Specialist Paramedic Exam Preparation - ACLS, ITLS, PALS Master Guide

A complete set of vocabulary flashcards covering ACLS, ITLS, and PALS guidelines and specific exam high-yield points for Specialist Paramedic preparation.

ACLS Core Principle

High-quality CPR + early defibrillation + reversible cause treatment.

CPR Compression Rate

$100-120/\text{min}$.

Adult Compression Depth

$\ge 5\,cm$ ($2\text{ inches}$), with a maximum of $6\,cm$.

Advanced Airway Ventilation Rate

$1\text{ breath every }6\,s$ ($10/\text{min}$).

PETCO₂ Indicating Inadequate CPR

$\text{PETCO}_2 < 10\,mmHg$ suggesting poor quality chest compressions.

Amiodarone Indication and Dose (Adult)

For shock-refractory VF/pVT; $300\,mg$ bolus followed by a subsequent dose of $150\,mg$.

Lidocaine Dose (Adult)

$1-1.5\,mg/kg$ as a first dose, followed by $0.5-0.75\,mg/kg$.

Magnesium Sulphate Indication

Torsades de Pointes; dose is $1-2\,g$ IV over $5-20\,min$.

Amiodarone Contraindication

Torsades de Pointes (Magnesium should be used instead).

The 5 H's (Reversible Causes)

Hypovolaemia, Hypoxia, Hydrogen ion (Acidosis), Hypo/Hyperkalaemia, and Hypothermia.

The 5 T's (Reversible Causes)

Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), and Thrombosis (coronary).

Beck's Triad

Hypotension, Elevated JVP (jugular venous distension), and muffled heart sounds; indicates cardiac tamponade.

Atropine Maximum Dose (Adult Bradycardia)

$3\,mg\text{ IV}$.

Atropine Contraindication (Post-Cardiac Transplant)

Ineffective for bradycardia in transplant patients; aminophylline should be used instead.

Adenosine SVT Sequence

$6\,mg\text{ rapid IV push}$, followed by $12\,mg\text{ rapid IV push}$ if needed (can repeat $12\,mg$ once).

Targeted Temperature Management (TTM) Parameters

Maintain constant temperature between $32\,^{\circ}C$ and $37.5\,^{\circ}C$ for at least $24\,hours$ in comatose patients post-ROSC.

Perimortem Caesarean Delivery (PMCD) Timing

Perform within $5\,minutes$ of arrest if gestational age is $\ge 20\,weeks$ and ROSC is not achieved.

Ketamine (RSI Dose/Notes)

$1-2\,mg/kg\text{ IV}$; haemodynamically neutral bronchodilator preferred in trauma.

Suxamethonium RSI Avoidance

Avoid in patients at risk for hyperkalaemia ($K^+$), such as those with burns or crush injuries.

Scalpel-Finger-Bougie Cricothyrotomy Target population

Adults and children $\ge 12\,years$.

Needle Cricothyrotomy Target population

Children $< 12\,years$ due to soft laryngeal anatomy.

ITLS Assessment Sequence

Scene Size-Up \rightarrow Initial Assessment \rightarrow Primary Survey \rightarrow Rapid Trauma Survey or Focused Exam \rightarrow Secondary Survey \rightarrow Ongoing Assessment.

Tourniquet Placement

Position $5-7\,cm$ ($2-3\text{ inches}$) proximal to the wound; do not place over a joint.

Shock Class III (Blood Loss)

$1500-2000\,mL$ blood loss ($30-40\%$\text{ volume}$), characterized by reduced BP and confusion.

Needle Thoracocentesis Location

$2\text{nd intercostal space (ICS)}$ at the mid-clavicular line or $4\text{th}/5\text{th ICS}$ at the anterior-axillary line.

DCAP-BTLS

Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, and Swelling.

Cushing's Reflex

Hypertension, Bradycardia, and Irregular respirations; a sign of raised intracranial pressure (ICP)/herniation.

GCS Scoring Categories

Eye Opening ($1-4$), Verbal Response ($1-5$), and Motor Response ($1-6$).

Paediatric Assessment Triangle (PAT)

Appearance (TICLS), Work of Breathing, and Circulation to Skin.

Minimum Systolic BP for 1-10 Year Old

$70 + (2 \times \text{age in years})\,mmHg$.

Paediatric CPR Ratio (2 Rescuers)

$15:2$.

Atropine Minimum Paediatric Dose

$0.1\,mg$ (to avoid paradoxical bradycardia).

WETFLAG (W, E, T, F)

Weight ($2 \times [\text{Age} + 4]$), Energy ($4\,J/kg$), Tube size ($[\text{Age}/4] + 4$ for uncuffed), and Fluid ($20\,mL/kg$).

STEMI ECG Criteria (Limb Leads)

ST elevation $\ge 1\,mm$ in $\ge 2$ contiguous leads.

WPW + AF Contraindications

Avoid adenosine, digoxin, beta-blockers, and CCBs; risks rapid accessory pathway conduction leading to VF.