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

Download ACLS Study Guide: A Comprehensive Guide to Advanced Cardiac Life Support and more Exams Nursing in PDF only on Docsity! 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) 2. Check for Pulse 3. 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 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 -biphasic dose 120 J - 200 J Which drugs can be given through ET tube? - ✔lidocaine vasopressin epi atropine