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ACLS Advanced Cardiovascular Life
Support 2023 23 QUESTIONS AND
ANSWERS
Start CPR, beginning with? Compression rate? Where is hand placement? Compression depth? - answer Chest compression. 100-120 compressions/minute. Mid-nipple line and lower half of breastbone. 2 inches to 2.4 inches depth What to do before approaching a patient? Start CPR after confirming that a patient has what? How long does it take to confirm a pulse or no pulse? Which type of sound is not considered a normal breathing pattern?
Which type of sound is a sign of cardiac arrest? - answer The scene is safe prior to approaching the patient. No pulse. Minimum of 5, but no more than 10 seconds to confirm pulse or no pulse. Agonal gasoing is not considered a normal breathing pattern. Agonal gasping is a sign of cardiac arrest. chest recoils between compressions allows for what function? Compression interruptions limited to how many seconds? How often to rotate compression and rescue breathing? - answer For the heart to adequately refill between each compressions. Interruptions are Limited to less than 10 seconds. Switch compressors every 2 minutes. For airway maintenance, Which technique is used for suspected trauma versus no suspected trauma? How to ensure adequate breaths? What to do keep the bag mask valve from leaking? What to do if no method of breathing is available?
Compression to ventilation ratio for adults - answer 30 compressions to 2 breaths during single or multiple rescuer CPR. How often to ventilate a patient with or without an advanced airway and for cardiac arrest with an advanced airway? Always look for what to confirm adequate ventilations? Why avoid excessive ventilation during CPR? - answer 1 breath every 6 seconds for respiratory arrest with or without an advanced airway and for cardiac arrest with an advanced airway. Always look for visible rise of chest. Excessive ventilation can lead to decreased blood flow and gastric inflation. When to use defibrillation once it is available? If patient requires electrical shock from defibrillator, what can still be done to minimize interruption? When is it appropriate to stop CPR within a two-minute cycle is appropriate? After AED is in place, we will only use what for two minute pause-pulse check? When the AED prompts to defibrillate, what must be done before pressing the shock button? After defibrillation, what to do next? - answer Immediately.
While the defibrillator is charging up a shock. When the AED device is about to deliver an electrical shock. AED is used only after the two minute pause/pulse check. Clear bystanders and healthcare providers before defibrillation. Immediately resume and Start CPR. Adult pads should he used on who? What to do on a chest if adult pads during snow? What to do if patient was submerged in water? What to do if chest is hairy? - answer Adult patients. Clear the snow on chest. Remove patient out of water and wipe the victims chest. Medical razor to shave chest. In a responsive choking adult what to perform?
What are the defibrillator joules setting for biphasic or mono-phasic for both Pulseless ventricular tachycardia and ventricular fibrillation? What setting should the joules be set to when delivering second or subsequent shocks? What joules setting to use if unknown? - answer If unknown, use maximum setting available. Biphasic: initial 120-200 joules. Second and subsequent doses should be equal or higher. Monophasic: 360 joules Drug therapy for pulseless ventricular tachycardia and ventricular fibrillation. How many mg for epinephrine? How often can we give epinephrine? How many mg for amiodarone 1st and 2nd dose? What is the maximum mg total for amiodarone? How many mg for lidocaine 1st and 2nd dose? - answer Epinephrine 1mg every 3-5 minutes. Amiodarone 1st dose is 300 mg. Amiodarone 2nd dose is 150 mg. Max amiodarone dose total is 450mg.
Lidocaine 1st dose is 1 to 1.5 mg/kg. Lidocaide 2nd dose is 0.5 to 0.75 mg/kg. What is pulseless electrical activity (PEA)? PEA includes what rhythms and what block? Pulseless rhythm that are excluded by definition include what 3? What are the 2 most common causes of PEA? - answer Any organized rhythm without a pulse is defined as PEA. Sinus rhythm without a detectable pulse is called PEA. Idioventricular or ventricular escape rhythms. Sinus rhythm. Atrial fibrillation or flutter. Bundle branch block. Pulseless rhythms that are excluded by definition include VF, pVT, and asystole. Hypovolemia and hypoxia are the 2 most common underlying, potentially reversible causes of PEA. Drug therapy for pulseless electrical activity and asystole. How much epinephrine to give? How often to give epinephrine?
Obtain 12-lead ECG. STEMI present. Unstable cardiogenic shock. Mechanical circulatory support. ROSC comatose intervention - answer Targeted temperature management. Obtain EEG monitoring. Obtain Brain CT. Bradycardia, 1st degree, 2nd degree type 1 or type 2, and 3rd degree block treatment. - answer Symptomatic bradycardia is treated with atropine 1mg every 3-5 minutes (max 3mg). If atropine is ineffective, consider transcutaneous pacing. Dopamine 5-20 mcg/kg/min. Consider epinephrine 2-10 mcg per minute infusion. Supraventricular Tachycardia (SVT) treatment: stable vs unstable. - answer If stable, use the Vagal maneuver. adenosine
- 6mg rapid IV push.
- After 1-2 minutes, then 12mg if no conversion. If unstable, perform synchronized cardioversion. Ventricular tachycardia with a pulse - answer Administer 150 mg over 10 minutes.
If unstable, perform synchronized cardioversion. acute coronary syndrome (ACS) treatment - answer Immediately obtain 12-lead ECG. Administer 162-335 mg of aspirin if no contraindications. Administer nitroglycerin sublingual or translimgual. -caution if right ventricular AMI is present. -caution if known sexual enhancements drug was used. Administer oxygen. Administer morphine in 2mg increments for pain relief. door-to-balloon within 90 minutes. Stroke treatment - answer 1. Perform Cincinnati stroke scale assessment.
- Alert receiving hospital ASAP.
- Perform non-contrast Head CT with 25 minutes arrival at ED.
- Start fibrinolytic therapy if no hemorrhage. Team dynamic, open loop, close loop, team leaders, tasks, rapid response team - answer Open loop: ask questions during resuscitation. Close loop: confirm/repeat orders Team leaders: address team members for issues, clearly delegate tasks.
