ACLS BLS |41 QUESTIONS AND ANSWERS

Who Makes Up the Guidelines? American Heart Association Two subcommittees ACLS Subcommittees EKG Subcommittees In JAMA every 2 years Whats the most common cause of death in adults? Coronary Artery Disease (CAD) Narrowing of small blood vessels which supplies blood and oxygen to the heart. Why are RT's a valuable part of the resuscitation team? Maintain Oxygenation Head of the bed during codes Code Team Members Leader(MD) Recorder Airway manager Compressor Cardiologist Medication RN Pharmacist Good advanced Cardiac Life Support Begins With? Early Defibrillation Compression's Ask yourself does the patient really need it Clinical death HR & Breathing Stop Biological Death Brain cells dying Begins 4-6 minutes after clinical death Five H's Hypovolemia Hypoxemia Hydrogen Ion Hypo/hyperkalemia Hypothermia Hypovolemia Sever Fluid, or blood loss (dehydration,vomiting, bleeding) which keeps the heart from pumping enough blood to the body. Can cause organ failure. Treatment: Fluid Given Blood Transfusion Albumin Hypoxemia Low oxygen in blood Caused by V/Q mismatch (Volume of air entering the lungs, transfer of air from the lungs to blood) and shunts 100% O2 given in code Albumin Main protein in human body Key to regulate osmotic pressure of blood Hydrogen ion Acidosis To much acid in bodily fluids. When kidneys and lungs cant keep ph balance. PT needs to blow off CO2 (hyperventilate increace RR) Hypo/hyperkalemia Serum potassium concentration higher then 3.5-5.5 mEq/L 8.5 and higher can lead to respiratory paralysis or cardiac arrest. Sodium BiCarb given Hypothermia Slows metabolism, Warm up patient, bag with heated humidity or warm IV Five T's Toxins Tamponade Tension Pneumothorax Thrombosis Trauma Toxins Drugs Poisons Treat with Mucomyst Tamponade closure or blockage Blood cooling in heart pericardium Drain blood in the space Tension Pneumothorax Build up of air in pleural space Aspirate Shifts away from trachea pt hypotensive Thrombosis Clots Anticoagulants taken Trauma Recognize all injuries Support for oxygenation 100% FIO2 (Toxicity not an issue during CPR) O2 within four to five minutes Airway control= Masks or artificial Airways goal: Restore airway patency Adequate ventilation Prevent aspiration Secretion clearance Alternate drug route How to restore airway patency? Separate the tongue from the posterior pharyngeal wall Endotracheal Intubation Preferred method of securing airway during CPR Should be 30 sec or less LMA Laryngeal Mask Airway Better for Short term Sits in pt hypopharynx Less gastric inflation Rescue Breathing 10-12 breaths per minute (1 breath every 5-6 sec) Advanced airway breathing 8-10 breaths per minute (1 breath every 6-8 sec) rescue pod Using Bag-Valve-Mask Head-Tilt Oral airway Look for bilateral chest rise Watch for gastric distension (Belly getting bigger) Check for equipment failure Allow exhalation time Slow down Adults only use self inflating bags Three types of electrical interventions Defibrillation Cardioversion Electrical Pacing Defibrillation Unsychronized high energy shock Simultaneously depolarizes myocardial fibers Treatment for pulseless v tach and V-fib AHA guidelines for Defibrillation One shock only (360J monophasic/ 200J biphasic) VT/VF code Pattern: CPR/Shock/Drug/CPR/Shock/Drug Cardioversion synchronized with heart electrical activity Has pulse lower energy used (50-100J) Premedicate with analgesic and sedative (pt will be concious) Used for Atrial flutter, Atrial fibrillation, V-tach with a pulse Electrical Pacing Stimulates hearts natural pacemaker Intermittently timed, low energy Two types of Electrical pacing External (transcutaneous pacing) Internal (Transvenous pacing)