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1

Disease of the coronary arteries and their resulting complications such as angina pectoris and acute MI

Coronary heart disease

2

Disease of the arteries that supply the heart muscle with blood

Coronary artery disease

3

A sudden loss of effective blood flow that's caused by cardiac and/or peripheral vascular factors that may reverse spontaneously (like syncope) or only with intervention (like cardiac arrest)

Cardiovascular collapse

4

The absence of cardiac mechanical activity, which is confirmed by the absence of a detectable pulse, unresponsiveness and apnea or agonal gasping breathing

Cardiopulmonary (cardiac) arrest

5

A natural death of cardiac cause that's preceded by an abrupt loss of consciousness within one hour of the onset of an acute change in cardiovascular status

Sudden cardiac death

6

What are the heart rhythms that may be observed in a cardiac arrest?

1. Pulseless VT (wide regular QRS faster than 120 bpm)
2. VFib (irregular chaotic deflections that vary in shape and height are observed but there's no coordinated ventricular contraction)
3. Asystole (no cardiac electrical activity is present
4. Pulseless electrical activity (Electrical activity is visible on EKG but central pulses are absent)

7

What are the shockable rhythms? the nonshockable?

Shockable - VT and VF
nonshockable - Asystole and PEA

8

What are the links in the chain of survival?

1. early recognition and activation
2. early CPR
3. Early defibrillation
4. Effective advanced life support
5. Integration of post-cardiac arrest care

9

Who makes up a medical emergency team or a rapid response team?

A physician and a nurse with critical care training who are available at all times

10

What are the components of basic life support?

1. recognition of signs of cardiac arrest, heart attack, stroke and foreign body airway obstruction.
2. relief of foreign body airway obstruction
3. cardiopulmonary resuscitation (CPR)
4. defibrillation with an automated external defibrillator (AED

11

When performing chest compressions, when is systole and when is diastole?

Systole is in the chest compression phase and diastole is in the release phase

12

Whats the key detereminant of the success of resuscitation ?

Coronary perfusion pressure, generated when performing external chest compressions

note that adequate cerebral and coronary perfusion pressures are critical to neurologically normal survival

13

when you determine that CPR is needed what is the initial action performed?

Chest compression - this enables better delivery of the oxygen that's already present in the lungs and arterial circulation to the heart and brain

14

What's the Cardiac output during CPR?

25-33% of normal

15

What makes high quality chest compressions?

- Pushing had on a victims chest
- Ccompressing at a rate of at least 100 compressions/minute allowsing full chest recoil after each compression (so the heart can refill)
- Minimizing the interruptions in chest compressions

16

How hard should you push on an adults chest?

at least 2 inches (5cm) in adults

17

How hard should you push on an infants chest?

A depth of at least one third the AP diameter of the chest or about 1.5 inches (4cm)

18

how hard should you push on a childs chest?

about 2 inches (5cm)

19

What is the post-cardiac arrest syndrome?

Pathophysiology due to the ischemia-reperfusion response that occurs during cardiac arrest and subsequent return of spontaneous circulation

20

What are the components of the post cardiac arrest syndrome?

- post-cardiac arrest brain injury
- post-cardiac arrest myocardial dysfunction
- systemic ischemia/reperfusion response
- persistent precipitating pathology that caused or contributed to the cardiac arrest

21

What are the PATCH-4-MD possible treatable causes of cardiac emergencies?

Pulmonary embolism - anticoagulant, surgery
Acidosis - ventilation, correct acid-base disturbance
Tension pneumothorax - needle decompress
Cardiac tamponade - pericardiocentesis
Hypovolemia - replace volume
Hypoxia - ensure adequate oxygenation and ventilation
Hypothermia/Hyperthermia
Hypo/Hyperkalemia (and other electrolytes) - monitor glucose carefully wile correcting electrolytes
Myocardial infarction - reperfusion therapy
Drug overdose/accidents

22

What are the 5 H's for possible treatable causes of cardiac emergencies?

Hypovolemia
Hypoxia
Hypothermia
Hypo/Hyperkalemia
Hydrogen ion (acidosis)

23

What are the 5 T's for possible treatable causes of cardiac emergencies?

Tamponade, cardiac
Tension pneumothorax
Thrombosis: lungs (massive PE)
Thrombosis: heart (ACS)
Tablets/Toxins

24

What are the three phase of cardiopulmonary resuscitation due to VF?

1. Electrical phase
2. Circulatory (hemodynamic) phase
3. Metabolic phase

25

What is the time frame and intervention of phase 1 of cardiopulmonary resuscitation?

Electrical phase
Occurs from the time of VF arrest to about the first 5 min after the arrest
Intervention is electrical therapy (defibrillation)

26

What is the time frame and intervention of phase 2 of cardiopulmonary resuscitation?

Circulatory (hemodynamic) phase
Occurs from 5 min to 15 min after VF arrest
Intervention is CPR before electrical therapy

27

What is the time frame and intervention of phase 3 of cardiopulmonary resuscitation?

Metabolic phase
Occurs after about 15 minutes
Intervention is therapeutic hypothermia

28

What type of drug may improve perfusion pressures during cardiac arrest?

Vasopressors

29

What is a common cause of intrathoracic pressure during CPR?

Hyperventilation
Increased pressure can decrease venous return during the release (diastolic) phase of chest compression

30

What therapeutic method should be part of a standardized treatment strategy for comatose survivors of cardiac arrest?

Therapeutic hypothermia
- suppresses damaging chemical reactions
- can improve oxygen deliver to the brain
- Decreases HR and increases TPR while maintain stroke volume and BP