Heartcode ACLS Online Class

Heartcode ACLS Online Class Integrated response known as the system of care ANS: structure processes system patient outcome Structure ANS: People Education Equipment Process ANS: Protocols Policies Procedures System ANS: Programs Organization Culture Patient Outcome ANS: Satisfaction Quality Safety Properly functioning resuscitation equipment represents that element of a system of care? ANS: Structure Among others which of the following factors has been associated with improved survival in patients with cardiac arrest? ANS: Immediate high quality CPR What is the first link in the out of hospital cardiac arrest (OHCA) Chain of Survival? ANS: Activation of emergency response The purpose of a rapid response team (RRT) or medical emergency team (MET) is to ANS: improve patient outcomes by identifying and treating early clinical deterioration. Components of a rapid response system: ANS: Event detection and response triggering arm A plant response such an RRT or MET Quality monitoring Administrative support Criteria for RRT ANS: Airway compromise Respiratory rate less than six per minute or more than 30 per minute Heart rate less than 40 per minute or greater than 140 per minute Systolic blood pressure less than 90 mm HG Symptomatic hypertension Unexpended decrease in level of consciousness Unexplained agitation Seizure Significant decrease in urine output Clinical deterioration that would prompt the activation of a rapid response system ANS: Symptomatic hypertension Seizure Unexplained agitation IHCA ANS: In hospital cardiac arrest Benefits of implementing a rapid response system ANS: Decreased in hospital cardiac arrest IHCA Decreased ICU length of stay Decrease in total hospital length of stay Whenever compressions are paused ANS: Compressor should hover over the chest (not touching it) and be prepared for his integration Before passing compressions ANS: 15 seconds before passing through fashion at the end of each two minute cycle high-performance teams should check for a pulse, recharge the defibrillator, if he supposed to deliver a shock in 10 seconds or less Switch compressors every ANS: Switching between cycles every two minutes is best Real time feedback devices ANS: His best practice to use real time feedback devices during CPR such as a metronome, or metronome app on your mobile device Which component of effective high-performance teams is represented by the use of real time feedback Devices? ANS: Quality Main advantage of effective teamwork? ANS: Division of tasks CPR Coach ANS: Supports performance of high-quality BLS skills allowing the team leader to focus on other aspects of clinical care Which is the best example of a role of the team leader ANS: Excellent team behavior What is the best example of a role of a team member? ANS: Prepared to fulfill their role responsibilities What is the primary purpose of the CPR coach on a resuscitation team ANS: Increasing CPR quality Which high-performance team member is part of the resuscitation triangle ANS: Monitor/defibrillator/CPR Coach What is an example of summarizing and reevaluating ANS: Increasing monitoring if the patient's condition deteriorates examples of mutual respect ANS: Ensuring that only one person talks at a time Acknowledging correctly complete tasks in a positive way HIGH QUALITY CPR INCLUDES: ANS: Compress the chest hard and fast at least 2 inches at a rate of 100 to 120 for a minute (30:2) Allow the chest you completely recoil after each compression Minimize interaction in compression (CHS compression fracture). Switch compressors about every two minutes or earlier if the tea. The switch should only take about five seconds Avoid excessive Ventilation Limit interactions for defibrillation or rhythm analysis to no longer than ANS: 10 seconds Used bag mask device to ANS: Give continuous chest compressions with asynchronous ventilation once every six seconds What defines chest compression fraction (ccf) ANS: Actual chest compression time divided by total code time During CPR, chest compression fraction (CCF) should be at least % and ideally greater than %. ANS: At least 60 Ideally Greater than 80 Coronary perfusion pressure (CPP) ANS: CPP = aortic diastolic pressure - right atrial diastolic pressure The higher the coronary perfusion pressure doing CPR, the higher the chances of survival Quantitative waveform capnography ANS: Uses entitle CO2 to estimate tissue perfusion and quality of chest compressions Used with an advanced airway in place of a bag mask device What are the signs of clinical deterioration that was not the activation of a rapid response system? ANS: Seizure Unexplained agitation Symptomatic hypertension How do you interruptions in chess compressions negatively impact survival after cardiac arrest ANS: Decreased coronary perfusion pressure Coronary perfusion pressure (CPP) equals aortic pressure minus atrial diastolic pressure ANS: Aortic diastolic Minus Right atrial In addition to decreased by HCA, what are some other benefits of implementing a rapid response system? ANS: Decreased total hospital length of stay Decreased ICU length of stay The interval from collapse to defibrillation ANS: It's one of the most important determinants of survival from cardiac arrest, and early defibrillation is critical. Electrical defibrillation is the most effective way to treat ANS: Pulseless ventricular tachycardia (PVT) Ventricular fibrillation (VF) Entire defibrillation sequence should take ANS: Less than five seconds Do not use an AED when ANS: Manual defibrillator and appropriate staff are available What is the only intervention that can restore an organized rhythm In a patient with ventricular fibrillation ANS: And effective defibrillation How quickly does the chance of survival decrease in patients with ventricular fibrillation every minute who do not receive bystander CPR ANS: 7-10% Components of the systematic approach ANS: Initial impression BLS assessment Primary assessment (A, B, C, D, and E) Secondary assessment (sample, H,s and T,s) the maximum amount of time you should simultaneously perform the pulse and breathing checks ANS: 10 seconds The BLS Assessment is a systematic approach to BLS for trained healthcare providers this approach stresses ANS: Early CPR and defibrillation Primary Assessment ANS: the portion of patient assessment that focuses only on life threats, specifically ABCs A airway B breathing C circulation D disability (neurological function AVPU alert, voice, painful, and unresponsive E exposure (Signs of trauma, bleeding, burns, unusual markings, or alert bracelets) Initial assessment reveals a conscious patient and the patient's airway is patent, and an advanced airway is not indicated. Which action in the primary assessment should you perform next? ANS: Administer oxygen as needed Secondary Assessment Mnemonic ANS: S~signs and symptoms A~allergies M~medications P~pertinent Past Medical Information L~last Oral Intake E~events leading up to incident H's ANS: Hydrogen ion/acidosis Hypo/hyper kalemia Hypothermia T's ANS: Tension pneumothorax Cardiac Tamponade Thrombosis or pulmonary embolism Coronary thrombosis Which action is part of the secondary assessment of a conscious patient? ANS: Formulate a differential diagnosis H causes a reversible cardiac arrest ANS: Hyper kalemia/hypokalemia Hypoxia Hypothermia Acidosis T causes of reversible cardiac arrest ANS: Tension pneumothorax Cardiac Tamponade Pulmonary thrombosis Coronary thrombosis Toxins Most common symptom of myocardial ischemia and infarction ANS: Retrosternal chest pain Which demographic group experiencing acute coronary syndrome is more likely to present without chest pain ANS: Females and older adults Oxygen should be delivered to a patient has obvious signs of heart failure if the oxygen saturation is less than ________ Or unknown ANS: 90% Obtaining a________ Is the most important assessment tool for a patient displaying signs and symptoms of acute coronary syndrome ANS: 12 lead ECG For a patient with STEMI the goals of reperfusion are ANS: First medical contact to balloon inflation within 90 minutes Door to drug (fibrinolytcs) In 30 minutes of arrival 12 lead ECG ANS: Only way to identify STEMI Anterior STEMI ANS: ST segment elevation Inferior Mi ANS: ST segment has no low point Unless allergies contra indications exist consider these 4 agents in patients with ischemic type chest discomfort ANS: Oxygen for saturation less than 90% start at 4 L per minute Aspirin 162 to 325 mg if not given by EMS Nitroglycerin sublingual or translingual Morphine if Justine is not relieved by nature Coast trains Call for how quickly a fibrinolytic checklist should be completed ANS: 10 minutes How to give nitroglycerin ANS: One sub lingual nitroglycerin tablet every 3 to 5 minutes for ongoing symptoms may repeat for a total of three doses Which clinical finding represents a contraindication to the administration of nitroglycerin ANS: Confirmed right ventricular infarction Which class of medication is commonly given to patients with acute coronary syndrome may be adversely affected by morphine administration ANS: Oral antiplatelet medication Morphine cans of kris absorption of oral anti-platelet medication which include Plavix and others Benefit of morphine when given for the management of acute coronary syndrome ANS: Central nervous system analgesia STEMI is characterized by ST segment elevation in two or more continuous leads or new left bundle branch block ANS: Threshold values for ST segment elevation consistent with MI J point elevation greater than 2 mm in leads v2 and v3 1mm or more in all other leads or new LBBB What electrocardiographic finding Is suggestive of high-risk non-ST segment elevation acute coronary syndrome ANS: Dynamic T Wave inversion Which clinical findings represents a contraindication to be administration of nitroglycerin ANS: Confirmed right ventricular infarction What is the recommended time ago patch of symptom onset or early fibrinolytic therapy or direct catheter based reperfusion for patient with ST segment elevation myocardial infarction and no contraindication ANS: Within 12 hours What is the most common type of stroke ANS: ischemic stroke CPSS ANS: Cincinnati Prehospital Stroke ScaleLook for three physical findings: Facial droop Arm drift Abnormal speech Structural that helps EMS differentiate from large vessel and non-large vessel occlusion stroke ANS: Los Angeles motor scale Primary advantage of using a stroke severity score ANS: Helps identify large vessel occlusion stroke What is the time goals for the neurological assessment of the stroke team and noncontrast CT or MRI performed after hospital arrival ANS: 20 minutes What is the highest level of stroke center certification ANS: Comprehensive Stroke center The time goal for initiation of fibrinolytic therapy without contraindications after hospital arrival ANS: 45 minutes What is the door to needle time goal for 85% or more of a cute ischemic stroke patients treated with IV thrombolytics ANS: 60 minutes Max time after onset for endovascular surgery ANS: 24 hours What tidal volume maintains oxygenation and elimination of carbon dioxide ANS: 6-8l/ min Q ANS: