ADVANCED LIFE SUPPORT ALS EXAM STUDY
QUESTIONS WITH 100% SOLVED ANSWERS!!
Primary cardiac arrest cause
Ischameic heart disease
Congenital cardiac defect
Ion channelopathies
Pericardial effusion/tamponade
Valvular disease
Cardiomyopathy
MI
ALS algorithm
En route think about the kit you need
Age, gender, name
Scene - bystander cpr?
When last seen alive? DOWN TIME?
Patient assessment triangle
Cat hem
Response
Airway clear?
Pulse check and breathing
Compressions and pads - p1 back up
Set up advanced airway and etco2, o2, good position, ventilating 1 every 6 seconds
Iv/io drugs - get a bm
,Reversible causes - keep an eye on end tidal. Post ROSC care
Top to toe assessment, history
ROSC or ROLE - advice line?
Involve family - explain what is happening!
Important things to note down in a cardiac arrest
Time started resus - How many rounds of CPR
Down time - any bystander CPR?
The rhythms at rhythm check and times - especially asystole
Etco2 trend
The drugs given and what times
How many shocks and what time
Time resus stopped - time of death
Medical history
Reversible causes
Secondary cardiac arrest cause
Airway - complete or partial obstruction
CNS depression, blood/vomit in airway, epiglottis, bronchiole secretions, foreign body
Breathing - acute or chronic conditions (asthma, copd, pulmonary embolism, lung contusion)
Circulation - shock
,Cardiogenic - MI, arrhythmia
Haemorrhagic - trauma/bleed, fluid loss
Distributive shock - sepsis, anaphylaxis
Neurogenic shock - sci, brain stem injury/infarction, stroke
Obstructive shock - tension pneumothorax, aortic compression/dissection, tamponnade
Good quality chest compressions
Regularly swapping provider - every 2 mins
Pauses - less than 5 seconds rhythm check/defibrillation - peri-shock pause
Rate 100-120 bpm
At least 5cm but not more than 6cm (1/3 chest)
Chest recoil - do not lean on chest
Use puck
Etco2 to measure quality
Defib pad placement
AA - Antero-lateral - top choice
AP - Anterior posterior - children maybe
Bi-axillary - challenging location and can't turn. Goes under both armpits
Cardiac arrest rhythms
Non shockable
Asystole - flatline, no pulse check, no shock
(If very low and wide - less than 10pm then agonal rhythm and treated like asystole)
, PEA - Anything other than vt, vf, asystole,
Pulse check/signs of life - might be ROSC
No shock
Shockable (initially 20%, during arrest 25%)
VF - chaotic, no pulse check, shock!)
Pulseless VT - wide, fast, regular, poly/monomorphic
Check pulse - if not pulse, shock!
Pre-shock - how to get ready
Everyone clear - top, middle, bottom
Oxygen away
Analysing rhythm - what not to forget
Make sure to check for pulse - especially for VT and PEA!
Three stacked shocks
If pulseless vt or vf occurs whilst:
Witnessed, Monitored cardiac arrest with a defib immediately available - pads need to be already
on.
Three quick shocks, check for rhythm change between each shock.
If unsuccessful, treat as 1 shock for drugs administration and time two minutes (chest
compressions) before pressing analyse
QUESTIONS WITH 100% SOLVED ANSWERS!!
Primary cardiac arrest cause
Ischameic heart disease
Congenital cardiac defect
Ion channelopathies
Pericardial effusion/tamponade
Valvular disease
Cardiomyopathy
MI
ALS algorithm
En route think about the kit you need
Age, gender, name
Scene - bystander cpr?
When last seen alive? DOWN TIME?
Patient assessment triangle
Cat hem
Response
Airway clear?
Pulse check and breathing
Compressions and pads - p1 back up
Set up advanced airway and etco2, o2, good position, ventilating 1 every 6 seconds
Iv/io drugs - get a bm
,Reversible causes - keep an eye on end tidal. Post ROSC care
Top to toe assessment, history
ROSC or ROLE - advice line?
Involve family - explain what is happening!
Important things to note down in a cardiac arrest
Time started resus - How many rounds of CPR
Down time - any bystander CPR?
The rhythms at rhythm check and times - especially asystole
Etco2 trend
The drugs given and what times
How many shocks and what time
Time resus stopped - time of death
Medical history
Reversible causes
Secondary cardiac arrest cause
Airway - complete or partial obstruction
CNS depression, blood/vomit in airway, epiglottis, bronchiole secretions, foreign body
Breathing - acute or chronic conditions (asthma, copd, pulmonary embolism, lung contusion)
Circulation - shock
,Cardiogenic - MI, arrhythmia
Haemorrhagic - trauma/bleed, fluid loss
Distributive shock - sepsis, anaphylaxis
Neurogenic shock - sci, brain stem injury/infarction, stroke
Obstructive shock - tension pneumothorax, aortic compression/dissection, tamponnade
Good quality chest compressions
Regularly swapping provider - every 2 mins
Pauses - less than 5 seconds rhythm check/defibrillation - peri-shock pause
Rate 100-120 bpm
At least 5cm but not more than 6cm (1/3 chest)
Chest recoil - do not lean on chest
Use puck
Etco2 to measure quality
Defib pad placement
AA - Antero-lateral - top choice
AP - Anterior posterior - children maybe
Bi-axillary - challenging location and can't turn. Goes under both armpits
Cardiac arrest rhythms
Non shockable
Asystole - flatline, no pulse check, no shock
(If very low and wide - less than 10pm then agonal rhythm and treated like asystole)
, PEA - Anything other than vt, vf, asystole,
Pulse check/signs of life - might be ROSC
No shock
Shockable (initially 20%, during arrest 25%)
VF - chaotic, no pulse check, shock!)
Pulseless VT - wide, fast, regular, poly/monomorphic
Check pulse - if not pulse, shock!
Pre-shock - how to get ready
Everyone clear - top, middle, bottom
Oxygen away
Analysing rhythm - what not to forget
Make sure to check for pulse - especially for VT and PEA!
Three stacked shocks
If pulseless vt or vf occurs whilst:
Witnessed, Monitored cardiac arrest with a defib immediately available - pads need to be already
on.
Three quick shocks, check for rhythm change between each shock.
If unsuccessful, treat as 1 shock for drugs administration and time two minutes (chest
compressions) before pressing analyse
