AHA ACLS Provider flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sinus rhythm criteria

Regular rhythm, rate 60-100/min, upright P wave before every QRS in lead II, constant PR interval 0.12-0.20 s, and QRS under 0.12 s.

Atrial fibrillation ECG

Irregularly irregular ventricular rhythm with no distinct P waves and a fibrillatory baseline; QRS is usually narrow, and unstable patients require synchronized cardioversion.

Monomorphic ventricular tachycardia

Wide-complex tachycardia (QRS >0.12 s) at rate >100/min with uniform QRS morphology; a pulse may be present, and unstable patients need synchronized cardioversion.

Ventricular fibrillation

Chaotic, irregular electrical activity with no identifiable P waves, QRS complexes, or organized rhythm; it is a shockable arrest rhythm treated with immediate defibrillation and CPR.

Asystole

A flat-line arrest rhythm with no electrical activity; confirm in more than one lead, check gain and connections, and treat with CPR, epinephrine, and reversible-cause search, not defibrillation.

Third-degree AV block

Complete atrioventricular dissociation with independent atrial and ventricular rhythms; PR intervals vary and the ventricular rate is slow, often requiring pacing if the patient is unstable.

Adult compression rate and depth

Push at 100-120 compressions/min, at least 5 cm (2 in) deep but no more than 6 cm (2.4 in), allowing full chest recoil after each compression.

Compression-to-ventilation ratio

For an adult in cardiac arrest without an advanced airway, deliver 30 compressions followed by 2 ventilations; with an advanced airway, give 1 breath every 6 seconds and continuous compressions.

High-quality CPR fraction

Chest compression fraction is the proportion of arrest time spent compressing; target more than 60%, and minimize pauses to less than 10 seconds.

Two-person bag-mask technique

One rescuer seals the mask with both hands while the other squeezes the bag; give each breath over 1 second with just enough volume for visible chest rise.

Waveform capnography confirmation

After advanced airway placement, continuous waveform capnography plus clinical assessment confirms tracheal tube position; a persistent waveform indicates ventilation through the tube.

AED pad placement

Place one pad below the right clavicle and the other lateral to the left nipple, avoiding medication patches, implanted devices, and wet chest surfaces; dry the skin first.

VF/pVT shock sequence

Start CPR, defibrillate, resume CPR for 2 minutes, check rhythm, shock again, and continue cycles; give epinephrine after the second shock and an antiarrhythmic after the third.

Defibrillation energy

Use 120-200 J biphasic (manufacturer's recommended dose) or 360 J monophasic for the first shock; subsequent shocks use equal or higher energy.

PEA arrest treatment

Organized electrical activity without a palpable pulse: provide CPR, give epinephrine 1 mg IV/IO every 3-5 minutes, and search for reversible causes; defibrillation is not indicated.

Epinephrine arrest dose

Give 1 mg IV/IO of the 1:10,000 concentration every 3-5 minutes during cardiac arrest; in PEA or asystole, give it as soon as feasible.

Reversible arrest causes

Hypoxia, hypovolemia, hydrogen ion acidosis, hypo/hyperkalemia, hypothermia, tension pneumothorax, tamponade, toxins, and pulmonary or coronary thrombosis.

ETCO2 during CPR

A persistently low end-tidal CO2 below 10 mm Hg suggests poor compression quality or a nonperfusing rhythm; an abrupt sustained rise may indicate return of spontaneous circulation.

Bradycardia with a pulse

If unstable with hypotension, altered mental status, ischemic chest pain, acute heart failure, or shock, give atropine 1 mg IV every 3-5 minutes to a maximum of 3 mg.

Atropine failure in high-grade block

Atropine often fails in Mobitz type II or third-degree AV block; proceed to transcutaneous pacing or a dopamine or epinephrine infusion while preparing pacing.

Unstable tachycardia treatment

Tachycardia with a pulse and signs of instability is treated with synchronized cardioversion; if pulseless or polymorphic, use unsynchronized defibrillation instead.

Adenosine for SVT

For stable regular narrow-complex tachycardia, give adenosine 6 mg rapid IV push, then 12 mg if needed; it has a very short half-life and may cause transient asystole.

Synchronized cardioversion energies

Initial biphasic energy is often 50-100 J for narrow regular rhythms, 120-200 J for narrow irregular rhythms, and 100 J for wide regular rhythms; follow device recommendations.

Torsades de pointes

Polymorphic ventricular tachycardia with a twisting axis; if unstable, defibrillate, and consider magnesium 1-2 g IV along with correction of precipitating causes.

Amiodarone arrest dosing

For shock-refractory VF/pVT, give amiodarone 300 mg IV/IO bolus, then 150 mg after the next shock; a maintenance infusion may follow.

Lidocaine arrest dosing

For shock-refractory VF/pVT, give lidocaine 1-1.5 mg/kg IV/IO, then 0.5-0.75 mg/kg every 5-10 minutes to a maximum of 3 mg/kg.

Dopamine infusion range

For symptomatic bradycardia unresponsive to atropine, dopamine is infused at 5-20 mcg/kg/min and titrated to blood pressure and perfusion.

Adenosine administration technique

Give adenosine as a rapid IV push followed by a saline flush through a proximal IV; the drug's half-life is less than 10 seconds.

Synchronized vs unsynchronized shock

Synchronized cardioversion times the shock to the QRS complex for perfusing tachyarrhythmias; defibrillation is unsynchronized and used for VF, pulseless VT, and unstable polymorphic VT.

Post-ROSC oxygenation target

After return of spontaneous circulation, titrate oxygen to an SpO2 of 92-98% and adjust ventilation to a PaCO2 of about 35-45 mm Hg, avoiding hyperoxia and hypocapnia.

Post-arrest hypotension management

Treat systolic blood pressure below 90 mm Hg or mean arterial pressure below 65 mm Hg with IV fluids and vasopressors, and obtain a 12-lead ECG early.

Closed-loop communication

The team leader directs a specific person by name, that person repeats the order, and the leader confirms completion; this reduces errors during resuscitation.