Rick Shared "ACLS" - 18 Picmonics

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ACLS

12 Lead Contiguous Leads - Inferior Wall MI
Leads Elevated
Lead II
Lead III
Lead aVF
Artery Affected
Right Coronary Artery (RCA)
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55 secs
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
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1 min
Adenosine (Adenocard)
Mechanism
Slows AV Conduction
Indications
Supraventricular Tachycardia (Paroxysmal)
Side Effects
Bradycardia
Flushing
Dyspnea
Considerations
Rapid IV Push
Caffeine and Theophylline Decrease Effectiveness
Dipyridamole May Intensify Effects
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2 mins
Atrioventricular Block Types
First Degree
First Degree
PR Interval > 200ms
No Treatment Needed
Second Degree
Second Degree
Mobitz I (Wenckebach)
Progressive PR Interval Lengthening with Nonconducted QRS Complex
Mobitz II
Constant PR Interval with Nonconducted QRS Complex
Third Degree
Third Degree
Atrioventricular Dissociation
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3 mins
Atropine
Mechanism of Action
Muscarinic Antagonist
Indications
Bradycardia
Increased Exocrine Secretions
Smooth Muscle Spasms
Side Effects
Tachycardia
Dry Mouth
Urinary Retention
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2 mins
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
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3 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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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
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min
ECG: Sinus Tachycardia
Rate
> 100 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Treat Underlying Cause
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2 mins
Epinephrine (Adrenaline)
Mechanism
Alpha and Beta Agonist
Indications
Anaphylaxis
Primary Open Angle Glaucoma (POAG)
Bleeding
Cardiac Arrest
Side Effects
Tachycardia
Hypertension
Tremors
Insomnia
Considerations
Multiple Strengths
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2 mins
Evolution of Myocardial Infarction and Complications
Hours to Days
Arrhythmia
Before 7 Days
Fibrinous Pericarditis
Papillary Muscle Rupture
Interventricular Septum Rupture
Before 14 Days
Ventricular Pseudoaneurysm
Ventricular Free Wall Rupture
After 14 Days
True Ventricular Aneurysm
Dressler Syndrome
Other
Left Ventricular Failure
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2 mins
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Myocardial Infarction Assessment
Assessment
Substernal Chest Pain
Crushing or Dull Sensation
Arm, Jaw, and Neck
> 20 Minutes
Unrelieved by Nitro
Palpitations
Diaphoresis
Fear of Impending Doom
Nausea and Vomiting
Shortness of Breath
Considerations
Monitor for Arrhythmias
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2 mins
Myocardial Infarction Diagnosis
Diagnosis
12 Lead ECG
ST Elevation
Q Wave
T Wave Inversion
Troponin T and I
CK-MB
Considerations
Early ECG
Cardiac Stress Test
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2 mins
Myocardial Infarction Interventions
MONA
Morphine
Oxygen
Nitrates
Aspirin
Thrombolytics (tPA)
Invasive Procedures
Cardiac Catheterization
Stent Placement
Angioplasty
Coronary Artery Bypass Grafting (CABG)
Considerations
Decrease Modifiable Risk Factors
Resuming Activity (Physical, Sexual)
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2 mins
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
Torsades de Pointes
Characteristics
Polymorphic Ventricular Tachycardia
Prolonged QT Interval
QRS Twist Around Isoelectric Line
Causes
Congenital
Antibiotics
Antiarrhythmics
Antipsychotics
Antidepressants
Electrolyte Deficiencies
Complications
Ventricular Fibrillation
Treatment
Stable: Magnesium Sulfate
Unstable: Defibrillation
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3 mins

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