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ACLS Study Guide: A Comprehensive Guide to Advanced Cardiac Life Support, Exams of Nursing

Staffordshire UniversityNursing

A comprehensive study guide for advanced cardiac life support (acls). It covers various aspects of acls, including the primary and secondary surveys, medication administration, aed usage, pea, ventilation, non-responsive patients, stable chest pain patients, nitro administration, ecg clues for various conditions, effective interventions for different conditions, and various drugs that can be administered through an endotracheal tube. It is a valuable resource for medical students, nurses, and healthcare professionals seeking to improve their knowledge and skills in acls.

Typology: Exams

2023/2024

Available from 04/15/2024

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ACLS Study Guide
Primary Survey - ✔ABCD
A-airway
B-breathing
C-circulation
D-defibrilation
Secondary Survey - ✔IAID
I-intabate (if resp. arrest or can't get good venitlaiton)
A-access airway
I-IV/IO access for Drugs
D-differential diagnosis (H's & T's)
What do you do with a non responsive patient? - ✔1st survey, then second survey
Med Administration - ✔-IV access: large bore 18 g
-Site: AC
-always flush after med admin
What do you do if AED determines non-shockable rhythm? - ✔continue chest
compressions
What is PEA? - ✔Pulseless electrical activity
(ECG shows activity but there is no pulse felt in patient)
ACLS Survey - ✔ABCD
A-airway
B-breathing
C-circulation
D-defibrilation
ACLS Airway Survey - ✔SUPPLEMENTAL OXYGEN when indicated:
-100% for cardiac arrest
-titrate others to achieve >94% O2 sats
MONITOR VENTILATION EFFECTIVENESS by:
-chest rise/fall
-cyanosis
-O2 sats
-waveform capnography
AVOID EXCESSIVE VENTILATION
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ACLS Study Guide

Primary Survey - ✔ABCD A-airway B-breathing C-circulation D-defibrilation Secondary Survey - ✔IAID I-intabate (if resp. arrest or can't get good venitlaiton) A-access airway I-IV/IO access for Drugs D-differential diagnosis (H's & T's) What do you do with a non responsive patient? - ✔1st survey, then second survey Med Administration - ✔-IV access: large bore 18 g

  • Site: AC
  • always flush after med admin What do you do if AED determines non-shockable rhythm? - ✔continue chest compressions What is PEA? - ✔Pulseless electrical activity (ECG shows activity but there is no pulse felt in patient) ACLS Survey - ✔ABCD A-airway B-breathing C-circulation D-defibrilation ACLS Airway Survey - ✔SUPPLEMENTAL OXYGEN when indicated:
  • 100% for cardiac arrest
  • titrate others to achieve >94% O2 sats MONITOR VENTILATION EFFECTIVENESS by:
  • chest rise/fall
  • cyanosis
  • O2 sats
  • waveform capnography AVOID EXCESSIVE VENTILATION

How many ventilations do you provide when patient is in cardiac arrest? With an advanced airway? In respiratory arrest only? - ✔2 ventilations every 30 compressions if advanced airway: 1 every 6-8 seconds if respiratory arrest: 1 every 5-6 seconds What do you do with a non-responsive patient? - ✔1. Shout for help/Activate the Emergency Response System (get AED)

  1. Check for Pulse
  2. Start CPR What do you do for a patient who is stable and has chest pain? - ✔Monitor-support ABC Be prepared to give CPR & Defib Admin Aspirin (O2-sats<94%, Nitro, Morphine if needed) Get 12 lead ECG Cases NOT to give Nitro - ✔hypotension (SBP < 90) bradycardia (< 50/min) tachycardia Nitro Administration - ✔1 tablet (or spray dose) every 3-5 min up to total of 3 doses H's - ✔Hypovolemia Hypoxia Hypothermia Hyper/Hypokalemia Hydrogen ions (acidosis) ECG Clues for Hypovolemia - ✔Narrow complex Rapid rate Clues from History/Physical for Hypovolemia & Effective Intervention - ✔Flat neck veins History of condition internal bleeding & severe dehydration Intervention: volume infusion ECG Clues for Hypoxia - ✔slow rate Clues from History/Physical for Hypoxia & Effective Intervention - ✔Cyanosis ABG Airway Problems Intervention: O2, ventilation, advanced airway ECG Clues for Hydrogen Ions (acidosis) - ✔Smaller-amplitude QRS Complexes

ECG Clues for Tension pneumothorax - ✔narrow complex slow rate (Hypoxia) History/Physical Clues for Tension pneumothorax & Effective Intervention - ✔history of condition no pulse felt w/CPR neck vein distention tracheal deviation unequal breath sounds difficulty ventilating patient INTERVENTION: needle decompression; tube thoracostomy ECG Clues for Tamponade (cardiac) - ✔narrlow complex rapid rate History/Physical Clues for Tamponade & Effective Intervention - ✔history of condition no pulse felt w/CPR vein distention INTERVENTION: pericardiocentesis ECG Clues for Toxins - ✔various but predominately prolongation of QT interval History/Physical Clues for Toxins & Effective Intervention - ✔bradycardia empty bottles at scene pupils neurologic exam INTERVENTION: intubation; specific antidotes ECG Clues for Thrombosis (pulmonary) - ✔narrow complex rapid rate History/Physical Clues for Thrombosis (pulmonary) & Effective Intervention - ✔history of condition no pulse felt w/CPR distended neck veins prior positive test for DVT or PE INTERVENTION: surgical embolectomy; fibrinolytics ECG Clues for Thrombosis (Cardiac-MI) - ✔abnormal 12-lead ECG with

  • Q waves
  • ST segment changes
  • T waves, inversions

History/Physical Cues for Thrombosis (Cardiac-MI) & Effective Intervention - ✔history of condition cardiac markers good pulse with CPR INTERVENTION: none listed Amiodarone - ✔VF/VT Cardiac Arrest (unresponsive to Shock, CPR & Vasopressor-epi)

  • first dose 300mg
  • second dose 150mg NON Arrest
  • 150 mg Atropine - ✔Bradycardia (with or without ACS)
  • 0.5mg every 3-5 min not to exceed 3 mg Adenosine - ✔stable, narrow complex SVT
  • first dose: 6 mg
  • second dose: 12mg given 1-2 min after 1st dose Vasopressin - ✔Cardiac Arrest:
  • 40 mg 1 time only
  • can be given instead of 1st or 2nd dose of EPI Dopamine - ✔Bradycardia (used after atropine) use for hypotension <70 w/S&S of shock
  • 2 to 20 mcg/kg per min Magnesium Sulfate - ✔Cardiac Arrest (due to Hypomagnesemia OR Torsades de Pointes)
  • 1 to 2 g diluted in 10mL of D5W IV/IO Torsades de Pointes w/Pulse or AMI with Hypomagnesemia
  • 1 to 2 g mixed in 50-100mL of D5W over 5-160 min What is the desired PETCO2? - ✔ 35 - 40

or = 10 means good compressions <10 means need to evaluate compressions When is synchronized cardioversion indicated? - ✔Symptomatic or Unstable SVT VT with pulses What joules dose do you use during cardio version? - ✔Atrial flutter and SVT: initial 50 J

  • 100 J Monomorphic VT with pulse: inital 100 J Unstable atrial fib:
  • monophasic dose 200 J