Cardiovascular Life Support (CLS) 2023 Exam

Cardiovascular Life Support (CLS) 2023 Exam According to a study in 1993, for every minute a patient experiences VT, asystole, or PEA, the risk of mortality increases by how much? - CORRECT ANSWER-7-10% CPR uses chest compressions to restore blood flow to important organs such as? - CORRECT ANSWER-The heart and brain 4 types of arrhythmias discussed - CORRECT ANSWER-- VT - PVT - PEA - Asystole What is ventricular tachycardia? - CORRECT ANSWER-Wide QRS tachycardia characterized by 3 or more consecutive PVC ~ 100-200 BPM VT can lead to what? - CORRECT ANSWER-Ventricular fibrillation, systole, or cardiac arrest Causes of VT - CORRECT ANSWER-- Ischemia - Drug toxicity (digoxin) - Electrolyte abnormalities - Heart disease What is sustained VT? - CORRECT ANSWER-- Lasts for 30 seconds - Symptomatic - Can progress to life threatening incident What is unsustained VT? - CORRECT ANSWER-- Brief and self-limited - Asymptomatic How can V fib lead to death? - CORRECT ANSWER-No electric activity in the heart - no cardiac output - cardiac arrest - death What is V fib caused by? - CORRECT ANSWER-- Scar tissue: MI or cardiomyopathy - Irritants: CAD, electrolyte abnormalities, hormones - Electrocution Tx for V-fib - CORRECT ANSWER-- ACLS - Correct underlying cause - ICDWhat is PEA and asystole? - CORRECT ANSWER-Absence of detectable pulse and the presence of some other form of electrical activity other than VT or PVT Tx for PEA/asystole - CORRECT ANSWER-CPR - airway control - IV access - reconfirm asystole with a second lead - do NOT defibrillate patient with asystole because the parasympathetic discharge that occurs with defibrillation reduces the change of ROSC and worsens outcomes Are the following recommended for PEA/asystole? Epinephrine Vasopressin Atropine - CORRECT ANSWER-Epinephrine is recommended; vasopressin and atropine are not In patients with PEA/asystole we must treat the underlying cause, which may include: - CORRECT ANSWER-- Hypovolemia - Hypoxia - Acidosis - Hyper/hypokalemia - Hypothermia - Hypoglycemia - Drug overdose - Tamponade - Thrombosis, coronary - Tension pneumothorax - PE - Trauma High quality CPR focuses on proper technique to ensure: - CORRECT ANSWER-- Adequate HR - Depth of compression - 100-200 beats/minute - Full chest recoil after each compression (at least 2 inches) - Avoidance of excessive ventilation - Reduction in interruptions to increase compression fraction to 60% or above Basic life support focuses on what? (Hint: CAB) - CORRECT ANSWER-- Compressions - CAB = circulation, airway, and breathing T or F: everyone should do a pulse check when performing BLS - CORRECT ANSWER-False - limit pulse checks unless medical professional (check for 10 seconds and then start compressions) How should a healthcare professional execute BLS? - CORRECT ANSWER-30 compressions --2 breaths until AED arrivesHow should a non-healthcare professional execute BLS? - CORRECT ANSWERCompression only - NO breaths Once AED arrives, what should be done? - CORRECT ANSWER-Check rhythm - if the patient has a shockable rhythm then give 1 shock (if non-shockable, do not shock) - resume CPR immediately for 2 minutes What should be administered during CPR? - CORRECT ANSWER-End tidal carbon dioxide (ETCO2) Goal is 20 mmHg What is CCR? - CORRECT ANSWER-Cardiocerebral resuscitation - an alternative T or F: CCR has better outcomes in VF/PVT patients and may improve survival to hospital discharge - CORRECT ANSWER-True Briefly describe the community component of CCR - CORRECT ANSWER-- Check - prompt recognition - Call - activate EMS - Compress - CPR only with compressions Briefly describe the EMS component of CCR - CORRECT ANSWER-- Phase 1: electrical phase (0-5 minutes) - Phase 2: hemodynamic phase (5-15 minutes) - Phase 3: metabolic phase Briefly describe the hospital component of CCR - CORRECT ANSWER-- Aggressive post-resuscitation care - Hypothermia protocol - Emergent cardiac catherization - PCI MOA and dose of epinephrine - CORRECT ANSWER-MOA: alpha-mediated vasoconstrictor that increases coronary reperfusion, but may reduce perfusion to other vital organs Dose: 1 mg IV or IO Q3-5 minutes Is high dose epinephrine recommended for cardiac arrest? Is it more effective in nonshockable or shockable rhythms? - CORRECT ANSWER-- No it is not - More effective in non-shockable rhythms; therefore it should be administered ASAP MOA and dose of vasopressin - CORRECT ANSWER-MOA: potent antidiuretic hormone that is a non-adrenergic vasoconstrictor - increases blood pressure and systemic vascular resistance via V1 receptor