ACLS Provider Final

The sequence for BLS for an Adult or Child who is unresponsive and pulseless. - ANSWER-C-A-B (Chest compressions, Airway, Breathing) A pulse check during the BLS survey should be performed for this length of time. - ANSWER-5 to 10 seconds A likely indicator of a cardiac arrest in the unresponsive patient. - ANSWER-Agonal gasps After discovering an unresponsive patient, what is the next step in the assessment and management of this patient? - ANSWER-Check the patient's breathing and pulse Compressions rate in an arrest. - ANSWER-100/min to 120/min The ratio of compressions to breaths for the Adult, Child and 1 rescuer infant arrest. - ANSWER-30 compressions to 2 breaths The ratio of compressions to breaths for Infant 2-rescuer arrest. - ANSWER-15 compressions to 1 breath What you should do if the patient is unconscious and apneic and you are uncertain rather or not a patient has a pulse - ANSWER-Begin compressions To properly ventilate a patient with a perfusing rhythm, what is the rate to squeeze the bag (BVM) - ANSWER-Once every 5 to 6 seconds The potential complication of excessive ventilations. - ANSWER-Decreased cardiac output Where to measure to appropriately size an oropharyngeal airway. - ANSWER-Measure from the corner of the mouth to the angle of the mandible When an advanced airway is in place, how should compressions be delivered? - ANSWER-Continuous chest compressions without pauses In the intubated patient, the technique to assess the quality of CPR. - ANSWER-Monitor the patient's PETCO2 Your next action if after 2 minutes of CPR an organized, nonshockable rhythm is identified. - ANSWER-Check a carotid pulse The recommendation for chest compression depth for an Adult and CHILD. - ANSWER-At least 2 inches (5 cm) but not more than 2.4 inches Components of High-Quality CPR - ANSWER-• Compress the chest hard and fast • Allow complete recoil after each compression • Chest compressions should be interrupted 10 seconds or less • Switching providers every 2 minutes or every 5 compression (if unable to determine exact time) cycles improves the quality of chest compressions • Continue CPR while the defibrillator charges The AHA position on routine use of cricoid pressure in cardiac arrest. - ANSWER-The guidelines do not recommend routine use of cricoid pressure in cardiac arrest. The definitive treatment for ventricular fibrillation - ANSWER-Prompt defibrillation The recommended next step after a defibrillation attempt - ANSWER-Resume CPR, starting with chest compressions One measure to minimize interruptions in chest compressions - ANSWER-Continue CPR while charging the defibrillator Action to take if during the use of an AED you are not directed to check the rhythm - ANSWER-Continue CPR (starting with chest compressions) then check the equipment. Measures to provide electrical safety during cardioversion or defibrillation. - ANSWER-• Being sure oxygen is not blowing over the patient's chest during the shock • Verbally and visually "clear" the field • Charge defibrillator when paddles are in place on the chest • Consider hands free pads An advantage of hands-free pads verses defibrillator paddles - ANSWER-Hands-free pads allows for more rapid defibrillation Physiology of how CPR is a survival advantage - ANSWER-Supplying a small amount of blood flow to the heart and reducing ischemia Problem and management of using of an AED with a hairy chest - ANSWER-If skin contact is not made AED pads the machine will not be able to analyze; remove the hair. Problem and management of using of an AED when the patient is partially submerged in water - ANSWER-Remove the patient from the water and dry off Problem and management of using of an AED when patient is lying on snow or ice - ANSWER-Use the AED If a patient has an implantable device such as a pacemaker/AICD that is not functioning the location you should place the universal pads - ANSWER-Place the AED pads on either side not directly on top of an implantable device Special consideration where to locate AED pads if a patient has a medication patch who requires defibrillation - ANSWER-Do not place AED directly over a medication patch The recommended initial biphasic energy dose for cardioversion of atrial fibrillation - ANSWER-120 to 200 Joules The recommended initial monophasic energy dose for cardioversion of atrial fibrillation - ANSWER-200 Joules Initial energy recommendation for an adult in unstable monomorphic ventricular tachycardia or SVT - ANSWER-Synchronized cardioversion initial energy of 100 Joules (or biphasic equivalent) If rhythm is unresponsive to the initial cardioversion attempt, the energy recommendation for next attempt for an adult in unstable monomorphic ventricular tachycardia or SVT - ANSWER-Increase the dose in a stepwise fashion for monophasic 200 joules, 300 joules, then 360 joules (or biphasic equivalent) Management for a patient who is rapidly deteriorating in SVT or monomorphic V-Tach with a pulse (even if profoundly hypotensive) - ANSWER-Immediately synchronized cardioversion starting at 100 joules (or biphasic equivalent) If equipment is available, the management of a witnessed arrest of V-Fib or pulseless V-Tach - ANSWER-Immediately defibrillation at 360 joules or biphasic equivalent In addition to the clinical assessment, ________________ is the most reliable method of confirming and monitoring correct placement of an endotracheal tube. - ANSWER-Continuous Waveform Capnography High quality chest compressions are achieved when the PETCO2 value reaches - ANSWER-At least, 10-20 mmHg The indication of a PETCO2 level 10 mmHg - ANSWER-Potential poor perfusion from ineffective CPR PETCO2 target range for the patient with return of spontaneous circulation - ANSWER-35-40 mmHg Algorithm indicated for the tachycardic patient with a pulse - ANSWER-ACLS Tachycardia Algorithm If a patient has respiratory failure but is perfusing and gradually becomes bradycardic, the management and treatment focus - ANSWER-Treat the respiratory cause of the bradycardia by airway maneuvers and assisting ventilation