ACLS Principles Flashcard 3

B. Rationale: Coronary artery disease (CAD) and acute coronary syndromes make up about 80% of sudden cardiac death. This is often the case even when the individual does not have a known prior history of CAD, as death can be the presenting sign of disease. While certain risk factors exist, many people have no obvious risk factors. Valvular disease and cardiomyopathy make up a smaller percentage (10% and 15%, respectively) of the underlying etiologies of sudden cardiac death. Congestive heart failure is increasingly becoming a cause of sudden cardiac death. However, many of these patients will have underlying coronary artery disease, as well.

C. Rationale: A sudden change in vital signs may alert the astute clinician of an impending emergent event. Specific criteria can suggest the need for a rapid response, including hypertensive emergencies, significant hypotension, airway emergencies, sudden changes in level of consciousness, seizures, significant bradycardia (< 40 bpm) or tachycardia (> 140 bpm) or bradypnea (< 6 breaths/min) or tachypnea (> 30 breaths/min). Mild responses, especially if expected, should not trigger rapid responses.

C. Rationale: The system of care is composed of a structure, process, system, and outcome. These elements are created to improve the delivery of healthcare systems, such as advanced cardiac life support.

D. Rationale: High-quality CPR involves chest compressions delivered at a rate of 100–120/minute at a depth of 2.0–2.4 inches, allowing full chest recoil after each compression, minimizing interruptions to chest compression, and avoiding excessive ventilations.

A. Rationale: Partial recoil between compressions is not a part of high-quality CPR. There should be full chest recoil to allow the heart to refill adequately before the next compression. This helps maintain cardiac output as well as coronary and brain perfusion during compressions. Partial recoil suggests poor quality compressions or responder fatigue. Components of high-quality CPR including avoiding overventilation, switching responder roles after 2 minutes, quick and strong compressions, and minimized interruptions to compressions.

A. Rationale: The ACLS course showcases nine clinical conditions designated as CASES in the ACLS provider manual. These clinical conditions include the following:

● Respiratory arrest
● Acute Coronary Syndromes
● Acute Stroke
● VF/pulseless VT
● Asystole
● Pulseless Electrical Activity
● Bradycardia
● Tachycardia (stable and unstable)
● Immediate Post-Cardiac Arrest Care

B. Rationale: If there is no access to an ECG, the advanced cardiac life support provider may use an AED instead. Remember that if the cardiac arrest is secondary to a shockable rhythm, then immediate defibrillation is warranted, provided that interruptions to chest compressions are minimized.

B. Rationale: For the single-rescuer approach, the recommended compression-to-ventilation ratio in CPR is 30:2.

A. Rationale: AHA guidelines recommend a 1 mg epinephrine (1:10,000 dilution) intravenous bolus injection. A 1:1,000 dilution is too concentrated and is reserved for anaphylactic shock delivered intramuscularly. Defibrillation is not an option for pulseless electrical activity.