| ?'s | Answers |
| If Patient has Bradycardia & is showing signs of Poor perfusion, What might you see? (try to give 3-4 examples). | -Acute Altered Mental Status. -Ongoing chest pain. -Hypotension. -Other signs of shock. |
| If Patient has Bradycardia & is showing S/S of poor perfusion. What interventions might you do and/or consider? | (P.A.E.D.) Pace, Atropine, Epi or Dopamine. |
| If Patient has Bradycardia & is showing signs of Poor perfusion. What 2 rhythms call for immediate transcutaneous pacing (TCP). | 2nd degree type II block & 3rd degree complete block (CHB) |
| If Patient has Bradycardia & is showing s/s of Poor perfusion. What are indications to start TCP immediately? | 1) 2nd degree type II & 3rd degree Heart Blocks. 2) If No response to Atropine. 3) Atropine is unlikely to be effective. 4) IV access cannot be quickly established. 5) the patient is Severely symptomatic. |
| In ACLS Bradycardia Algorithm Atropine is the 1st line drug. What is the dosage? | Atropine 0.5mg IV MR to max 3mg. |
| In ACLS Bradycardia Algorithm you might consider Epi or Dopamine. What dosage would be used for Epi and then for Dopamine? | Epi: 2-10 mics/ min Dopamine: 2-10 mics/kg per min. |
| Treat possible contributing factors. What are the 6 H,s & 5 T,s. | Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo/ hyperkalemia Hypoglycemia Hypothermia Toxins Tamponade-cardiac Tension pneumothorax Thrombosis (coronary or pulmonary) Trauma (hypovolemia, increased ICP). |
| In the ACLS secondary survey what does ABCD stand for? | Airway Breathing Circulation Differential Diagnosis |
| Give 2 reasons why you should avoid Hyperventilating a patient when assisting ventilations. | 1) Aspiration risk 2) Increases intrathoracic pressure, decreases venous return to the heart, and diminishes cardiac output. |
| For patients with a likely asphyxial arrest, What is the sequence of actions for a Lone rescuer? | Perform 2 min (5 cycles) of CPR before leaving the patient to activate the emergency response system and get an AED. Then return to the patient, resume CPR, and use the AED if indicated. |
| What are the steps of closed-loop communication that a team leader should use? | 1) Give assignment or order to team member. 2) Confirm it was heard and understood by receiving a clear response and good eye contact from the team member. 3) Listen for confirmation that the task was done before assigning another task. |
| When team resusitative efforts become ineffective what should the team then do? | go back to the basics and talk as a team. |
| What 3 things are going to be an essential role of the team leader to be monitoring and reevaluating? | 1) The patients status 2) Interventions that have been performed. 3) Assessment findings. |
| With Oropharyngeal suctioning always measure the catheter before suctioning. How do you measure the catheter to ensure that it is not inserted too far? | The distance from the tip of the nose to the ear lobe. |
| ACLS guidelines state to typically limit suction attempts to...How many secounds? | 10 seconds or less |
| With ET tube suctioning; How far or How do you measure the distance you can insert the suctioning catheter? | Insertion of the catheter beyond the tip of the ET tube is not recommended due to the chance that it may injure or stimulate cough and/or bronchospasm. To prevent this take note of the length of ET tube used and mark with thumb and forefinger. |
| What is a technique to help remove thick mucus or other material from the Advanced Airway (ET tube). | Instill 1-2ml of sterile saline into the airway before suctioning. (to dilute) |
| If you are called on-scene to witnessed arrest in 6 min what should you do first? | If call-to-response time interval is longer then 4-5min perform 2min of CPR (5 cycles) before defibrillating patient. if under 4-5min shock first. |
| AED use; If a patient is lying on snow or in a small puddle... | Action: Ok to use the AED. (ACLS p. 39) |
| AED use; If a patient has an implanted pacemaker... | Not contraindicated as lond as the electrode is not placed directly over the device. (at least 1in. to either side of the implanted device. |
| What ALS drugs are involved in cases of VF/Pulseless VT according to ACLS. | E.V.A.L.M. ; Epi, Vasopressin, Amiodarone, Lidocaine, Mag. Sulfate. |
| What are the energy doses of monopasic and biphasic defibrillator to effectively terminate VF. | monophasic=360joules. Biphasic=150-200joules (typically 200J) |
| VF/VT Epi dosage(s) are what? May replace with what other drug, include its dosage? | Epi=1mg IV/IO MR q 3-5min or may give 1 dose of Vasopressin= 40 U IV/IO to replace 1st or 2nd line Epi. |
| When should you consider giving Mag. Sulfate for? Dosage? | For torsades de pointes. Dose: 1-2 g IV/IO |
| During CPR of VF/VT what antiarrhythmics might you consider? | Amiodarone, Lidocaine. |
| What is the normal duration of a P-R interval? | 0.12-0.20 seconds |
| What is the normal duration of a QRS complex? | 0.04-0.12 seconds |
