ACLS Concepts
STARTED AT SLIDE 35: BEFORE APPROACHING A PATIENT - answers
What are the TWO steps before approaching a patient? - answers 1. Survey the scene
(if out in the field)
-Is it safe?
2. Use universal precautions
-Gloves
-Etc
****Make sure to remember that you need to "verbalize" that you put on gloves as some
instructors are sticklers for this****
What is the Acronym for what the initial steps are for a Patient who appears
Unconscious? What does it stand For? - answers RACD
1. Responsiveness
2. Activate EMS and get an AED
-Before starting CPR
3. Check Circulation (pulse) and breathing simultaneously
3a. If No Pulse (or unsure of one) Begin Chest Compressions Immediately
3b. If No Breathing, but there is a Pulse, Give TWO Rescue Breaths
4. Defibrillation
In ACLS, what are the "RACD" steps called? When should these Steps be done? -
answers 1. They are called the BLS Assessment
2. They are the first thing that a provider should do if a patient is or appears
unconscious
When you see an adolescent (or anyone) collapse, what is the most likely cause? -
answers Sudden Cardiac Arrest
In a Lone Rescuer situation for probable cardiac arrest, what is the first step the rescuer
should take? Explain why? - answers 1. A lone rescuer should call for help (activate
EMS) and even leave the patient to get an AED (if near an AED) BEFORE initiating
chest compressions
2. The idea is that if it's a probable cardiac arrest, EMS & defibrillation are needed even
more than chest compressions (i.e., chest compressions don't treat defibrillation, but
they can keep circulation going until defibrillation can take place)
When you see a drowning victim, what is the cause of of arrest? - answers Hypoxic
cause of arrest
,In a Lone Rescuer situation for a drowning victim with hypoxic cause of arrest, what is
the first step the rescuer should take? Explain why? - answers 1. A lone rescuer should
give 2 minutes of CPR, THEN activate EMS
2. The idea is that prompt CPR can treat and save the life of a hypoxic arrest victim, and
is therefore more important than getting a defibrillator
If a patient is Conscious, what part of the assessment can you skip? Explain why? -
answers 1. If a patient is conscious, you can skip the BLS primary survey/RACD steps
altogether
2. You don't need to check responsiveness, start CPR on, or defibrillate a conscious
patient, ya know what I'm sayin'?
If you're unsure of whether or not a patient is conscious, how should you handle the
situation based on ACLS? How does your approach change then depending on if they
are or are not conscious? - answers 1. If you're unsure of whether or not a patient is
conscious, always START by checking responsiveness (always START the BLS
primary survey/RACD steps)
2. If the patient doesn't respond, finish the BLS primary survey/RACD steps
3. If the patient responds (is conscious), abandon the BLS primary survey & RACD
steps and move on to the "primary assessment"
What is the Acronym for your Initial steps when dealing with a Conscious Patient? What
does the acronym stand for? - answers ABCDE's
1. Airway
2. Breathing
3. Circulation
4. Disability
5. Exposure
In ACLS, what is the name for the ABCDE's? - answers The "Primary Assessment"
What does the Primary Assessment (ABCDE's) Consist of? Explain each step? -
answers 1. Airway
-Check patency and consider advanced airway placement
2. Breathing
-Consider supplementary oxygen & advanced airway placement, monitor oxygenation &
ventilation, and avoid excessive ventilation
3. Circulation
-Assessing the pulse, ECG, BP (stable vs. unstable), CPR effectiveness, temperature &
glucose, the need for fluid and drug administration, and the need for
cardioversion/defibrillation
4. Disability
-Check for neurologic function
-Responsiveness, level of consciousness, and pupil dilation
-AVPU (Alert, Voice, Painful, Unresponsive)
5. Exposure
, -Remove clothing to perform a quick physical exam
-Look for obvious signs of trauma, bleeding, burns, unusual markings, or medical alert
bracelets
In an actual ACLS Megacode testing scenario, whenever you encounter a Conscious
patient, you should always start the Primary Assessment (ABCDE's) by verbalizing what
THREE things? Include what Monitors and Additional steps are associated with each of
the Three verbalized steps? - answers 1. Oxygen placed on the patient
-Takes care of "Airway" and "Breathing" of the ABCDEs
2. Monitors placed
-Take care of "Circulation" of the ABCDEs
-This includes a 12 lead ECG, SpO2 monitoring, and blood pressure
-Once SpO2 monitoring is on, I will titrate the oxygen down to an SpO2 of 94-99%
-The blood pressure is used to help determine whether or not a patient is stable
3. IV placed
-Take care of "Circulation" of the ABCDEs
What are the first THREE things you will verbalize if you encounter a Conscious
patient? Explain why you would do this? - answers 1. If you encounter a conscious
patient, just say, "Let's place some oxygen and monitors on the patient, and start an IV."
2. This takes care of the most immediate needs of the ABCDEs, and after this is done, it
gives you some time to consider the rest of the ABCDEs, which can include stuff like:
-Auscultation and checking the patency of the airway
-Checking the blood pressure/pulse (which indicates whether or not they are stable)
-Checking their ECG to see if their rhythm is stable
-Checking their neurologic function (mental state) and performing a physical exam
3. These steps can indicate further therapy (such as intubation, drug administration,
cardioversion, etc)
After you have started the Primary Assessment (by placing monitors), you can see that
the patient has an SVT rhythm. Based on this, what are your TWO approaches to
treatment, and what do these treatments depend on? - answers 1. If the patient is
stable, (good BP, palpable pulse), we can start with vagal maneuvers
2. If the patient is unstable (low BP, poor signs of perfusion, weak pulse, and/or loss of
consciousness), we go right to synchronized cardioversion
What will your Initial Approach to patients in ACLS depend on? Explain? - answers 1.
Will Depend on whether or not the patient is conscious or unconscious
2. If the patient is Unconscious, start with the BLS RACD Assessment and then move
onto the Primary and Secondary Assessments
3. If the patient is Conscious, Skips the BLS Assessment and start the Primary
Assessment Immediately, then move onto the Secondary assessment
What is the general "purpose" of the Secondary Assessment? What are the TWO
components of the Secondary Assessment? - answers To diagnose the cause of the
problem
STARTED AT SLIDE 35: BEFORE APPROACHING A PATIENT - answers
What are the TWO steps before approaching a patient? - answers 1. Survey the scene
(if out in the field)
-Is it safe?
2. Use universal precautions
-Gloves
-Etc
****Make sure to remember that you need to "verbalize" that you put on gloves as some
instructors are sticklers for this****
What is the Acronym for what the initial steps are for a Patient who appears
Unconscious? What does it stand For? - answers RACD
1. Responsiveness
2. Activate EMS and get an AED
-Before starting CPR
3. Check Circulation (pulse) and breathing simultaneously
3a. If No Pulse (or unsure of one) Begin Chest Compressions Immediately
3b. If No Breathing, but there is a Pulse, Give TWO Rescue Breaths
4. Defibrillation
In ACLS, what are the "RACD" steps called? When should these Steps be done? -
answers 1. They are called the BLS Assessment
2. They are the first thing that a provider should do if a patient is or appears
unconscious
When you see an adolescent (or anyone) collapse, what is the most likely cause? -
answers Sudden Cardiac Arrest
In a Lone Rescuer situation for probable cardiac arrest, what is the first step the rescuer
should take? Explain why? - answers 1. A lone rescuer should call for help (activate
EMS) and even leave the patient to get an AED (if near an AED) BEFORE initiating
chest compressions
2. The idea is that if it's a probable cardiac arrest, EMS & defibrillation are needed even
more than chest compressions (i.e., chest compressions don't treat defibrillation, but
they can keep circulation going until defibrillation can take place)
When you see a drowning victim, what is the cause of of arrest? - answers Hypoxic
cause of arrest
,In a Lone Rescuer situation for a drowning victim with hypoxic cause of arrest, what is
the first step the rescuer should take? Explain why? - answers 1. A lone rescuer should
give 2 minutes of CPR, THEN activate EMS
2. The idea is that prompt CPR can treat and save the life of a hypoxic arrest victim, and
is therefore more important than getting a defibrillator
If a patient is Conscious, what part of the assessment can you skip? Explain why? -
answers 1. If a patient is conscious, you can skip the BLS primary survey/RACD steps
altogether
2. You don't need to check responsiveness, start CPR on, or defibrillate a conscious
patient, ya know what I'm sayin'?
If you're unsure of whether or not a patient is conscious, how should you handle the
situation based on ACLS? How does your approach change then depending on if they
are or are not conscious? - answers 1. If you're unsure of whether or not a patient is
conscious, always START by checking responsiveness (always START the BLS
primary survey/RACD steps)
2. If the patient doesn't respond, finish the BLS primary survey/RACD steps
3. If the patient responds (is conscious), abandon the BLS primary survey & RACD
steps and move on to the "primary assessment"
What is the Acronym for your Initial steps when dealing with a Conscious Patient? What
does the acronym stand for? - answers ABCDE's
1. Airway
2. Breathing
3. Circulation
4. Disability
5. Exposure
In ACLS, what is the name for the ABCDE's? - answers The "Primary Assessment"
What does the Primary Assessment (ABCDE's) Consist of? Explain each step? -
answers 1. Airway
-Check patency and consider advanced airway placement
2. Breathing
-Consider supplementary oxygen & advanced airway placement, monitor oxygenation &
ventilation, and avoid excessive ventilation
3. Circulation
-Assessing the pulse, ECG, BP (stable vs. unstable), CPR effectiveness, temperature &
glucose, the need for fluid and drug administration, and the need for
cardioversion/defibrillation
4. Disability
-Check for neurologic function
-Responsiveness, level of consciousness, and pupil dilation
-AVPU (Alert, Voice, Painful, Unresponsive)
5. Exposure
, -Remove clothing to perform a quick physical exam
-Look for obvious signs of trauma, bleeding, burns, unusual markings, or medical alert
bracelets
In an actual ACLS Megacode testing scenario, whenever you encounter a Conscious
patient, you should always start the Primary Assessment (ABCDE's) by verbalizing what
THREE things? Include what Monitors and Additional steps are associated with each of
the Three verbalized steps? - answers 1. Oxygen placed on the patient
-Takes care of "Airway" and "Breathing" of the ABCDEs
2. Monitors placed
-Take care of "Circulation" of the ABCDEs
-This includes a 12 lead ECG, SpO2 monitoring, and blood pressure
-Once SpO2 monitoring is on, I will titrate the oxygen down to an SpO2 of 94-99%
-The blood pressure is used to help determine whether or not a patient is stable
3. IV placed
-Take care of "Circulation" of the ABCDEs
What are the first THREE things you will verbalize if you encounter a Conscious
patient? Explain why you would do this? - answers 1. If you encounter a conscious
patient, just say, "Let's place some oxygen and monitors on the patient, and start an IV."
2. This takes care of the most immediate needs of the ABCDEs, and after this is done, it
gives you some time to consider the rest of the ABCDEs, which can include stuff like:
-Auscultation and checking the patency of the airway
-Checking the blood pressure/pulse (which indicates whether or not they are stable)
-Checking their ECG to see if their rhythm is stable
-Checking their neurologic function (mental state) and performing a physical exam
3. These steps can indicate further therapy (such as intubation, drug administration,
cardioversion, etc)
After you have started the Primary Assessment (by placing monitors), you can see that
the patient has an SVT rhythm. Based on this, what are your TWO approaches to
treatment, and what do these treatments depend on? - answers 1. If the patient is
stable, (good BP, palpable pulse), we can start with vagal maneuvers
2. If the patient is unstable (low BP, poor signs of perfusion, weak pulse, and/or loss of
consciousness), we go right to synchronized cardioversion
What will your Initial Approach to patients in ACLS depend on? Explain? - answers 1.
Will Depend on whether or not the patient is conscious or unconscious
2. If the patient is Unconscious, start with the BLS RACD Assessment and then move
onto the Primary and Secondary Assessments
3. If the patient is Conscious, Skips the BLS Assessment and start the Primary
Assessment Immediately, then move onto the Secondary assessment
What is the general "purpose" of the Secondary Assessment? What are the TWO
components of the Secondary Assessment? - answers To diagnose the cause of the
problem
