(ACLS) Review 2024
Perfusing Rhythms
Ventricular contraction is occurring
Organs are receiving blood flow
Patient is responsive
Non Perfusing Rhythms
Ventricular contraction is not occurring
Organs are not receiving blood flow
Patient is unresponsive (no response to any stimuli)
Brainpower
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When is cardioversion used?
When the patient has a perfusing rhythm
What are the perfusing rhythms
Unstable tachycardia
A fib and A flutter
Cardioversion
Delivers a small electrical shock
Must be synced with the correct place in the patient's rhythm
When is defibrillation used?
When the patient has a non perfusing rhythm
What are the non perfusing rhythms?
V tach without a pulse
V fib
Defibrillation
Delivers a large electrical shock
Can be done at any time
What does a normal EKG look like?
, What does sinus bradycardia EKG look like?
Normal P, QRS, and T
Slower rate, normal rhythm
Sinus bradycardia
HR < 60 bpm
Sinus bradycardia most often results from ....
Parasympathetic excess
What does since tachycardia EKG look like?
Sinus tachycardia
HR > 100 bpm
What is the most common cause of sinus tachycardia?
Exercise
Produces sympathetic stimulation of the SA node
In order for a patient to have unstable tachycardia, what must be true?
Patient must have at least one of the following:
- Hypotensive (<90/60)
- Acute change in mental status
- Signs of shock
- Chest discomfort suggestive of ischemia
- Acute HF
Treatment of unstable tachycardia
Synchronized cardioversion
If regular narrow QRS complex, consider Adenosine
First dose: 6 mg IV rapid push with NS flush
Second dose: 12 mg IV rapid push with NS flush
If a patient has stable tachycardia, what must be determined?
Length of QRS complex
If the patient has a QRS /> ____ seconds, the patient has wide complex tachycardia
0.12 seconds
If a patient has wide complex tachycardia, what is their treatment?