Cardiac Emergencies (ACLS) Flashcards

The ACLS algorithm for ventricular fibrillation (VF) calls for defibrillation at which energy level with a biphasic defibrillator?

Answer: 200 joules (manufacturer-specific) for the first shock, escalating if needed

Biphasic defibrillators deliver effective shocks at lower energies than monophasic devices; the first shock is typically 200J (or manufacturer-specified dose), with equivalent or higher energy for subsequent shocks.

In ACLS, CPR cycles consist of:

Answer: 30 compressions to 2 ventilations (30:2) until an advanced airway is placed, then asynchronous

The 30:2 ratio applies until an advanced airway (ETT or supraglottic) is placed; once secured, continuous compressions at 100-120/min are given with ventilation at 10 breaths/min asynchronously.

Epinephrine dosing in ACLS cardiac arrest is:

Answer: 1mg IV every 3-5 minutes

Epinephrine 1mg IV/IO is administered every 3-5 minutes during cardiac arrest; it increases coronary and cerebral perfusion pressure through peripheral vasoconstriction, improving the probability of ROSC.

Amiodarone is given in ACLS for shock-refractory VF/pVT at which dose?

Answer: 300mg IV bolus first dose, followed by 150mg if needed

Amiodarone 300mg IV is given for VF/pVT that persists after 2-3 defibrillations; a second dose of 150mg can be administered for recurrent or refractory VF/VT.

Post-ROSC targeted temperature management (TTM) aims to maintain core temperature at:

Answer: 32-36°C for at least 24 hours in comatose survivors

TTM at 32-36°C for 24+ hours in comatose post-cardiac arrest survivors reduces neurological injury by decreasing cerebral metabolic demand, inflammation, and excitotoxicity following ischaemia-reperfusion injury.

In ACLS, pulseless electrical activity (PEA) is managed by:

Answer: CPR, epinephrine every 3-5 minutes, and treatment of reversible causes (Hs and Ts)

PEA is treated with high-quality CPR and epinephrine while simultaneously searching for and treating reversible causes (Hypovolaemia, Hypoxia, Hydrogen ion (acidosis), Hypo/hyperkalaemia, Hypothermia, Tension pneumothorax, Tamponade, Toxins, Thrombosis).