Acls Review

Front 1

What's the first thing you do when coming across an unconscious individual?

Back 1

1. Call 911
2. Obtain a defibrillator
3. Begin basic life support

Front 2

What's the normal ratio of compressions to breaths during CPR

Back 2

30:2

Front 3

What should the depth of compressions during CPR be

Back 3

2 inches

Front 4

How many compressions per minute should you try to obtain

Back 4

100 compressions per minute

Front 5

What are the shockable rhythms

Back 5

V fib and pulseless V-Tach

Front 6

What are the nonshockable rhythms

Back 6

asystole and any pulseless electrical activity/arrhythmia

Front 7

How often should you rotate compressors during CPR

Back 7

every 2 minutes or 5 cycles

Front 8

During CPR, what does a quantitative waveform capnography reading of PETCO2 < 10mmHg suggest

Back 8

poor quality CPR

Front 9

Return of spontaneous circulation is associated with what PETCO2 value

Back 9

> 40mmHg

Front 10

What voltage is used for a biphasic shock

Back 10

120-200 J

Front 11

What voltage is used for a monophasic shock

Back 11

360 J

Front 12

What's the normal dose of epinephrine given during cardiac arrest

Back 12

1mg every 3-5 minutes

Front 13

What's the normal dose of vasopressin given during cardiac arrest

Back 13

40 units, 1 time only

Front 14

What's the normal dose of amiodarone when given for the first time during cardiac arrest

Back 14

300mg bolus

(*you can only give this dose if the person is pulseless)

Front 15

When giving a second dose of amiodarone during cardiac arrest, what's the normal dose

Back 15

150mg bolus

(*if the person has a pulse, you would use this same dosage for the 1st and 2nd dose)

Front 16

When someone has an advanced airway in place, how many breaths per minute should they be given during cardiac arrest

Back 16

8-10 breaths per minute

Front 17

10 reversible causes of cardiac arrest

Back 17

Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hypo/Hyperkalemia, Hypothermia

Tension pneumothorax, Tamponade, Toxins, Thrombosis (pulmonary and cardiac)

Front 18

With ROSC, what should the oxygen saturation be maintained at

Back 18

>94%

Front 19

Once you have ROSC and have optimized ventilation, what steps do you do next

Back 19

1. give 1-2L saline or Ringer's lactate (at 4 degrees)
2. Give a vasopressor (Epi, Dopamine, or NER)
3. Obtain a 12-lead ECG
4. Consider the 10 treatable causes

Front 20

What's the normal dosage of dopamine when given after ROSC

Back 20

5-10mcg/kg per minute

Front 21

What's the normal dose of epinephrine when given after ROSC

Back 21

0.1-0.5mcg/kg per minute

(in an average 70kg person, this comes out to 7-35mcg per minute)

Front 22

What's the normal dose of norepinephrine when given after ROSC

Back 22

0.1-0.5mcg/kg per minute

(in an average 70kg person, this comes out to 7-35mcg per minute)

Front 23

After ROSC, if the person still remains unconscious and can't follow commands, what's the next step

Back 23

induce hypothermia

Front 24

Normal heart rate associated with a bradyarrythmia

Back 24

<50/min

Front 25

1st drug used in someone with a symptomatic bradyarrythmia

Back 25

atropine- 0.5mg bolus every 3-5 minutes (max dose 3mg)

Front 26

3 alternate treatments for a symptomatic bradyarrythmia if atropine proves ineffective

Back 26

1. dopamine
2. epinephrine
3. transcutaneous pacing

Front 27

Putting someone on a transcutaneous pacer requires what other drug therapy

Back 27

a sedative and analgesic

Front 28

What's the normal dose of dopamine when given to someone with a bradyarrythmia

Back 28

2-10mcg/kg per minute

Front 29

What's the normal dose of epinephrine when given to someone with a bradyarrythmia

Back 29

2-10mcg per minute

Front 30

In what bradyarrythmias would atropine be contraindicated

Back 30

2nd and 3rd degree heart blocks

Front 31

In someone with a tachyarrythmia, what's the cutoff for the QRS value that determines the next appropiate treatments

Back 31

+- 0.12 seconds

Front 32

What's the accepted voltage for cardioversion of a narrow regular tachyarrythmia

Back 32

50-100J

Front 33

What's the accepted voltage for cardioversion of a narrow irregular tachyarrythmia

Back 33

120-200J biphasic OR 200J monophasic

Front 34

What's the accepted voltage for cardioversion of a wide regular tachyarrythmia

Back 34

100J

Front 35

What's the accepted voltage for cardioversion of a wide irregular tachyarrythmia

Back 35

You do NOT cardiovert this rhythm but rather use a defibrillator

Front 36

What's the normal dose of adenosine when given for a tachyarrhythmia

Back 36

1st dose: 6mg rapid IV push followed by a flush

2nd dose: 12mg

Front 37

What's the accepted therapy for someone with a tachyarrhythmia that has a QRS < 0.12 seconds

Back 37

vagal maneuvers
6mg Adenosine
either a B-blocker or CCB (dialtezam)
expert consultation

Front 38

3 acceptable antiarrhythmics to give to someone with a tachyarrhythmia with a QRS > 0.12 seconds

Back 38

Procainamide, Amiodarone, and Sotalol

Front 39

What's the normal dose of procainamide when given for a tachyarrhythmia

Back 39

20-50mg/min with optional maintenance infusions of 1-4mg/min

Front 40

What's the normal dose of amiodarone when given for a tachyarrhythmia

Back 40

150mg over 10 minutes with maintenance infusions of 1mg/min (after the initial 10 minutes) for the next 6 hours

Front 41

What's the normal dose of Sotalol when given for a tachyarrhythmia

Back 41

100mg (1.5mg/kg) over 5 minutes

Front 42

When would sotalol be contraindicated

Back 42

if the QT is prolonged

Front 43

What are the different drug therapies commonly used in someone suspected to have a myocardial infarction or at high risk

Back 43

Nitroglycerin
Heparin
B-blockers
Clopidogrel
Aspirin
GPIIb/IIIa inhibitors
ACE inhibitors
HMG CoA reductase inhibitors
Morphine

Front 44

What is the proper order of the ABCs you should assess prior to starting BLS

Back 44

Circulation > Airways > Breathing

These are the things you assess for each:
*Circulation: providing an adequate blood supply to tissue, especially critical organs, so as to deliver oxygen to all cells and remove metabolic waste, via the perfusion of blood throughout the body.
*Airway: the protection and maintenance of a clear passageway for gases (principally oxygen and carbon dioxide) to pass between the lungs and the atmosphere.
*Breathing: inflation and deflation of the lungs (respiration) via the airway

Front 45

First thing you always do once you stabilize a patient who presented with a heart condition

Back 45

obtain a 12-lead ECG

Front 46

What does PEA mean

Back 46

Pulseless Electrical Activity

Front 47

How many ventilations should be given to someone in respiratory arrest

Back 47

10-12 breaths/min (i.e. 1 breath every 5-6 seconds)

Front 48

What is the scale used to assess the possibility of a stroke

Back 48

Cincinatti scale

Front 49

What's the major risk of improperly securing ET tubes around the neck

Back 49

you could compress nearby arteries

Front 50

When assessing capnography, if the colored paper turns from gold to purple, what does this mean?

Back 50

their is a problem with gas exchange

Front 51

How do you know if an ET tube is in the right place

Back 51

you will see rising of the chest when given a breath, or you can listen for lung sounds when giving a breath

Front 52

physical symptoms of bradycardia

Back 52

SOB, decreased consciousness, fatigue, light-headedness, dizziness, syncope