BLS/ACLS/ECG

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Created by
therese dezzieree

Cards (48)

  • BLS Survey

    1. Check responsiveness
    2. Activate emergency response
    3. Check circulation
    4. Defibrillation
  • By using the BLS Survey, healthcare providers may achieve their goal of supporting or restoring effective oxygenation, ventilation and circulation until the Return of Spontaneous Circulation (ROSC) or initiation of ACLS interventions
  • ACLS Survey (Pre-Arrest)

    1. Visualize vital signs
    2. Provide supplementary oxygen
    3. Monitor and provide HQCPR
    4. Establish IV/IO
    5. Treat reversible causes
  • For unconscious patients, healthcare providers should conduct the BLS Survey followed by ACLS Survey. For conscious patients, providers should conduct ACLS Survey first
  • Return of Spontaneous Circulation (ROSC)

    Resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest
  • ROSC Assessment/Interventions

    1. Circulation (Fluids, Auscultation)
    2. Airway Breathing (Advanced airway, Auscultation)
    3. Disability (Therapeutic hypothermia)
  • Care bundles

    • A group of 3-5 evidence-based interventions, when performed together, have a better outcome than if performed individually
    • Can be used to ensure the delivery of the minimum standards of care
    • Can be used as an audit tool to assess the delivery of interventions
    • Cannot be used to assess how well individual interventions are performed
    • Encourage the review of evidence and modification of clinical care guidelines, engendering staff education in best practice
    • Key principle = high level of adherence to all components
  • Checklists

    Quality and safety monitoring tool
  • PDCA - Plan-Do-Check-Act (PDCA) cycle

    1. Plan the change or improvement
    2. Conduct a pilot test of the change
    3. Gather data about the pilot change to ensure the change was successful
    4. Implement the change on a broader scale; continue to monitor the change and repeat as necessary by repeating the cycle
  • PDCA cycle

    • A management tool for continuous improvement of a business's products or processes
    • Can be applied to standardize nursing management and thus improve the nursing quality and increase the survival rate of patients
    • Cyclical nature; allows it to be utilized in a continuous manner for ongoing improvement
    • Easy to use and requires little or no training
    • Makes sure that all appropriate steps are followed
    • Offers a systematic improvement method
    • Is an effective process improvement guide
    • Informs future improvement by providing feedback
    • Maintains order during problem solving
    • Requires significant commitment over time
  • Multidisciplinary plans of care
    • Improve patient's outcome
    • Increased quality and continuity of care
    • Improve communications and collaboration
    • Identification of hospital system problems
    • Coordination of necessary services and reduced duplication
    • Prioritization of activities
    • Reduce length of stay and health care costs
  • Format for the multidisciplinary approach categories
    • Discharge outcomes
    • Patient goals
    • Assessment and evaluation
    • Consultations
    • Tests
    • Medications
    • Nutrition
    • Activity
    • Education
    • Discharge planning
  • Primary consideration = patient's safety
  • Information and communication technologies in CCU
    • Clinical Information System
    • Computerized provider order entry (CPOE)
    • Hand-held Technologies
    • Tele-health Initiatives (Tele-ICU)
  • Advocacy: Access to social care services
    • PhilHealth
    • DOH
    • DSWD
    • PAGCOR
    • PCSO
  • American Heart Association

    International organization based on the US that studies and give some best practices when it comes to Cardiopulmonary Resuscitation (CPR) and emergency cardiovascular care (ECC)
  • BLS Survey

    Systematic approach to basic life support that any trained healthcare provider can perform, stressing early CPR and early defibrillation
  • BLS Survey

    1. Check responsiveness
    2. Check if the scene is safe
    3. Activate emergency response
    4. Check breathing and circulation
    5. Perform chest compressions and ventilations
    6. Use of Automated External Defibrillator
  • ACLS Survey

    Conducted with conscious patient, where the healthcare provider continues to assess and perform appropriate actions until transfer to the next level of care
  • Cardiac Monitoring

    Provides continuous observation of the patient's heart rate and rhythm, a routine nursing procedure in critical care patients
  • Electrocardiograph (ECG)

    A graphic record or representation of the electrical activity of the heart muscles
  • Electrode Placement

    1. Shaving the skin if necessary
    2. Removing dead skin cells
    3. Removing oil, grease and dirt using alcohol
    4. Using electrodes from airtight packages
  • Electrode Placement

    • 3-Lead ECG System
    • 5-Lead ECG System
  • Precordial Leads

    • V1
    • V2
    • V3
    • V4
    • V5
    • V6
  • ECG Grid Paper/Strip

    Horizontal boxes measure time, while vertical boxes measure voltage
  • Normal ECG Components

    • Waves (P, Q, R, S, T)
    • Intervals (PR, QRS, QT, ST)
    • Segments (PR, ST, TP)
    • Complex (QRS)
  • Conduction System of the Heart
    • The sinoatrial node acts as a natural pacemaker and initiates atrial depolarisation
    • The impulse is propagated to the ventricles by the atrioventricular node and spreads in a coordinated fashion throughout the ventricles via the specialised conducting tissue of the His-Purkinje system
  • His-Purkinje Conduction system

    Electrical impulses from SA node spread in a coordinated fashion throughout the ventricles via the specialised conducting tissue
  • The heart pumps because of electrical impulses and the heart is made up of muscles that receive electrical activity from the SA node
  • The picture represents the wiring system of the heart, allowing the electricity to disperse throughout the heart so it can function
  • In a normal person, electricity is produced in the Sinus Node. If the sinus node fails, the atrioventricular node acts as a backup. If the atrioventricular node also fails, the heart will use the remaining electricity in the Purkinje fibers
  • The flow of electricity has a direction: SA node -> Atrioventricular Node -> Purkinje Fibers. This connection is seen when leads are placed on the client's chest and the heart functions
  • Waves

    Positive deflection (upwards) indicates the location of the electrodes is towards the positive pole. Negative deflection (downwards) indicates the direction is towards the negative pole
  • Waves

    • P-wave
    • R-wave
    • T-wave
    • Q-wave
    • S-wave
  • Intervals

    • PR Interval
    • QRS Interval
    • QT Interval
    • ST Interval
  • Segments

    • PR Segment
    • ST Segment
    • TP Segment
  • Interpreting the ECG Strip: The 8-step Approach
    1. Determine Rate
    2. Determine the Rhythm
    3. Determine Presence of P-wave
    4. Check PR Interval
    5. Check QRS Complex
    6. Determine Presence of T-wave
    7. Check QT Interval
    8. Evaluate other components
  • Sinus Rhythm

    Cardiac rhythm where the sinoatrial node is generating impulses within the cardiac muscle
  • Sinus Rhythm Types

    • Sinus Tachycardia
    • Sinus Bradycardia
    • Sinus Arrhythmia
    • Sinus Arrest
  • Rhythms Originating in the Atria
    • Atrial Flutter
    • Atrial Fibrillation