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Heartcode ACLS | Heartcode ACLS
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Integrated response known as the system of care - โ๏ธ structure processes system patient outcome Structure - โ๏ธ People Education Equipment Process - โ๏ธ Protocols Policies Procedures System - โ๏ธ Programs Organization Culture Patient Outcome - โ๏ธ Satisfaction Quality Safety Properly functioning resuscitation equipment represents that element of a system of care? - โ๏ธ Structure Among others which of the following factors has been associated with improved survival in patients with cardiac arrest? - โ๏ธ Immediate high quality CPR What is the first link in the out of hospital cardiac arrest (OHCA) Chain of Survival? - โ๏ธ Activation of emergency response The purpose of a rapid response team (RRT) or medical emergency team (MET) is to - โ๏ธ improve patient outcomes by identifying and treating early clinical deterioration. Components of a rapid response system: - โ๏ธ Event detection and response triggering arm A plant response such an RRT or MET Quality monitoring Administrative support Criteria for RRT -
โ๏ธ Airway compromise Respiratory rate less than six per minute or more than 30 per minute Heart rate less than 40 per minute or greater than 140 per minute Systolic blood pressure less than 90 mm HG Symptomatic hypertension Unexpended decrease in level of consciousness Unexplained agitation Seizure Significant decrease in urine output Clinical deterioration that would prompt the activation of a rapid response system - โ๏ธ Symptomatic hypertension Seizure Unexplained agitation IHCA - โ๏ธ In hospital cardiac arrest Benefits of implementing a rapid response system - โ๏ธ Decreased in hospital cardiac arrest IHCA Decreased ICU length of stay Decrease in total hospital length of stay Whenever compressions are paused - โ๏ธ Compressor should hover over the chest (not touching it) and be prepared for his integration Before passing compressions - โ๏ธ 15 seconds before passing through fashion at the end of each two minute cycle high- performance teams should check for a pulse, recharge the defibrillator, if he supposed to deliver a shock in 10 seconds or less Switch compressors every - โ๏ธ Switching between cycles every two minutes is best Real time feedback devices - โ๏ธ His best practice to use real time feedback devices during CPR such as a metronome, or metronome app on your mobile device Which component of effective high-performance teams is represented by the use of real time feedback Devices? - โ๏ธ Quality Main advantage of effective teamwork? - โ๏ธ Division of tasks CPR Coach - โ๏ธ Supports performance of high-quality BLS skills allowing the team leader to focus on other aspects of clinical care
The higher the coronary perfusion pressure doing CPR, the higher the chances of survival Quantitative waveform capnography - โ๏ธ Uses entitle CO2 to estimate tissue perfusion and quality of chest compressions Used with an advanced airway in place of a bag mask device What are the signs of clinical deterioration that was not the activation of a rapid response system? - โ๏ธ Seizure Unexplained agitation Symptomatic hypertension How do you interruptions in chess compressions negatively impact survival after cardiac arrest - โ๏ธ Decreased coronary perfusion pressure Coronary perfusion pressure (CPP) equals aortic pressure minus atrial diastolic pressure - โ๏ธ Aortic diastolic Minus Right atrial In addition to decreased by HCA, what are some other benefits of implementing a rapid response system? - โ๏ธ Decreased total hospital length of stay Decreased ICU length of stay The interval from collapse to defibrillation - โ๏ธ It's one of the most important determinants of survival from cardiac arrest, and early defibrillation is critical. Electrical defibrillation is the most effective way to treat - โ๏ธ Pulseless ventricular tachycardia (PVT) Ventricular fibrillation (VF) Entire defibrillation sequence should take - โ๏ธ Less than five seconds Do not use an AED when - โ๏ธ Manual defibrillator and appropriate staff are available What is the only intervention that can restore an organized rhythm In a patient with ventricular fibrillation - โ๏ธ And effective defibrillation How quickly does the chance of survival decrease in patients with ventricular fibrillation every minute who do not receive bystander CPR - โ๏ธ 7-10% Components of the systematic approach -
โ๏ธ Initial impression BLS assessment Primary assessment (A, B, C, D, and E) Secondary assessment (sample, H,s and T,s) the maximum amount of time you should simultaneously perform the pulse and breathing checks - โ๏ธ 10 seconds The BLS Assessment is a systematic approach to BLS for trained healthcare providers this approach stresses - โ๏ธ Early CPR and defibrillation Primary Assessment - โ๏ธ the portion of patient assessment that focuses only on life threats, specifically ABCs A airway B breathing C circulation D disability (neurological function AVPU alert, voice, painful, and unresponsive E exposure (Signs of trauma, bleeding, burns, unusual markings, or alert bracelets) Initial assessment reveals a conscious patient and the patient's airway is patent, and an advanced airway is not indicated. Which action in the primary assessment should you perform next? - โ๏ธ Administer oxygen as needed Secondary Assessment Mnemonic - โ๏ธ S~signs and symptoms A~allergies M~medications P~pertinent Past Medical Information L~last Oral Intake E~events leading up to incident H's - โ๏ธ Hydrogen ion/acidosis Hypo/hyper kalemia Hypothermia T's - โ๏ธ Tension pneumothorax Cardiac Tamponade Thrombosis or pulmonary embolism Coronary thrombosis Which action is part of the secondary assessment of a conscious patient? - โ๏ธ Formulate a differential diagnosis H causes a reversible cardiac arrest - โ๏ธ Hyper kalemia/hypokalemia Hypoxia Hypothermia
Which clinical finding represents a contraindication to the administration of nitroglycerin - โ๏ธ Confirmed right ventricular infarction Which class of medication is commonly given to patients with acute coronary syndrome may be adversely affected by morphine administration - โ๏ธ Oral antiplatelet medication Morphine cans of kris absorption of oral anti-platelet medication which include Plavix and others Benefit of morphine when given for the management of acute coronary syndrome - โ๏ธ Central nervous system analgesia STEMI is characterized by ST segment elevation in two or more continuous leads or new left bundle branch block - โ๏ธ Threshold values for ST segment elevation consistent with MI J point elevation greater than 2 mm in leads v2 and v 1mm or more in all other leads or new LBBB What electrocardiographic finding Is suggestive of high-risk non-ST segment elevation acute coronary syndrome - โ๏ธ Dynamic T Wave inversion Which clinical findings represents a contraindication to be administration of nitroglycerin - โ๏ธ Confirmed right ventricular infarction What is the recommended time ago patch of symptom onset or early fibrinolytic therapy or direct catheter based reperfusion for patient with ST segment elevation myocardial infarction and no contraindication - โ๏ธ Within 12 hours What is the most common type of stroke - โ๏ธ ischemic stroke CPSS - โ๏ธ Cincinnati Prehospital Stroke ScaleLook for three physical findings: Facial droop Arm drift Abnormal speech Structural that helps EMS differentiate from large vessel and non-large vessel occlusion stroke - โ๏ธ Los Angeles motor scale Primary advantage of using a stroke severity score - โ๏ธ Helps identify large vessel occlusion stroke What is the time goals for the neurological assessment of the stroke team and noncontrast CT or MRI performed after hospital arrival -
โ๏ธ 20 minutes What is the highest level of stroke center certification - โ๏ธ Comprehensive Stroke center The time goal for initiation of fibrinolytic therapy without contraindications after hospital arrival - โ๏ธ 45 minutes What is the door to needle time goal for 85% or more of a cute ischemic stroke patients treated with IV thrombolytics - โ๏ธ 60 minutes Max time after onset for endovascular surgery - โ๏ธ 24 hours What tidal volume maintains oxygenation and elimination of carbon dioxide - โ๏ธ 6-8l/ min