Advanced Life Support
Study online at https://quizlet.com/_9zsnwb
1. Principles of high quality CPR:
2. Ways to ensure the delivery of high quality CPR: - Allow the chest to recoil fully
- Compress to a depth of at least 2 in but not more than 2.4 in
- Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
3. How to insert an oropharyngeal airway.:
4. how to insert nasopharyngeal airway:
5. Considerations when an advanced airway is in place:
6. Proper placement of electrodes for monitoring of HR, rhythm, and obtaining
12 and 15-lead ECG:
7. Procedure for defibrillation:
8. Procedure for synchronized cardioversion:
9. Procedure for transcutaneous pacing:
10. Procedure for obtaining intraosseous (IO) access:
11. How to interpret EtCO2 during resuscitation ventilation?: 30-45 what it is
normally
15-20 during a resuscitation
Below 10 could be a problem with rate or quality of compressions
Spike is often the first sign of ROSC
12. Four components of communication: Sender, message, receiver, feedback
(closed loop communication)
13. Debriefing: Review, Analyze, Reflect, Summarize
14. Team leader responsibilities: - Assigns team roles
- Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
15. Team member responsibilities: - Have the knowledge and skills to perform
their assigned role
- Communicate with the team leader if they feel they are lacking the above, identify
something the team leader may have overlooked, recognize a dangerous situation
or need for urgent action
- Stay in their assigned role but assist others as needed, as long as they are able to
maintain their own responsibilities
, Advanced Life Support
Study online at https://quizlet.com/_9zsnwb
16. Six-Person High-Performance Resuscitation Team: Includes three CPR/de-
fibrillator roles, and three leadership/supportive roles
1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or interrup-
tions to chest compressions)
17. Example of a debrief review: A 15-year-old patient who had been brought to
the emergency department for evaluation of an earlier episode of syncope went
into witnessed ventricular fibrillation. Compressions were started, defibrillator pads
were applied and an initial shock of 120 J was delivered. An OPA was inserted
and high-flow oxygen was initiated. After 2 minutes of CPR and a rhythm check,
the patient was observed to still be in ventricular fibrillation; a second shock of
150 J was delivered, CPR was resumed, 1 mg of epinephrine was administered
and capnography monitoring was established. After approximately 1 more minute of
CPR, the patient achieved ROSC.
18. What should be prioritized during ventricular fibrillation - defibrillation or
ventilations?: Defibrillation is the most effective therapy for the treatment of vfib
19. A systematic approach to assessment includes a ____, ____, and ____
assessment.: Rapid, primary, secondary
20. - Initial impression
- Responsiveness
- Breathing
- Pulse
Are components of a _____ assessmetn: Rapid
21. - Airway
- Breathing
- Circulation
- Disability
- Exposure
are components of a _____ assessment: Primary
22. A broader assessment to narrow the list of differential diagnoses and
discover underlying causes is a _____ assessment: secondary (focused history,
physical examination, diagnostic testing)
, Advanced Life Support
Study online at https://quizlet.com/_9zsnwb
23. An OPA can only be used on a(n) ________ patient: unconscious
24. What could be adverse effects of an NPA too short or too long?: Too short,
may not relieve obstruction. Too long, may stimulate vagal response/bradycardia,
increase risk for aspiration, or damage epiglottis or vocal chords.
25. APPLY LUBRICANT TO PATIENT'S NOSTRIL AND BEVEL before: inserting
NPA
26. Which nostril do you start with NPA, because it is typically larger and more
straight?: Right
27. Assessing breathing: - Rate and rhythm
- Chest rise and cyanosis
- Presence or absence of breath sounds
- Bilateral equality
- Establish capnography to monitor the adequacy of ventilation (ETCO2 values 35-45
confirm adequacy of ventilation)
- Establish pulse oximetry
28. To minimize complications when using a BVM, depress the bag...: slowly
over 1 second, and only about halfway (400mL to 700mL tidal volume for an adult)
29. Assessing circulation: -High quality CPR
-Establish cardiac monitoring and provide electrical therapy
-Establish vascular access for the administration of fluids/meds
30. Three electrode placement: White (RA) under the right clavicle, mid clavicular
line
Black, green, or brown under the left clavicle MCL
Red on LL abdomen
31. Where is the brown electrode placed in a 5-electrode system?: Fourth
intercostal space, right sternal border
32. Which rhythms are shockable?: V-Fib and pulseless V-Tach.
33. Synchronized cardioversion: Low dose direct current electricity timed to cor-
respond with peak of R wave
34. Why is synchronized cardioversion delivered at the peak of the R wave?-
: Avoids delivering shock during the refractory phase, which could lead to V fib or
torsades de pointes
35. What conditions are synchronized cardioversion used for?: Supraventricu-
lar tachycardia, Atrial fibrillation, Atrial flutter, Monomorphic v tach
36. Cardioversion and transcutaneous pacing are uncomfortable, administer
___ and ___ if situation allows: Sedation, analgesia
Study online at https://quizlet.com/_9zsnwb
1. Principles of high quality CPR:
2. Ways to ensure the delivery of high quality CPR: - Allow the chest to recoil fully
- Compress to a depth of at least 2 in but not more than 2.4 in
- Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
3. How to insert an oropharyngeal airway.:
4. how to insert nasopharyngeal airway:
5. Considerations when an advanced airway is in place:
6. Proper placement of electrodes for monitoring of HR, rhythm, and obtaining
12 and 15-lead ECG:
7. Procedure for defibrillation:
8. Procedure for synchronized cardioversion:
9. Procedure for transcutaneous pacing:
10. Procedure for obtaining intraosseous (IO) access:
11. How to interpret EtCO2 during resuscitation ventilation?: 30-45 what it is
normally
15-20 during a resuscitation
Below 10 could be a problem with rate or quality of compressions
Spike is often the first sign of ROSC
12. Four components of communication: Sender, message, receiver, feedback
(closed loop communication)
13. Debriefing: Review, Analyze, Reflect, Summarize
14. Team leader responsibilities: - Assigns team roles
- Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
15. Team member responsibilities: - Have the knowledge and skills to perform
their assigned role
- Communicate with the team leader if they feel they are lacking the above, identify
something the team leader may have overlooked, recognize a dangerous situation
or need for urgent action
- Stay in their assigned role but assist others as needed, as long as they are able to
maintain their own responsibilities
, Advanced Life Support
Study online at https://quizlet.com/_9zsnwb
16. Six-Person High-Performance Resuscitation Team: Includes three CPR/de-
fibrillator roles, and three leadership/supportive roles
1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or interrup-
tions to chest compressions)
17. Example of a debrief review: A 15-year-old patient who had been brought to
the emergency department for evaluation of an earlier episode of syncope went
into witnessed ventricular fibrillation. Compressions were started, defibrillator pads
were applied and an initial shock of 120 J was delivered. An OPA was inserted
and high-flow oxygen was initiated. After 2 minutes of CPR and a rhythm check,
the patient was observed to still be in ventricular fibrillation; a second shock of
150 J was delivered, CPR was resumed, 1 mg of epinephrine was administered
and capnography monitoring was established. After approximately 1 more minute of
CPR, the patient achieved ROSC.
18. What should be prioritized during ventricular fibrillation - defibrillation or
ventilations?: Defibrillation is the most effective therapy for the treatment of vfib
19. A systematic approach to assessment includes a ____, ____, and ____
assessment.: Rapid, primary, secondary
20. - Initial impression
- Responsiveness
- Breathing
- Pulse
Are components of a _____ assessmetn: Rapid
21. - Airway
- Breathing
- Circulation
- Disability
- Exposure
are components of a _____ assessment: Primary
22. A broader assessment to narrow the list of differential diagnoses and
discover underlying causes is a _____ assessment: secondary (focused history,
physical examination, diagnostic testing)
, Advanced Life Support
Study online at https://quizlet.com/_9zsnwb
23. An OPA can only be used on a(n) ________ patient: unconscious
24. What could be adverse effects of an NPA too short or too long?: Too short,
may not relieve obstruction. Too long, may stimulate vagal response/bradycardia,
increase risk for aspiration, or damage epiglottis or vocal chords.
25. APPLY LUBRICANT TO PATIENT'S NOSTRIL AND BEVEL before: inserting
NPA
26. Which nostril do you start with NPA, because it is typically larger and more
straight?: Right
27. Assessing breathing: - Rate and rhythm
- Chest rise and cyanosis
- Presence or absence of breath sounds
- Bilateral equality
- Establish capnography to monitor the adequacy of ventilation (ETCO2 values 35-45
confirm adequacy of ventilation)
- Establish pulse oximetry
28. To minimize complications when using a BVM, depress the bag...: slowly
over 1 second, and only about halfway (400mL to 700mL tidal volume for an adult)
29. Assessing circulation: -High quality CPR
-Establish cardiac monitoring and provide electrical therapy
-Establish vascular access for the administration of fluids/meds
30. Three electrode placement: White (RA) under the right clavicle, mid clavicular
line
Black, green, or brown under the left clavicle MCL
Red on LL abdomen
31. Where is the brown electrode placed in a 5-electrode system?: Fourth
intercostal space, right sternal border
32. Which rhythms are shockable?: V-Fib and pulseless V-Tach.
33. Synchronized cardioversion: Low dose direct current electricity timed to cor-
respond with peak of R wave
34. Why is synchronized cardioversion delivered at the peak of the R wave?-
: Avoids delivering shock during the refractory phase, which could lead to V fib or
torsades de pointes
35. What conditions are synchronized cardioversion used for?: Supraventricu-
lar tachycardia, Atrial fibrillation, Atrial flutter, Monomorphic v tach
36. Cardioversion and transcutaneous pacing are uncomfortable, administer
___ and ___ if situation allows: Sedation, analgesia
