseless Ventricular Tachycardia (VTach) and Ventricular Fibrillation (VFib).
- Two non-shockable rhythms: Pulseless Electrical Activity (PEA) and Asystole.
Medication Protocols
- Epinephrine: dose of 1mg every 3-5 minutes during CPR and symptomatic bradycardia.
- Shock settings for VTach/VFib:
- 360 J for monophasic rhythms.
- 120 J for biphasic VFib or pulseless VTach.
- Amiodarone: first dose of 300mg for pulseless VTach/VFib; second dose 150mg if needed; maximum total dose is 450mg.
Reversible Causes of Cardiac Arrest
- 5 H's: Hypovolemia, Hypoxia, Hydrogen ions, Hypo/Hyperkalemia, Hypo/Hyperthermia.
- 5 T's: Tension pneumothorax, Thromboembolism (PE), Thrombosis (MI), Tamponade, Tablets/Toxins (OD).
Return of Spontaneous Circulation (ROSC)
- ROSC is indicated by the return of a pulse and effective blood flow after cardiac arrest.
- Initiate fluid bolus of normal saline to achieve a minimum systolic BP of 90 mmHg after ROSC.
Post-Cardiac Arrest Care
- Medications for hypotension during ROSC: Dopamine and Epinephrine.
- Door-to-balloon time for post-code STEMIs: 90 minutes.
- Door-to-needle time for fibrinolytic therapy for ACS: 30 minutes.
Bradycardia Management
- Asymptomatic bradycardia: monitor and observe.
- Symptomatic bradycardia: first-line treatment is atropine (0.5mg q3-5min), with a maximum dose of 3mg.
- If atropine is ineffective, proceed to transcutaneous pacing.
- Consider dopamine and epinephrine infusions for symptomatic bradycardia.
Tachycardia Management
- Use vagal maneuvers for SVT; techniques include Valsalva, facial ice, breath-holding, and carotid massage.
- First-line treatment for stable symptomatic narrow complex tachycardia: administer 6mg adenosine; second dose is 12mg if needed.
- Synchronized cardioversion is indicated for unstable SVT and unstable VTach with a pulse.
Medication Infusions
- Infuse amiodarone (150mg/10 minutes) for VTach with a pulse.
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