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ACLS
2020-2025
| Question | Answer |
|---|---|
| Pasos de la cadena de supervivencia para adultos(6) | 1.-Reconocer síntomas y activar el SME 2.-Realizar RCP temprana 3.-Desfibrilar con DEA 4.- Soporte Vital Avanzado 5.- Cuidados post-paro cardiaco 6.-Recuperación |
| Prinicipal causa de muerte en los EU | Paro cardiaco |
| Principal paso de la cadena de supervivencia pediátrica? | Prevención |
| Pasos de la cadena de supervivencia para niños (6) | 1.-Prevenir el paro 2.-Realizar RCP temprano 3.- Activar el SME 4.- Soporte Vital Avanzado 5.- Cuidados post-paro cardiaco 6.- Recuperación |
| Ciclo de RCP | 30 compresiones x 2 respiraciones |
| Criterios de RCP de alta calidad (6) | 1.- Inicie compresiones dentro de 10 segundos 2.- Permita la expansión del tórax entre compresiones 3.-Minimize interrupciones 4.-Asegurese que el tórax se levante con las ventilaciones 5.- No sobre-ventilar 6.-Evalue si existe ritmo desfibrilable |
| Casos en los que se deben de usar las almohadillas pediátricas del DEA | Niños menores de 8 años y menores de 25 kg |
| Cuántas compresiones se deben de dar por minuto en niños y adultos? | 100-120 |
| Cada cuántos ciclos se intercambian papeles en el RCP con dos personas? | Cada 5 ciclos |
| Si hay dos personas en el RCP para niños cómo son los cliclos? | 15 compresiones x 2 respiraciones |
| Which of the following is true regarding BLS? a. It is obsolete. b. Recent changes prohibit mouth-to-mouth. c. It should be mastered prior to ACLS. d. It has little impact on survival. | C |
| What is the first step in the assessment of an individual found “down”? a. Check their blood pressure. b. Check their heart rate. c. Check to see if they are conscious or unconscious. d. Check their pupil size. | C |
| What factor is critical in any emergency situation? a. Scene safety b. Age of the individual c. Resuscitation status d. Pregnancy status | A |
| CPR is initiated on an Adult and the person’s pulse returns, but he is not breathing. What ventilation rate should be used for this person? a. 6-8 breaths per minute b. 10-12 breaths per minute c. 18-20 breaths per minute d. Depends on his color | B |
| Arrange the BLS Chain of Survival in the proper order: b. Check responsiveness, call EMS get AED, defibrillation, and recovery c. Check responsiveness, call EMS and get AED, chest compressions, early defibrillation, and recovery | C |
| After activating EMS and sending someone for an AED, which of the following is correct for one-rescuer BLS of an unresponsive individual with no pulse? a. Start rescue breathing. b. Apply AED pads. c. Run to get help. d. Begin chest compressions. | D |
| Reflects time elapsed between two successive R-waves of the QRS. | RR Interval |
| Onset of the T wave to the end of the P-wave. Reflects a period of electrical inactivity. | TP Interval |
| Onset of the QRS complex to the end of the T-wave. Reflects the period between ventricular depolarization and ventricular repolarization. | QT Interval |
| End of the S-wave (J point) to the start of the T-wave. Reflects ventricular repolarization. | ST Segment |
| Onset of the S-wave to the start of the T-wave. Reflects initial, slow phase of ventricular repolarization. | ST Interval |
| End of the P-wave to the start of the QRS complex. Reflects time delay between atrial and ventricular activation. | PR Segment |
| Onset of the P-wave to the start of the QRS complex. Reflects conduction through the atrioventricular (AV) node. | PR Interval |
| Synonymous with ventricular repolarization. Reflects the start of ventricular relaxation. | T-wave |
| Electrical activity is traveling through the ventricles. Depolarization of the left and right ventricles. Reflects ventricular contraction. | QRS Complex |
| Electrical activity is traveling through the atria. Synonymous with atrial depolarization. Reflects atrial contraction. | P-wave |
| • Normal P-wave • Normal QRS Complex • Normal T-wave • HR: 60-100 BPM (at rest) • Treatment: None | Normal Sinus Rhythm (NSR) |
| • Normal P-wave • Normal QRS Complex • Normal T-wave • HR: <60 BPM (at rest) • Treatment (Symptomatic): Atropine, Dopamine (infusion), Epinephrine (infusion) | Sinus Bradycardia |
| • Normal P-wave • Normal QRS Complex • Normal T-wave • HR: >100 BPM (at rest) • Treatment: Reverse underlying condition (fever, anxiety, exercise),b beta-blockers (metoprolol, sotalol) | Sinus Tachycardia |
| • Prolonged PR interval due to delay in AV signal transmission • P-wave may be buried in the preceding T-wave • Treatment: Transcutaneous pacing (only indicated if prolongation of the PR interval is >400 ms) | 1st Degree Heart Block |
| • Progressive lengthening of the PR interval • Progression occurs until the QRS complex is dropped • Treatment: Atropine, Dopamine, Transcutaneous pacing | 2nd Degree AV Block Type I (Mobitz Type I, Wenckebach’s) |
| • PR interval is > 0.20 seconds and consistent (not gradually getting longer) but drops a beat, generally on a pattern of 3:1 or 4:1 • Treatment: Transcutaneous pacing | 2nd Degree AV Block Type II (Mobitz Type II) |
| • No identifiable relationship between the P-wave and QRS waves • P-P intervals are normal but do not relate to the QRS complex • Treatment: Transcutaneous pacing | 3rd Degree AV Block (complete heart block, CHB) |
| • Profoundly rapid atrial rhythm with narrow QRS complexes • Occurs when the signal impulse originates over the bundle branches • HR: 150-250 BPM • Treatment: Vagal maneuvers, Adenosine, synchronized cardioversion | Supraventricular Tachycardia (SVT) |
| • Uniquely characterized by an absence of P-waves before the QRS complex • HR: Highly irregular with significant fluctuation • Treatment: beta-blockers, Ca++ channel blockers(Diltiazem, Verapamil, etc.), Digoxin, synchronized cardioversion. | Atrial Fibrillation (aFib) |
| • Uniquely characterized by a saw-toothed flutter appearance • Toothed fluttering represents multiple P-waves for a single QRS complex • Treatment: synchronized cardioversion, beta-blockers ,Ca++ channel blockers (Diltiazem, Verapamil, etc), Digoxin. | Atrial Flutter |
| • Abnormally-patterned wide QRS complex • No P-waves • High likelihood of rapid deterioration to a state of ventricular fibrillation (vFib) • HR: >100 BPM • Treatment: Defibrillation | Ventricular Tachycardia (vTach) |
| • Characterized by a chaotic and disorganized wave pattern • Patient has no palpable pulse • Treatment: Defibrillation, epinephrine, amiodarone, lidocaine HCl | Pulseless Ventricular Fibrillation (vFib) |
| Qué significa el ABCD de la encuesta ACLS | Airway, Breathing, Circulation, Diferential diagnosis |
| Que EtCO se espera en el RCP de alta calidad? | 10-20 mmHg |
| Dosis de Adenosina | 6 mg IV en bolo, se puede repetir con 12 mg en 1 o 2 min |
| Dosis de Amiodarona | TV/FV conciente : 150mg en10 minutos TV/FV inconciente : 300mg, agregar 150 mg si no es efectivo Dosis máxima: 450mg |
| Dosis de Atropina en bradicardia sintomática | 1 mg IV Dosis máxima: 3mg |
| Dosis de Dopamina | 5 to 20 mcg/kg/min |
| Dosis de Epinefrina (Adrenalina) en paro cardiaco | 1 mg IV en 10 ml de sol salina Mantenimiento: 0.1 to 0.5 mcg/kg/min |
| Dosis de Epinefrina (Adrenalina) en anafilaxia | 0.3-0.5 mg IM |
| Dosis de Epinefrina (Adrenalina) en bradicardia sintomática | 2 to 10 mcg/min infusion |
| Dosis de lidocaína en paro cardiaco ( FV/TV) | InIcial: 1 to 1.5 mg/kg IV de carga A seguir: La mitad de la primer dosis en 5-10 min Mantenimiento: 1 to 4 mg/min |
| Dosis de lidocaína en taquicardia de complejo amplio con pulso | InIcial: 0.5 to 1.5 mg/kg IV de carga A seguir: La mitad de la primer dosis en 5-10 min Mantenimiento: 1 to 4 mg/min |
| Dosis de sulfato de magnesio en paro cardiaco | 1 to 2 gr diluido en 10 mL |
| Dosis de sulfato de magnesio en Torsade de pointe con pulso | Si no esta en paro : 1 to 2 gm IV en 5 a 60 min Mantenimiento: 0.5 to 1 gr/hr IV |
| Dosis de procainamida en taquicardia de QRS amplio o TV. con pulso | 20 to 50 mg/min IV hasta que mejore el ritmo, se presente hipotensión o el QRS se ensanche el 50 % o si se alcanza la dosis máxima: MAX dose: 17 mg/kg Goteo: 1 to 2 gm in 250 to 500 mL a 1 to 4 mg/min |
| Dosis de Sotalol | 100 mg (1.5 mg/kg) IV en 5 min |
| An individual presents with symptomatic bradycardia. Her heart rate is 32. Which of the following are acceptable therapeutic options? a. Atropine b. Epinephrine c. Dopamine d. All of the above | D |
| A person with alcoholism collapses and is found to be in Torsades de Pointes. What intervention is most likely to correct the problem? a. Correct hypothermia. b. Administer magnesium sulfate c. Administer glucose d. Administer naloxone | B |
| You have just administered a drug for an individual in supraventricular tachycardia (SVT). She complains of flushing and chest heaviness. Which drug is the most likely cause? a. Aspirin b. Adenosine c. Amiodarone d. Amitriptyline | B |
| Los pacientes con un dispositivo avanzado de vía aérea se ventilan de la sig manera: | Una respiración cada 5 o 6 segundos o 10-12 respiraciones por minuto |
| Cuándo se debe usar un DEA? (3) | -El individuo no responde cuando se le habla o se mueven sus hombros -El individuo no respira o su respiración no es efectiva -No se detecta pulso carotídeo |
| Cuáles son los cuidados del paciente que regresa a la circulación espontánea? (5) | 1.-Oxigenación 2.-Control de la TA 3.-Evaluar la necesidad de intervención coronaria percutánea 4.-Manejo de la temperatura 5.-Neuropronóstico multimodal |
| Temperatura objetivo en pacientes comatosos con RCE después del paro cardiaco | 32-36 grados centígrados |
| Objetivo de SatO2 en pacientes con RCE | >94% |
| Pasos de la cadena de supervivencia en SCA (5) | 1.-Reconocer síntomas y activar el SME 2.-SME- Manejo prehospitalario 3.-Cuidados basados en la evidencia 4.- Reperfusión con ICP o fibrinolíticos 5.- Cuidados post de calidad |
| Metas en el tratamiento del SCA (3) | 1.- Reducir necrosis miocárdica para preservar la función cardiaca 2.- Prevenir eventos adversos cardiacos mayores 3.- Tratar las complicaciones del SCA ( FV, TV, Shock) |
| Son los eventos adversos cardiacos mayores (2) | Muerte e infarto al miocardio no fatal |
| Son las complicaciones del SCA (5) | 1.- Fibrilación ventricular 2.- Taquicardia ventricular sin pulso 3.- Bradiarritmias 4- Shock cardiogénico 5.- Edema de pulmón |
Created by:
mune13