Questions and Answers
What is an effect of excessive ventilation?
Decreased Cardiac Output
Which is the recommended next step after a defibrillation attempt?
Resume CPR, starting with chest compressions.
How does complete chest recoil contribute to effective CPR?
Allows maximum blood return to the heart.
What is an advantage of a systematic approach to patient assessment?
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What is the first step in the systematic approach to patient assessment?
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Which action is part of the Secondary Assessment of a conscious patient?
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Which is one of the H's and T's that represent a potentially reversible cause of cardiac arrest?
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What should be the primary focus of the CPR Coach on a resuscitation team?
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The CPR Coach role can be blended into which of the following roles?
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What is the recommended compression rate for high-quality CPR?
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Which best describes the length of time it should take to perform a pulse check during the BLS Assessment?
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Compression depth should be at least how many inches?
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Which component of high-quality CPR directly affects chest compression fraction?
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Normal ETCO2 is between -
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To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
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What is the acceptable method of selecting an appropriately sized oropharyngeal airway?
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What is the difference between stable angina and unstable angina?
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What is the recommended dose of aspirin if not contraindicated?
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Contraindications for aspirin for ACS include:
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Contraindications for Nitro include:
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Adjunctive treatments for STEMI include:
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What is the preferred reperfusion strategy for STEMI?
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What is the initial drug therapy for ACS?
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Contraindications to fibrinolytic therapy include:
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SBP should be less than ___ and DBP should be less than ___ for TPA.
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What is the time goal for neurologic assessment by the stroke team or designee and non-contrast CT or MRI performed after hospital arrival?
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What is the primary time window for the administration of fibrinolytic therapy, timed from the onset of symptoms?
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Patients who don't meet the time criteria for IV fibrinolytics may be candidates for endovascular therapy up to ___ after last known normal.
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Reasons to treat bradycardia include:
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Treatment choices for bradycardia in order include:
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2nd Degree Type 1 AV block (Wenckebach) defining factor?
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2nd Degree Type 2 AV block defining factor?
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3rd Degree AV block defining factor?
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Symptoms of tachycardia that require treatment include:
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Treatment of persistent tachyarrhythmias is...
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If there is a regular narrow complex with persistent tachycardia, what med should be considered?
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If a patient is stable with a wide QRS >= 0.12 seconds, what should be considered?
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For stable patients with tachyarrhythmias with a narrow complex QRS, what treatments should be considered?
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Contraindications for Adenosine include:
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A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next?
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A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next?
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Epinephrine can be given every - minutes.
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A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with a polymorphic ventricular tachycardia on the monitor. Which action is indicated next?
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A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first?
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A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be given next?
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What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest?
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During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range?
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Study Notes
CPR and Resuscitation
- Excessive ventilation can lead to decreased cardiac output.
- After defibrillation, immediate resumption of CPR is vital, starting with chest compressions.
- Complete chest recoil during CPR enhances blood return to the heart, optimizing effectiveness.
- The CPR Coach's primary responsibility is to ensure high-quality CPR delivery within the resuscitation team.
- The recommended compression rate for high-quality CPR is 100 to 120 compressions per minute, with a compression depth of at least 2 inches.
- During the BLS assessment, a pulse check should be conducted within 5 to 10 seconds.
Patient Assessment
- A systematic approach to patient assessment minimizes the risk of overlooking critical signs or symptoms.
- The initial impression is the first step in a thorough patient assessment, crucial for guiding subsequent evaluations.
- The secondary assessment of a conscious patient should include formulating a differential diagnosis.
Cardiac Arrest Causes and Management
- Hypothermia is one of the reversible causes of cardiac arrest identified in the "H's and T's".
- Aspirin is recommended for acute coronary syndrome, with a dosage of 162-325 mg if not contraindicated (e.g., allergy, recent GI bleed).
ACS and Emergency Interventions
- First-line medications for acute coronary syndrome include oxygen (if necessary), aspirin, nitroglycerin, and morphine (if indicated).
- Contraindications for nitroglycerin include severe bradycardia, tachycardia, hypotension, recent use of phosphodiesterase inhibitors, and right ventricular infarction.
Fibrinolytic and Reperfusion Therapy
- Preferred reperfusion strategy for STEMI is percutaneous coronary intervention (PCI).
- The ideal timeframe for administering fibrinolytic therapy after symptom onset is within 3 hours.
- Patients without time criteria for IV fibrinolytics may eligible for endovascular therapy up to 24 hours after the last known normal.
Cardiac Monitoring and Drug Administration
- For bradycardia treatment, initial actions include administering atropine, followed by transcutaneous pacing or infusion of dopamine or epinephrine.
- Tachycardia treatment depends on stability; sync cardioversion is recommended for persistent tachyarrhythmias.
- For stable patients with regular narrow complex tachycardia, treatments include vagal maneuvers and adenosine; contraindications for adenosine exist for unstable or irregular tachyarrhythmias.
Post-Cardiac Arrest Care
- Post-cardiac arrest, targeted temperature management should be maintained between 32°C to 36°C for at least 24 hours.
- During resuscitation after cardiac arrest, certain drugs are administered sequentially: After epinephrine during refractory ventricular fibrillation, amiodarone may follow after initial shocks.
Important Timeframes and Measurements
- Neurologic assessments post-stroke should occur within 20 minutes of hospital arrival.
- Blood pressure parameters for administering TPA (tissue plasminogen activator) are systolic less than 185 mmHg and diastolic less than 110 mmHg.
- The typical pulse check duration during assessments is crucial, ideally taking no more than 10 seconds for accuracy.
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Test your knowledge with these flashcards focused on Advanced Cardiovascular Life Support (ACLS). Each card covers critical aspects of effective CPR, defibrillation, and ventilation strategies. Perfect for healthcare professionals preparing for ACLS certification.