Post-Arrest Management, Acute Coronary Syndromes, and Central Venous Line Procedures

Flashcards covering post-arrest stabilization, rescue breathing techniques, MAP calculations, acute coronary syndrome classifications and management (OANM), and central venous line insertion procedures.

Primary confirmation of Advanced Airway

$5$-pt auscultation.

Qualitative Secondary confirmation

A colorimetric device where the color changes from White to Yellow or from Purple to Yellow.

Quantitative PETCO2 (Alive Patient)

Normal range of $35\text{ to }45\,mmHg$.

Quantitative PETCO2 (During CPR)

Target of $10\,mmHg$; values below this indicate ineffective CPR.

Targeted Temperature Management (TTM)

A protocol for comatose patients involving maintaining a core body temperature of $32^{\circ}C-36^{\circ}C$ for at least $24\,\text{hours}$.

Inotrope Dosages (Post-Arrest)

Dopamine at $5-10\,mcg/kg/min$, Epinephrine at $0.1-0.5\,mcg/kg/min$, and Norepinephrine at $0.1-0.5\,mcg/kg/min$.

Adult Rescue Breathing

$1\,\text{breath every }6\,\text{seconds}$ or $10\,\text{breaths per minute}$.

Infant Rescue Breathing

$1\,\text{breath every }2-3\,\text{seconds}$ or $20-30\,\text{breaths per minute}$.

MRSOPA

A mnemonic for airway management: Mask adjustment, Reposition the head and neck, Suction secretions, Open the mouth, Pressure increase, and Airway adjuncts.

Nasopharyngeal Airway (NPA) Sizing

Measured from the tip of the nose to the earlobe.

Oropharyngeal Airway (OPA) Sizing

Measured from the corner of the lips to the angle of the mandible.

Mean Arterial Pressure (MAP)

The average pressure in arteries during one full heartbeat cycle; calculated as $(2 \times \text{diastolic} + \text{systolic}) \div 3$.

Minimum MAP for Organ Perfusion

>65\,mmHg.

Acute Coronary Syndromes (ACS)

A medical emergency where the heart muscle receives less blood and oxygen due to a blocked or narrowed coronary artery.

STEMI

ST-Elevation Myocardial Infarction; characterized by complete blockage and ST elevation on an ECG.

NSTEMI

Non-ST Elevation Myocardial Infarction; characterized by partial blockage and elevated cardiac enzymes (troponin) without ST elevation.

Unstable Angina (UA)

Chest pain at rest or a worsening pattern with no significant cardiac enzyme elevation.

OANM (ACS Initial Management)

Mnemonic for Oxygen, Aspirin ($162-325\,mg$), Nitroglycerin ($0.3-0.4\,mg$), and Morphine ($2-4\,mg$).

Aspirin Administration in ACS

Must be chewed, not swallowed, to ensure faster absorption; contraindicated if active bleeding is present.

Nitroglycerin Nursing Considerations

Avoid if SBP < 90\,mmHg; can give every $5\,\text{min}$ up to $3\,\text{doses}$; watch for headache, hypotension, and dizziness.

Morphine Effects in ACS

Provides pain relief, decreases anxiety, and calms the patient, leading to lower heart rate and blood pressure.

Fibrinolytic Treatment

The use of medications like Alteplase (tPA), Tenecteplase (TNK-tPA), or Streptokinase to dissolve blood clots and restore blood flow.

Percutaneous Coronary Intervention (PCI)

The preferred treatment for ACS, target time is $90\,\text{minutes or less}$ from first medical contact to balloon inflation.

Trendelenburg Position

Placing the patient head-down during central line insertion to distend veins and reduce the risk of air embolism.

Seldinger technique

A procedure for guidewire insertion where the wire is passed through an introducer needle into the vein.

CLABSI

Central line-associated bloodstream infections; a critical risk to prevent during central venous line placement.

Central Venous Line Confirmation

A Chest X-ray is performed to confirm tip position near the Superior Vena Cava (SVC) and rule out pneumothorax.