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33 Cards in this Set
- Front
- Back
- 3rd side (hint)
End Total CO2 Goal (PETCO2) |
30-40 mm Hg |
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94% or > |
O2 in post-cardiac care phase |
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O2 during initial resuscitation |
100% |
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Temp x 24 hr s/post Cardiac Arrest in a comatose pt with ROSC |
32-36° C, or 89.6-95.2° F |
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MAP Goal for titration meds s/post Cardiac Arrest |
65 mm/Hg or > |
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Quality Compression depth |
2 ", and no > 2.4" |
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Compression Rate |
100-120/Minute |
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Rescue Breathing rate |
1 breath every 5-6 seconds |
(Ensuring they still have a pulse every 2 minutes) |
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List he most common causes of Cardiac Arrest |
H's: 1. Hypovolemia,2. Hypoxia, 3.Hydrogen Ion (Acidosis), 4. Hypo/Hyperkalemia, 5. Hypothermia T's: 1. Tension Pneumothorax, 2. Tamponade, 3. Toxins, 4. Thrombosis (pulmonary), 5. Thrombosis (coronary) |
5 H'S & 5 T's |
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2 Common causes of PEA |
Hypovolemia & Hypoxemia |
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Excessive Ventilation may cause what? |
Cerebral Vasoconstriction (reducing blood flow to the brain) |
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How strong should ventilations be? |
1. *strong enough to produce visible chest rise (500-600 ml OR 6-7 mm/kg) *pts with airway obstruction or poor lung compliance may require > pressures, neccisating bypassing the pressure relief valve on some bags mask devices). |
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Nitroglycerin contra-indications |
1.RV Infarction/Inferior wall MI (RV infarction may complicate an inferior wall MI). NOTE: if R.sided pre-cordial leads confirm RV infarction, MOSO4 & other vasodilators or volume depleting drugs are contraindicated as well (the right ventricalfilling pressures have to maintain cardiac output). 2. Hypotension, bradycardia/ Tachycardia 3. Phosphodiesterase use: sildenafil/Vardenafil <24 hr OR Tadalafil <48 hr. (cause severe hypotension with vasopressors) |
3 Major considerations/contraindications |
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Physiological effects of nitrates |
Reduction in both right & left ventricular pre-load through peripheral arterial & venous dilation (Pt must be hemodynamically stable with SBP >90 or no lower than 30 mm Hg below baseline, and ♡rate 50-100 bpm. |
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MOSO4; Opiate indications for ACS use for STEMI (NOT FOR NSTEMI--> increased mortality!) |
1. Analgesia: < neuro hormonal activation, catecholamines, ~<O2 demand. 2. >venodilation (~ < LV pre-load & O2 demand) 3. < systemic vascular resistance, ~< LV after load. 4. Helps redistribute blood volume in acute pulmonary edema pt's. |
somewhat of a series of 4 cascade events |
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IF a 12 lead ECG indicates a STEMI, what checklist should be done? |
Fibronolytic checklist |
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Timing of fibronolytics |
given within 30 min of arrival OR PCI within 90 min of arrival |
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3 Classifications of ST Segment deviation |
1. STEMI 2. NSTE-ACS (ST depression or dynamic T-wave inversion) 3. Low/Intermediate-risk ACS (Normal, or non-dx'stc ECGL |
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Delays of therapy for STEMI (out of hospital delays are only 5%; most delays occur in hospital->25-33%). |
1. Door:data (ECG) 2. Data:decision 3. Decision:Drug ( or PCI) |
"4 D's", really 3 D's |
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IV Nitro treatment goals |
1. Relief of chest discomfort (titration to effect while maintaining SBP >90 mm hg; Limit drop of SBP to 30 mm Hg below pt baseline in hypertensive pt's). 2. Improvement in pulmonary edema and hypertension (titrate to effect, limit drop to 10% of baseline in normotensive pt's, limit drop in SBP to 30 mm Hg below baseline in hypertensive patients). |
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IV Nitro Indications |
1. Recurrent or continuing chest discomfort unresponsive to s.l. or spray Nitro 2. Pulmonary edema complicating STEMI 3. HTN complicating STEMI |
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ECG vs CT-->>which takes priority in Arrhythmia with Stroke? |
CT!! No Arrhythmia is specific for stroke, and many pt's with Stroke may show Arrhythmia, but if the pt is hemodynamically stable, most Arrhythmia will not require treatment |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , 1st general assessment due: |
10 minutes |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Immediate NEUROLOGICAL assessment due: |
25 minutes |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Acquisition of CT scan: |
25 min |
same time alottment as the NEUROLOGICAL assessment |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Interpretation of CT scan due: |
45 min. |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Administration of fibronolytics (timed FROM ER arrival): |
60 min!!! |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Administration of fibronolytics from ONSET of sx's: |
3 hr, or 4.5 hr in selected pt's |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , Administration of endovascular therapy (timed from ONSET of sx's) |
6 hr in selected pt's |
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National Institute of Neurological Disorders and Stroke (NINDS) time line , admission to a monitored bed: |
3 hr |
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3 Inclusion Criteria for rTPA |
1. It's happenned within 3 hr before beginning treatment 2. >18 yr old 3. Dx of ISCHEMIC stroke causing measurable neuro defect |
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Shockable Rhythm (2) |
V-fib, & Pulseless V-tach |
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NONSHOCKABLE rhythms (2) |
PEA, Asystole |
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