11/16/2014AHA ACLS Written Test flashcards | Quizlet AHA ACLS Written Test 67 terms by shaneei Ready to study? Start with Flashcards You find an unresponsive pt. who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action? Start chest compressions of at least 100 per min. You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now? Obtaining a 12 lead ECG. What is the preferred method of access for epi administration during cardiac arrest in most pts? Peripheral IV An AED does not promptly analyze a rythm. What is your next step? Begin chest compressions. You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the pt. has no pulse. You partner resumes chest compressions and an IV is in place. What management step is your next priority? Administer 1mg of epinepherine During a pause in CPR, you see a narrow complex rythm on the monitor. The pt. has no pulse. What is the next action? Resume compressions What is acommon but sometimes fatal mistake in cardiac arrest management? Prolonged interruptions in chest compressions. Which action is a componant of highquality chest comressions? Allowing complete chest recoil http://quizlet.com/44256087/aha-acls-written-test-flash-cards/ 1/8 After calling for help and determining that the pt. the ECG screen displayed asystole which has persisted despite 2 doses of epi. EMS crews have attemptedresuscitation of a pt who originally presented with V-FIB.com/44256087/aha-acls-written-test-flash-cards/ 2/8 . you are unsure whether the pt. one memeber of your team inserts an ET tube while another performs continuous chest comressions. What is an advantage of using hands-free d-fib pads instead of d-fib paddles? Hands-free allows for more rapid d-fib. and high quality CPR.with an advanced airway in place? Provide continuous chest compressionswithout pauses and 10 ventilations per minute. is not breathing. The use of quantitative capnography in intubated pt's does what? Allowsfor monitoring CPR quality For the past 25 min. What action is recommended to help minimize interruptions in chest compressions during CPR? Continue CPR while charging the defibrillator. http://quizlet. What is your next action? Begin chest compressions. a fluid bolus. Which is a safe and effective practice within the defibrillation sequence? Be sure O2 is NOT blowing over the pt's chest during shock. What is the significance of this finding? Chest compressions may not be effective. What is your next treatment? Consider terminating resuscitive efforts after consulting medical control. has a pulse. During subsequent bentilation. After the 1st shock. 3 min after witnessing a cardiac arrest. Which situation BEST describes PEA? Sinus rythm without a pulse What is the best strategy for perfoming high-quality CPR on a pt. your pt suddenly loses consciousness. During your assessment. you notice the presence of a wavefom on the capnogrophy screen and a PETCO2 of 8 mm Hg.11/16/2014 AHA ACLS Written Test flashcards | Quizlet Which action increases the chance of successful conversion of ventricular fibrillation? Providing quality compressions immediately before a defibrillation attempt. s heart rate is 180. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min? 1 breath every 5-6 seconds A pt. BP is 70/50. resp. rate is 22 per min. O2 sat is 98%.com/44256087/aha-acls-written-test-flash-cards/ 3/8 . BP is 110/70. rate is 18. What is the appropriate 1st medication? Atropine 0. in refractory V-FIB? Amioderone 300mg What is the appropriate intervalfor an interruption in chest compressions? 10 seconds or less Which of the following is a sign of effective CPR? PETCO2 = or > 10mm Hg What is the primary purpose of a medical emergency team or rapid response team? Identifying and treating early clinical deterioration.11/16/2014 AHA ACLS Written Test flashcards | Quizlet Which action is included in the BLS survey? Early defibrillation Which drug and dose are recommended for the management of a pt. resp. has an onset of dizziness. presents to the ER with dizziness and SOB with a sinus brady of 40/min. O2 sat is 95%. the pt's heart rate is 35 beats/min.5mg A pt. http://quizlet. presents to the ER with a new onset of dizziness and fatugue. This is a reg narrow complex tach rythm. Which action improves the quality of chest compressions delivered during resuscitave attemepts? Shitch providers about every 2 min or every 5 compression cycles. What is the appropriate dose of Dopamine for this pt? 2-10mcg/kg/min A pt. What is the next intervention? Vagal manuever. The pt. Onexamination. who may be having a stroke. What intervention has the highest priority? Simple airway manuevers and assisted ventilations. Choose an appropriate inidication to stop or withhold resuscitive efforts. resp. in the ICU developed a suddent onset of narrow complex tach at a rate of 220/min. What is the most appropriate next action? Obtain a 12 lead ECG. What is the next intervention? Adenosine 12mg IV You receiving a radio report from an EMS team enroute with a pt. The heart rate is dropping paridly and now shows a sinus brady rate at 30/min. heart rate is 92/min. rate is 14 non-labored and O2 sat is 96%. and the O2 sat is 98%. While treating a stable pt for dizziness. A pt. a BP of 68/30. you see a brady rythm on the ECG. What is the appropriate procedure for ET suctioning after the catheter is selected? Suction during withdrawl. to a hospital 15 min away with CT capabilities. cool and clammy.11/16/2014 AHA ACLS Written Test flashcards | Quizlet A monitored pt. but not for longer than 10 seconds.5mg http://quizlet. She has been taking antacids PO for the past 6 hours because she she had heartburn. The hospital CT scanner is broken. There is an EJ established for vascular access. Evidence of rigor mortis.com/44256087/aha-acls-written-test-flash-cards/ 4/8 . The pt's BP is 128/58. in respiratory failure becomes apneic but contineues to have a strong pulse. BP is 118/72. What should you do? Divert the pt. the PETCO2 is 38mm Hg. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. How do you treat this? Atropine 0. A 49 y/ofmaile arrives in the ER with persistant epigastric pain. The pt. denies taking any vasodialators. reps rate is 14/min. BP is 142/98. pulse is 190/min. Lead 2 in the ECG shows a sinus rythm. diaphretic. What would be your next action? Cinncinati Stroke Scale You are transporting a pt. pale. resp rate is 12/min. and you are unable to obtain an 02 sat due to no radial pulse. BP is 140/90. in cardiac arrest who has an advanced airway in place? 8-10 breaths per minute A 62 y/o male pt. resp rate is non-labored 14/min. resp rate is 18.com/44256087/aha-acls-written-test-flash-cards/ 5/8 . What intervention should be next? Syncronized cardioversion. You are evaluating a 48 y/o male with crushing sub-sternal pain. Which rythm requires synchronized cardioversion? Unstable SVT What is the recommended dose for adenosine for pt's in refractory. pulse rate is 200/min. What is next. experienced a sudden onset of right arm weakness. The ECG shows a wide complex tach rythm. BP is 138. BP is 58/32. Glucose levels are normal and the ECG shows a sinus rythm. What is the initial priority for an unconscious pt.11/16/2014 AHA ACLS Written Test flashcards | Quizlet A 68 y/o female pt. and slow to respond to your questions. 02 sat is 97%. pulse is 78/min. He is cool. in the ER says his heart is beating fast. 02 sat is 95% room air. Head CT scan What is the proper ventilation rate for a pt. No chest pain or SOB. but stable narrow complex tachycardia? 12mg http://quizlet. O2 sats are 95 at room air. What should be the next evaluation? Obtain a 12 lead ECG. pulse is 80/min. with any tachycardia on the monitor? Determine if a pulse is present. with a positive stroke assessment. or vasopressor administration in a hypotensive post-cardiac arrest who achieves ROSC? 90mm Hg What is the 1st treatment priority for a pt.11/16/2014 AHA ACLS Written Test flashcards | Quizlet What is the usual post-cardiac arrest target range for PETCO2 who achieves return of spontaneous circulation (ROSC)? 35-40mm Hg Which conditionis a contraindication to theraputic hypothermia during the postcardiac arrest period for pt's who achieve return of spontaneous circulation (ROSC)? Responding to verbal commands What is the potential danger to using ties that pass circumfrentially around the pt's neck when securing an advanced airway? Obstruction of veneous return from the brain What is the most reliable method of confirming and montioring correct placement of an ET tube? Continuous waveform capnography What is the recommended IV fluid (NS or LR) bolus dose for a pt. Inotropic. vasopressin and lidocaine and you will need to double the dose http://quizlet. who achieves ROSC? Optimizing ventilation and oxygenation.com/44256087/aha-acls-written-test-flash-cards/ 6/8 . who achieves ROSC but is hypotensive during the postcardiac arrest period? 1 to 2 Liters What is the minimum systolic BP one should attempt to achieve with fluid. Ventilations during Cardiac Arrest 2 every 30 compressions with a bag mask or 1 every 6 to 8 seconds w/advanced airway (8-10 breaths/minute) ventilations during respiratory arrest 1 every 5 to 6 seconds 10 to 12 breaths/minute tidal volume delivered w/bag mask 600mL what does a PETCO2 of <10mmHg indicate in an intubated patient their CO is inadequate to to achieve ROSC which drugs can be given with endotracheal route? only epi. . monomorphic tachycardia w/a pulse therapy for pt w/narrow QRS w/regular rhythm vagal maneuver or give adenosine http://quizlet.11/16/2014 AHA ACLS Written Test flashcards | Quizlet why do we give a saline bolus after infusion of a drug via peripheral IV? to hasten the time for peak response steps for treating hypotension 1.5 mg Atropine every 3-5 minutes. must have SBP >90mmHg when is nitroglycerin contraindicated? inferior wall MI or RT ventricular infarction hypotension. IV bolus 1-2L normal saline 2. max of 3 mg if ineffective: transutaneous pacing or dopamine 210mcg/kg/min or epi 2-10mcg/min when do you use synchronized shocks unstable SVT unstable afib unstable a flutter unstable. regular. door-to-needle (fibrinolysis) if pt is hemodynamically unstable do you give nitroglycerin? No. obtain ECG Do you shock PEA? do not shock asystole or PEA! treatment is vasopressor only! reperfusion goal: time from door to balloon inflation (PCI) 90 minutes reperfusion goal of 30 minutes is for.5 mcg/kg/min for epi or norepi or 5-10mcg/kg/min of dopamine 3.. brady or tachycardia recent phosphodiesterase use (Viagra) 4 D's of in-hospital therapy door to data to decision to drug (or PCI) treatment of bradyarrhythmia 0.1-0. treatable causes? (H's and T's) 4.com/44256087/aha-acls-written-test-flash-cards/ 7/8 . pressor: 0. 11/16/2014 stroke general assessment w/in __ minutes of arrival CT w/in __ minutes interpret CT within __ minutes initiate fibrinolytic therapy within ? door-to-admission time of 3 hours http://quizlet.com/44256087/aha-acls-written-test-flash-cards/ AHA ACLS Written Test flashcards | Quizlet general assessment w/in 10 minutes of arrival CT w/in 25 minutes interpret CT within 45 minutes -initiate fibrinolytic therapy within 1 hour of arrival and 3 hours from symptom onset 8/8 .