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ACLS 2015 guidelines

acls, mnemonics H's T's, AEIOU-TIPS, meds

How to Remember the Causes of Arrhythmias (including asystole (the H’s and T’s) 6 H‘s: think about what blood does:VOGPAT Volume (hypovolemia) Oxygen (hypoxemia) Glucose (hypoglycemia) Potassium (hypo- or hyperkalemia) Acid-base balance (H+ or acidosis) Temperature regulation (hypothermia)
How to Remember the Causes of Arrhythmias (including asystole (the H’s and T’s) 5 T's imagine a (toxic) lead bullet piercing a chest. What can it cause? Trauma Toxins Tamponade Tension pneumothorax Thrombosis (PE or MI)
look for causes of Altered mental status. AEIOU-TIPS A — Alcohol/Acidosis E — Endocrine, Epilepsy, Electrolytes, Encephalopathy I — Infection O — Opiates, Overdose U — Uremia/Underdose T — Trauma I — Insulin P — Poisoning/Psychosis S — Stroke/Seizure/syncope
what is ABCD Airway, breathing, circulation, differential diagnosis
instead of ABC it is what? CAB (compressions, airway, breathing)
Compression depth Between 5 cm and 6 cm (2 inches and 2.4 inches) in adults
Compression frequency No less than 100, no more than 120
Chest recoil Allow the chest to fully recoil between compressions do not lean on the chest between compressions; allow the heart to fully fill with blood
Vasopressin use? No. Vasopressin plus epinephrine provides no advantage as a substitute for epinephrine
admin Epinephrine for what type of cardiac arrest rhythm and when? Administer epinephrine ASAP for non‑shockable cardiac arrest rhythm
In a Witnessed cardiac arrest with shockable rhythm, EMS may or may not delay ventilation? EMS may delay ventilation for up to 3 cycles of 200 continuous chest compressions
Advanced airway during CPR -how many breaths per how many seconds? which = how many per minute? Deliver 1 breath every 6 seconds (10 per minute) when using an advanced airway during CPR
Chain of survival in hospital or out of hospital different how? In-hospital and out-of-hospital cardiac arrest chain of survival are different; primary providers and lay rescuers provide immediate care and then transfer care to the code team or EMS crew, respectively.
Post-cardiac arrest: use lidocaine and/or beta-blocker? there Inadequate evidence to support the routine use of lidocaine and/or beta-blocker
Post-cardiac arrest re: temp for comatose pts with ROSC? Comatose patients with ROSC should be cooled to between 32°C and 36°C for >24 hrs
Post-cardiac arrest what to do re: systolic BP <90 or MAP <65? Consider avoiding/correcting hypotension systolic BP <90 or mean arterial pressure <65
Administer a vasopressor every ____ minutes. Use what if no IV access? Administer a vasopressor every 3 to 5 minutes; use an endotracheal (ET) tube, if available, until IV access is established
when do you-do IV insertions, delivery of medications, and insertion of advanced airways; wait until preparation for defibrillation and do treatments during that lull in CPR
The optimal endotracheal dose 2 to 2½ times the recommended IV dose.
Dilute the dose in __ to __ mL of_______ (or _____ _____) and inject the drug as a rapid _____ directly into the endotracheal tube. 5 to 10 mL, sterile water or normal saline, spray
During CPR with an advanced airway in place, a _____ rate of rescue breathing reduces risk of ____________. lower, hyperventilation
Advanced airway placement in cardiac arrest should ___ _____initial CPR and defibrillation for what type/or rhythm of cardiac arrest not delay, VF
Use an adult (__to __L) bag and deliver approximately ____mL of tidal volume sufficient to produce chest rise over 1 second. 1-2L, 600
before placement of an advanced airway (supraglottic airway or tracheal tube), EMS providers perform CPR with cycles of 30 compressions and __breaths. 2
oropharyngeal airway (OPA) is also known as an _____airway oral
nasopharyngeal airway (NPA) is also called a _____airway, NPAT (nasopharyngeal airway tube), or nasal _______ nasal, trumpet
oropharynx is the primary site of upper airway obstruction in what type of pt? unconscious or anesthetized patients
Nasopharyngeal airways are also used to keep the airway open and can be used with patients who are what? conscious or semi-conscious
If an advanced airway is used, the _________ airway can be used for adults with out of hospital cardiac arrest in settings with low tracheal intubation success rate or minimal training opportunities for endotracheal tube placement. the supraglottic airway
If an advanced airway is used, either the supraglottic airway orET can be used for adults with out-of-hospital cardiac arrest in settings with high what? or high tracheal intubation success rates or optimal training opportunities for endotracheal tube placement.
Clinical assessment to confirm endotracheal intubation consists of visualizing chest expansion bilaterally and listening over the ? Clinical assessment to confirm endotracheal intubation consists of visualizing chest expansion bilaterally and listening over the e
what is recommended in addition to clinical assessment as the most reliable method of confirming and monitoring correct placement of an endotracheal tube Continuous waveform capnography
If continuous waveform capnometry is not available,what other options are there to confirm ET placement? a nonwaveform carbon dioxide (CO2) detector, esophageal detector device, or ultrasound used by an experienced operator is a reasonable alternative.
Created by: kerinska