BLS and ALS Study Guide

• Study notes for BLS and ALS topics are below

BLS Section

• Stridor in a child indicates upper airway obstruction with high-flow O2 administration being the priority action.

• Repositioning the airway via head-tilt/chin-lift is the initial step for snoring respirations in a patient without trauma.

• An OPA is contraindicated if the patient has an intact gag reflex because of the risk of aspiration.

• A BVM to maintain the airway is the priority for an unresponsive diabetic patient with a low glucometer reading (48 mg/dL), because oral glucose is contraindicated.

• Anaphylaxis is indicated by airway compromise and hypotension while urticaria alone suggests only an allergic reaction.

• With febrile seizures, protecting the patient, protecting the airway, and preventing injury are the first priorities.

• JVD, hypotension, and absent breath sounds indicate a tension pneumothorax which requires decompression.

• Any complaint of neck pain post-trauma necessitates spinal precautions regardless of the patient's ability to walk.

• Positive pressure ventilation is needed for a limp newborn with a heart rate less than 100 and gasping respirations and compressions should only begin if the heart rate is less than 60 after ventilation

• Painful vaginal bleeding in the third trimester suggests abruptio placentae.

• Type 3 ambulances are van chassis with a modular box.

• SLUDGE symptoms (salivation, lacrimation, urination, defecation, GI upset, emesis) indicate cholinergic toxidrome with organophosphates likely involved.

• During triage, a red tag is given to patients with breathing greater than 30/min, a capillary refill greater than 2 seconds, or altered mental status.

ALS Section

• ETCO2 waveform is the gold standard for confirming tube placement after intubation.

• Muscle rigidity or myoclonus can occur after etomidate administration during RSI.

• Immediate cardioversion is needed for a wide-complex tachycardia with signs of instability.

• P waves before every QRS and a slow rate indicate sinus bradycardia.

• High-quality CPR is most critical in asystole.

• Magnesium sulfate is the first-line treatment for torsades de pointes.

• Dopamine drip calculation for a 75 kg patient at 10 mcg/kg/min using a concentration of 800 mg in 500 mL: calculate to be 35 mL/hr

  • Dose (mcg/kg/min) × Weight (kg) × 60 / Concentration (mcg/mL)

• Fluid resuscitation is the first-line treatment for hypotension due to nitroglycerin.

• Peaked T waves and a wide QRS are hallmarks of hyperkalemia.

• IV/IN naloxone should be administered by ALS providers for severe opiate overdose with respiratory depression.

• IM glucagon is the next best intervention for an unresponsive hypoglycemic patient if there is no IV access.

• Morphine is contraindicated if SBP is under 100 mmHg because it can worsen the hypotension.