You are hereForums / USMLE Forums / USMLE Notes and Medical Mnemonics / ACLS
ACLS
V-fib/pulseless v-tach (new ACLS as of 2001)
"EVAL My Pumper":
Epinephrine Vasopressin Amiodarone (class IIb--better for heart failure) Lidocaine (indeterminate - better for young, healthy or persistent) MgSO4 (IIb for hypomagnesemic state or torsades) Procainamide (IIb for intermittent/recurrent VF/VT) Trauma: motor vehicle accident considerations
I AM SCARED:
Impact (head-on, rear-end, t-bone, rollover, rotational etc.) Auto vs. pedestrian, bike, motorcycle (start @ speed >10mph) Medical history (cardiac, coagulolation, liver, immuno, obese, prego) Speed (>50 mph?) Compartment intrusion (>12 inches?) Age (<5 or >55 y.o.?) Restraints (lap & shoulder, either, airbag, infant or child seat?) Ejection/ Extrication (eject=25x greater death, extr>20min) Death (at scene, same vehicle, other) Decompression sickness
Boyle's law: volume of gas is inversely proportionate to its pressure. ? Therefore, BOYLE:
Breathe (as you ascend) Or Your Lung Explodes ? Breathe as you ascend after scuba diving, since the pressure decreases on surfacing, so the gas volume in lungs increases. Pain history checklist
OLDER SAAB:
Onset Location Description (what does it feel like) Exacerbating factors Radiation Severity Associated symptoms Alleviating factors Before (ever experience this before) Asystole: treatment
"Have some asystole "TEA":
Transcutaneous pacing Epi Atropine Endotrachial tube deliverable drugs
O NAVEL:
Oxygen Naloxone Atropine Ventolin (albuterol) Epinephrine Lidocaine ? If you can't get IV access established, and have necessity to administer resuscitative meds, remember you have the airway and can give the above drugs. ? Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization. ? Alternatively, bare bone version is ALE, as above. RLQ pain: differential
APPENDICITIS:
Appendicitis/ Abscess PID/ Period Pancreatitis Ectopic/ Endometriosis Neoplasia Diverticulitis Intussusception Crohns Disease/ Cyst (ovarian) IBD Torsion (ovary) Irritable Bowel Syndrome Stones Subarachnoid hemorrhage (SAH) causes
BATS:
Berry aneurysm Arteriovenous malformation/ Adult polycystic kidney disease Trauma (eg being struck with baseball bat) Stroke Syncope causes, by system
HEAD HEART VESSELS:
? CNS causes include HEAD:
Hypoxia/ Hypoglycemia Epilepsy Anxiety Dysfunctional brain stem (basivertebral TIA)
? Cardiac causes are HEART: Heart attack Embolism (PE) Aortic obstruction (IHSS, AS or myxoma) Rhythm disturbance, ventricular Tachycardia
? Vascular causes are VESSELS: Vasovagal Ectopic (reminds one of hypovolemia) Situational Subclavian steal ENT (glossopharyngeal neuralgia) Low systemic vascular resistance (Addison's, diabetic vascular neuropathy) Sensitive carotid sinus Coma and signicantly reduced conscious state causes:
Causes COMA:
CO2 and CO excess Overdose: TCAs, Benzos, EtOH, insulin, paracetamol, etc. Metabolic: BSL, Na+, K+, Mg2+, urea, ammonia, etc. Apoplexy: stroke, SAH, extradural, subdural, Ca, meningitis, encephalitis, cerebral abscess, etc.
"EVAL My Pumper":
Epinephrine Vasopressin Amiodarone (class IIb--better for heart failure) Lidocaine (indeterminate - better for young, healthy or persistent) MgSO4 (IIb for hypomagnesemic state or torsades) Procainamide (IIb for intermittent/recurrent VF/VT) Trauma: motor vehicle accident considerations
I AM SCARED:
Impact (head-on, rear-end, t-bone, rollover, rotational etc.) Auto vs. pedestrian, bike, motorcycle (start @ speed >10mph) Medical history (cardiac, coagulolation, liver, immuno, obese, prego) Speed (>50 mph?) Compartment intrusion (>12 inches?) Age (<5 or >55 y.o.?) Restraints (lap & shoulder, either, airbag, infant or child seat?) Ejection/ Extrication (eject=25x greater death, extr>20min) Death (at scene, same vehicle, other) Decompression sickness
Boyle's law: volume of gas is inversely proportionate to its pressure. ? Therefore, BOYLE:
Breathe (as you ascend) Or Your Lung Explodes ? Breathe as you ascend after scuba diving, since the pressure decreases on surfacing, so the gas volume in lungs increases. Pain history checklist
OLDER SAAB:
Onset Location Description (what does it feel like) Exacerbating factors Radiation Severity Associated symptoms Alleviating factors Before (ever experience this before) Asystole: treatment
"Have some asystole "TEA":
Transcutaneous pacing Epi Atropine Endotrachial tube deliverable drugs
O NAVEL:
Oxygen Naloxone Atropine Ventolin (albuterol) Epinephrine Lidocaine ? If you can't get IV access established, and have necessity to administer resuscitative meds, remember you have the airway and can give the above drugs. ? Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization. ? Alternatively, bare bone version is ALE, as above. RLQ pain: differential
APPENDICITIS:
Appendicitis/ Abscess PID/ Period Pancreatitis Ectopic/ Endometriosis Neoplasia Diverticulitis Intussusception Crohns Disease/ Cyst (ovarian) IBD Torsion (ovary) Irritable Bowel Syndrome Stones Subarachnoid hemorrhage (SAH) causes
BATS:
Berry aneurysm Arteriovenous malformation/ Adult polycystic kidney disease Trauma (eg being struck with baseball bat) Stroke Syncope causes, by system
HEAD HEART VESSELS:
? CNS causes include HEAD:
Hypoxia/ Hypoglycemia Epilepsy Anxiety Dysfunctional brain stem (basivertebral TIA)
? Cardiac causes are HEART: Heart attack Embolism (PE) Aortic obstruction (IHSS, AS or myxoma) Rhythm disturbance, ventricular Tachycardia
? Vascular causes are VESSELS: Vasovagal Ectopic (reminds one of hypovolemia) Situational Subclavian steal ENT (glossopharyngeal neuralgia) Low systemic vascular resistance (Addison's, diabetic vascular neuropathy) Sensitive carotid sinus Coma and signicantly reduced conscious state causes:
Causes COMA:
CO2 and CO excess Overdose: TCAs, Benzos, EtOH, insulin, paracetamol, etc. Metabolic: BSL, Na+, K+, Mg2+, urea, ammonia, etc. Apoplexy: stroke, SAH, extradural, subdural, Ca, meningitis, encephalitis, cerebral abscess, etc.
