ACLS review
81. List the steps for performing CPR on a victim of an unwitnessed cardiac arrest.
Assess responsiveness and breathing
Feel for a pulse for up to 10 seconds
If no pulse then begin CPR beginning with chest compressions
After 2 minutes or 5 cycles of CPR activate the EMS system
Squeeze the bulb and allow the bulb to self- expand; if the bulb expands in < 5 sec, then the ETT is in the trachea. Ventilate the patient and clinically check placement: check for symmertical chest rise and auscultate over the stomach and lungs.
If bulb expands slowly (over 5 sec) tracheal intubation is questionable
If bulb remains collapsed or gastric contents obtained, the ETT is in the esophagus. Remove the ETT immediately and ventilate with BVM device
The rhythm is suppressed
The patient becomes hypotensive
The QRS complex widens over 50% from baseline.
No relationship between the P waves and the QRS complex
QRS complex is often wide: > .12 sec
Rate is less than 60 bpm
Never perform bilateral carotid massage
Listen for bruits before carotid massage- contraindicated if bruits are present
It should not be continued for more than 10 sec.
Patient should be on cardiac monitor
Should have IV access before attempting vagal maneuvers
Reviewed 2/28/16
Assess responsiveness and breathing
Feel for a pulse for up to 10 seconds
If no pulse then begin CPR beginning with chest compressions
After 2 minutes or 5 cycles of CPR activate the EMS system
82. How is an esophageal detector device used?
Attach the detector device to the ETT while maintaining ETT placementSqueeze the bulb and allow the bulb to self- expand; if the bulb expands in < 5 sec, then the ETT is in the trachea. Ventilate the patient and clinically check placement: check for symmertical chest rise and auscultate over the stomach and lungs.
If bulb expands slowly (over 5 sec) tracheal intubation is questionable
If bulb remains collapsed or gastric contents obtained, the ETT is in the esophagus. Remove the ETT immediately and ventilate with BVM device
83. What are the therapeutic endpoints for the administration of Procainamide for VT with a pulse?
The patient receives the maximum dose of 17mg/kgThe rhythm is suppressed
The patient becomes hypotensive
The QRS complex widens over 50% from baseline.
84. What are the ECG characteristics of 3rd degree heart block?
Atrium and ventricles are beating asynchronously.No relationship between the P waves and the QRS complex
QRS complex is often wide: > .12 sec
Rate is less than 60 bpm
85. Name 5 precautions that should be considered prior to performing carotid sinus massage?
Avoid carotid massage in older adultsNever perform bilateral carotid massage
Listen for bruits before carotid massage- contraindicated if bruits are present
It should not be continued for more than 10 sec.
Patient should be on cardiac monitor
Should have IV access before attempting vagal maneuvers
Reviewed 2/28/16
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