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CPR/RQI ACLS EXAMINATION
Recommended time window after symptom onset for early fibrinolytic therapy or PCI with STEMI - ✔✔12 HOURS Goal for PCI with symptomatic ischemia in STEMI - ✔✔ When to administer first dose of epi with shockable rhythm - ✔✔between second and third shock How much and how often epi - ✔✔1 mg q 3-5 minutes Amiodarone first and second dose amounts - ✔✔300/ Lidocaine first and second dose amounts - ✔✔ 1 - 1.5 mg/kg then 0.5-0.75 mg/kg H's and T's - ✔✔5 H's H ypoxia H ypovolemia H ydrogen ion (acidosis) H ypo / H yper kalemia H ypothermia 5 T's T ension pneumothorax T amponade T oxins
T hrombosis (pulmonary) T hrombosis (coronary) Two most common underlying causes of PEA - ✔✔hypovolemia and hypoxia When is the recommended point to administer epinephrine to a pt with asystole? - ✔✔As soon as IV/IO access is available Which alteration to standard ACLS algorithm is appropriate for patient's whose cardiac arrest is secondary to hypothermia? - ✔✔Spacing medications further apart Which arrhythmia is caused by methadone and propoxyphene? - ✔✔Torsades de Pontes List all possible ways to administer Narcan - ✔✔IV IM Nasal Sub Q Nebulize for inhalation ET Tube 2 Most common causes of LVAD RVAD or BVAD devices - ✔✔1. Disconnection of Power
- Disconnection of Driveline How will the current generation of continuous-flow VADs complicate BLS assessment - ✔✔The devices will not produce a pulse
- esophogeal thermometer
- Pulm artery catheter if one is already in place for other indications Temp range goal for TTM patients - ✔✔ 32 - 36C Which factor can confound neuroprognostication during the post-cardiac arrest phase? - ✔✔Targeted temperature management How long should you wait to determine the neurologic prognosis of a patient treated with TTM after the pt returns to normothermia? - ✔✔72 hours Which EKG finding is indicative of high risk non st elev'n ACS? - ✔✔Dynamic T wave inversion STEMI is characterized by: - ✔✔1. ST elevation in two or more contiguous leads and
- New LBBB Oxygen should be delivered to a HF patient if O2 sats are __________ or below or unknown - ✔✔90% What invasive CPR measure reflects changes in CO due to chest compressions if O2 consumption, arterial O2 sats, and hgb remain constant? - ✔✔Central Venous Oxygen Saturation What is an example of knowledge sharing by a team leader? - ✔✔Asking for suggestions about interventions Which is an example of summarizing and reeavluating? - ✔✔Increasing monitoring if the patient's situation deteriorates
What is an example of knowledge sharing by a team leader - ✔✔Asking for suggestions about interventions What is the recommended depth of chest compressions? - ✔✔at least 2 inches What is an effect of excessive ventilation? - ✔✔Decreased Cardiac Output Five steps of Primary Assessment - ABCDE - ✔✔A Airway B Breathing C Circulation D Disability E Exposure AVPU - Part of "Disability" during primary assessment - ✔✔Alert, Verbal, Pain, Unresponsive Secondary Assessment - SAMPLE - ✔✔- Signs and Symptoms (history of present issues);
- Allergies;
- Medications;
- Past Medical History, Pertinent Negatives;
- Last Oral Intake;
- Events (leading to present: trauma or medical) Body temps that qualify as hypothermia - ✔✔< 95 F or < 35 C What is the first step in the systematic approach to patient assessment? - ✔✔Initial Impressioon
PCI within first ____ minutes of first medical contact or fibrinolytics within ____ minutes of arrival to ED - ✔✔90, 30 Immediate assessment by medical staff within first _____ minutes of arrival of ACS pt to ED - ✔✔ 10 ED assessment checklist after arrival of Cardiac Alert patient - ✔✔1. Check vital signs
- Obtain medical hx
- Review fibrinolytic checklist
- Obtain blood studies
- Obtain CXR
- Draw a STEMI panel 8 D's of Stroke Care - ✔✔1. Detection
- Dispatch
- Delivery
- Door
- Data
- Decision
- Drug
- Disposition
