Danielle Shared "CPR" - 55 Picmonics
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CPR
Cardiopulmonary Resuscitation (CPR) for Adults
- Steps Before CPR
- Scan Scene
- Activate Emergency Response System
- Check For Breathing (Max 10 Seconds)
- Open Airway
- Compressions, Airway, Breathing (CAB)
- Compressions: 2 Inches Deep (100-120 Compressions/Min)
- Airway: Ensure Airway is Still Open
- Breathing: Administer 2 Rescue Breaths
- Considerations
- Repeat C-A-B Sequence (30:2) Until Help Arrives
3 mins
Cardiac Arrest Algorithm
- A) Begin CPR, Administer O2, Attach defib/monitor
- B) Shockable Rhythm (VF/pVT): SHOCK
- C) Continue CPR for 2 minutes
- 1st time around: IV/IO access
- 2nd: Epi q3-5 minutes, Consider intubating
- 3rd+ : Amiodarone + treat reversible causes
- C) Non-Shockable Rhythm (PEA, Asystole): CPR 2 minutes
- 1st time around: IV, EPI q3-5, Intubate
- 2nd time around: Consider reversible causes
- Post-Resuscitation Considerations
- Post-resuscitation
- A) BP Control
- 1-2L NS or LRIs
- Pressors
- Keep systolic above 90
- B) Optimize breathing
- ET CO2 35-40, PaO2 40-45
- C) 12 lead to monitor for ACS, consider cath lab
- D) Therapeutic hypothermia
Ventricular Tachycardia (V-tach)
- Causes
- Heart Disease
- Electrolyte Imbalances
- Drugs
- CNS Disorders
- Manifestations
- Hypotension
- Pulmonary Edema
- Decreased Cerebral Blood Flow
- Cardiopulmonary Arrest
- Treatment
- Treat Underlying Cause
- Antidysrhythmics (amiodarone)
- Cardioversion
- CPR
- Defibrillation
2 mins
Maslow's Hierarchy of Needs
- Physiological Needs
- Oxygen, Water, Nutrition
- Body temperature, Elimination, Shelter, Sexual Expression
- Safety and Security
- Physical Safety
- Physiological Safety
- Love and Belonging
- Affection and Companionship
- Esteem
- Self Respect and Respect for Others
- Self Actualization
- Fulfillment
2 mins
Airway, Breathing, Circulation (ABC's)
- Airway Assessment
- Changed Sound of Voice
- "See-saw" Respirations
- Stridor
- Breathing Assessment
- Normal Respiratory Rate: 12–20 Breaths/Min
- Use of Accessory Muscles in Respiration
- Cyanosis
- Circulation Assessment
- Color of Hands and Digits
- Normal Capillary Refill Time (CRT): 2 Seconds
- Decreased LOC
- Considerations
- Initial ‘Look, Listen and Feel” Assessment
- Emergency Treatment
- Prioritization in Exam Questions
5 mins
Guidelines for Prioritizing
- First-level priority problems
- Airway, Breathing, Circulation (ABCs)
- Second-level Priority Problems
- MAA-U-AR
- Mental Status Change
- Acute Pain
- Acute Urinary Elimination Problems
- Untreated Medical Problems
- Abnormal Laboratory Values
- Risk of Infection, Safety or Security
- Third-Level Priority Problems
- Long-Term Treatments
2 mins
The Nursing Process
- ADPIE
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
2 mins
ACLS Tachycardia
- Tachycardia
- Regular Tachycardias
- Irregular Tachycardias
- Narrow Complex
- Wide Complex
- Supraventricular Tachycardia (Paroxysmal)
- Adenosine (Adenocard)
- First dose = 6 mg; 2nd dose = 12 mg
- AV nodal
- Beta Blocker
- Metoprolol
- 5 mg
- Calcium Channel Blockers
- Verapamil
- First dose = 2.5-5 mg; 2nd dose = 5-10 mg
- Ectopic Atrial Tachycardia
- Junctional Tachycardia
- Procainamide
- Amiodarone
- 150 mg over 10 min
- 20-50 mg/min
- Torsades de Pointes
- Magnesium (Mg2+)
- Ventricular tachycardia/fibrillation
- Pre-excitation tachycardia
- e.g. Wolf-Parkinson-White
- Paced ventricular tachycardia
- SVT w/ aberrancy (i.e. bundle branch block)
- Irregular, Narrow Complex Tachycardias
- Atrial fibrillation
- Multifocal Atrial tachycardia
- ECG: Sinus Tachycardia
- AV nodal blockers
- Irregular, wide complex tachycardias
- Pre-excitation Atrial fibrillation
- Procainamide
- Sotalol
- Unstable regular tachycardia = 100 J synchronized
- Unstable Irregular tachycardias = 200 J shock
ACLS: No pulse, VTach/VFib
- Begin CPR
- Epinephrine
- Pulse check, rhythm check, shock if indicated
- Continue 2 min of CPR
- Give Amiodarone
- Repeat the cycle starting with a pulse, rhythm and shock
2 mins
ACLS Cardiac Arrest Algorithm
- Supporting Oxygenation, Ventilation, and Circulation to preserve Neuro Function
- Begin CPR! Oxygen/Ventilation, EKG, Defibulator. SHOCKABLE RHYTHM?
- Shockable Rhythm? V-Fib or pulseless V-Tach; Shock(120-200J); CPR (2 min) &have IV. Determine again is this Shockable Rhythm? Repeat with increased joules.
- Not Shockable? Signs of ROSC? If yes, then use post Cardiac Arrest algorithm. If ROSC and returned to Shockable Rhythm, Remain in the Shockable Rhythm algorithm.
- A Non-Shockable rhythm. Ask “PEA or Asystole?” Continue CPR 2 min, IV Epinephrine Q3-5min, Advanced Airway. Checking again for a shockable rhythm.
- Continue in that loop until ROSC or the code is called and the patient is declared deceased.
- Shock, Shock, Epi, Shock, Amio, Shock, Sometimes Mag, Shock
4 mins
Ventricular Fibrillation (V-fib)
- Causes
- Myocardial Infarction
- Ischemia
- Disease States
- Cardiac Catheterization
- Pacemaker
- Symptoms
- Unresponsive
- Pulseless
- Apnea
- Treatment
- CPR/ACLS
- Defibrillation
- Drugs (epinephrine & vasopressin)
2 mins
ECG: Atrial Flutter
- Rate
- Variable
- Rhythm
- Regular or Irregular
- P Wave
- Saw Tooth, Multiple Before Every QRS
- PR Interval
- Non-measurable
- QRS Interval
- < 0.12 seconds
2 mins
Phases of Disaster Management
- Mitigation
- Preparedness
- Response
- Recovery
2 mins
FEMA Levels of Disaster
- Levels of Disaster
- Level I Disaster
- Level II Disaster
- Level III Disaster
- Nurse's Role In Disaster Planning
- Personal and Professional Preparedness
2 mins
Triage
- Simple Triage And Rapid Treatment (START)
- Tags
- Red: Immediate (Critical)
- Yellow: Delayed (Urgent)
- Green: Minor (Ambulatory)
- Black: Deceased (Expired)
- Step 1: Movement
- Ability to Walk
- Step 2: Respirations
- Spontaneous Breathing
- Respiratory Rate
- Step 3: Perfusion
- Check Circulation
- Step 4: Mental Status
- Mental Status
4 mins
Fire - Environmental Emergencies
- R.A.C.E
- Rescue
- Alarm
- Confine
- Extinguish
- P.A.S.S.
- Nursing Considerations
- Fire Exits
- Do Not Use Elevators
- Manual Ventilation
2 mins
Documentation Guidelines
- Factual
- Objective Information
- Subjective Information from Patient
- Objective Supports Subjective
- Accurate
- Avoid Unnecessary Words and Details
- Exact Measurements
- Current
- Assessments
- Document ASAP
- Treatment and Response
- Change in Status
- Admission, Transfer, Discharge or Death
- Organized
- Document in a Logical Order
- Ensure Information Recorded is Complete
4 mins
Parts of an ECG
- PQRST
- P Wave
- Atrial Depolarization
- QRS Complex
- Ventricular Depolarization
- T Wave
- Ventricular Repolarization
2 mins
ECG Interpretation
- Rate
- Rhythm
- P Waves
- Upright, Rounded, Before Every QRS
- PR Interval (< 0.20 seconds)
- Normal QRS (< 0.12 seconds)
2 mins
12 Lead Contiguous Leads - Lateral Wall MI
- Leads Elevated
- Lead I
- Lead aVL
- Lead V5
- Lead V6
- Artery Affected
- Circumflex
1 min
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