ABAD, ANGELICA JOY N.

BSN IV-B1
BASIC LIFE SUPPORT (BLS)
 Definition: A level of medical care used for victims of life-threatening illnesses or injuries until they
can be given full medical care at a hospital. It can be provided by trained medical personnel,
including emergency medical technicians, paramedics, and by qualified bystanders.
 Purpose: Promotes adequate blood circulation in addition to breathing through a clear airway.

ADVANCED CARDIAC LIFE SUPPORT (ACLS)

 Definition: refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and
other life-threatening medical emergencies, as well as the knowledge and skills to deploy those
interventions.
 Purpose: Achieve the best possible outcome for individuals experiencing a life-threatening event
 Code Team
NURSE ACTIVITIES
NURSE 1 (Bedside Nurse)  Identifies the situation
 Calls for code
 Initiates BLS and continues until reliever
arrives (Nurse 5)
 Monitor VS
NURSE 2 (Airway Nurse)  Inserts cardiac board
ABAD, ANGELICA JOY N.
BSN IV-B1
NURSE 3 (Medication Nurse)
NURSE 4 (Documentation Nurse)
NURSE 5 (Reliever Nurse)
 Assists with BLS (airway) until physician
arrives
 Prepares intubation set and assists in
intubation
 Laryngoscope
 ET with stylet
 KY Jelly
 10 cc syringe
 Bite block/OPA
 Gloves
 Swaps position with N1 or N5
 Prepares venoclysis equipment and starts IB
line
 Prepares medication IV drips
 Prepares bolus medications and administers it
 Passes equipment from the crash cart
 Does other procedures (ABG, SpO2)
 Gather initial information
 Document vital information (Time code
stated, medications given, procedures done,
ECG checks, defib energy levels, VS, time
code ended)
 Coordinates activities of all personnel and
recaps events
 Interprets ECG q 2mins.
 Reminds rhythm checks and medications due
 Connects electrodes
 Prepares equipment and performs
defibrillation
 Swaps position with N1 or N2 (Team
members should switch q 2 mins.)
ABAD, ANGELICA JOY N.
BSN IV-B1
ALGORITHMS
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1

EMERGENCY ROOM CRASH CART MEDICATIONS

DRUG CLASS. DRUG INDICATION ACTION S/E

Analgesics Codeine -Mild to moderate -Binds with opiate -Dizziness
(Narcotics) pain reeptors in CNS, -N/V
altering pereption -Respiratory
of and emotional depression
response to pain
Tramadol -Moderate to severe -Binds to opioid -Headache
pain receptor sites -N/V
inhibiting reuptake -Respiratory
of norepinephrine depression
and serotonin
Morphine -Severe pain -Binds with opioid -Sedation
receptors in CNS, -Hypotension
altering perception -bradycardia
of and emotional -N/V
response to pain -respiratory
depression

Fentanyl -Chronic pain -Binds with opioid -Sedation

-Postop pain receptors in CNS, -dry mouth
altering pain -N/V
perception and -respiratory
response depression
(Non-narcotics) Paracetamol -Mild pain -Produces analgesia -rash
-Fever by inhibiting -urticaria
prostaglandin
synthesis
-Relieves fever by
action in
hypothalamic heat-
regulating center
Ibuprofen -Mild to moderate -Inhibits -headache
pain prostaglandin -drowsiness
-Fever synthesis -dizziness
-epigastric pain
Anesthetics Lidocaine -Anesthetic -Alters signal -confusion
-Arrythmias conduction in -lethargy
neurons  blocks -bradycardia
fast voltage gated N -restlessness
channels in
neuronal cell
membrane 
membrane of
ABAD, ANGELICA JOY N.
BSN IV-B1
postsynaptic neuron
will not depolarize
-Decrease
depolarization,
automaticity and
excitability in
ventricles during
diastolic phase by
direct action on
tissues
(Infiltrative) Bupivacaine -local anesthetic -Inhibits initiation -decrease BP
and conduction of -bradycardia
sensory nerve -dizziness
impulses by -anxiety
altering influx of
sodium, and
potassium in
neurons, slowing or
stopping pain
transmission.
Lidocaine with -regional anesthesia Stabilizes neuronal -confusion
Epinephrine (peripheral nerve membrane by -lethargy
block) inhibiting the ionic -bradycardia
fluxes required for -restlessness
the initiation and -light headedness
conduction of
impulses, effecting
local anesthetic
action
Anti-bleeding Vit K -Prevent -Promotes hepatic -flushing
hemorrhage formation of active -dizziness
prothrombin 
controls abnormal
bleeding
Tranexamic Acid -Prevent -Inhibits activation -hypotension
hemorrhage of plasminogen, -dizziness
preventing -N/V
conversion of
plasminogen to
plasmin
Anti-convulsants Midazolam -Sedation -Depresses CNS at -headache
limbic and -N/V
subcortical levels of -decrease RR
brain by
potentiating effects
of GABA
promoting calmness
and sleep
ABAD, ANGELICA JOY N.
BSN IV-B1
Phenytoin -Control of tonic- -Stabilizes neuronal -confusion
clonic and complex membranes in the -nervousness
partial seizures motor cortex by -headache
altering sodium ion
movement across
them stopping
seizures
Lorazepam -Anxiety -Stimulates gamma- -drowsiness
-Status epilepticus aminobutyric -lethargy
receptors in the
ascending reticular
activating system,
promoting calmness
Diazepam -Anxiety -Depresses CNS at -drowsiness
-Muscle spasm limbic and -hypotension
-Status epilepticus subcortical levels
of the brain
relieving seizures
Phenobarbitol -Epilepsy -Depresses CNS -drowsiness
-Status epilepticus synaptic -resp depression
transmission and -apnea
increase seizure
activity threshold
in motor cortex
Anti-diabetics Insulin R -DM -Increases glucose -hypoglycemia
-DKA transport across -Lipohypertrophy
muscle and fat cell
membranes
reducing blood
glucose level. 
converts glucose to
its storage form
glycogen 
triggers AA uptake
 converts protein
in muscle cells 
inhibits protein
degradation ->
stimulates
triglyceride
formation 
inhibits release of
free fatty acids
from fats  lowers
glucose levels
CVS Agents Captopril -Hypertension -Inhibits ACE, -hypotension
(ACE Inhibitors) -Heart failure preventing -dizziness
onversion of
angiotensin I to
ABAD, ANGELICA JOY N.
BSN IV-B1
angiotensin II
decreasing
peripheral aterial
resistance and
aldosterone
secretion
Adrenergic Norepinephrine -restore BP during -Stimulates alpha -headache
Stimulants hypotension, shock and beta adrenergic -weakness
and cardiac arrest receptors in the -bradycardia
SNS
Dobutamine -Inreases cardiac -Directly stimulates -increased heart
output, cardiac beta 1 receptors to rate
contractility increase myocardial -hypertension
contractility and -angina
stroke volume thus
increasing cardiac
output
Dopamine -Improves -Stimulates -hypotension
perfusion dopaminergic beta- -bradycardia
-Increase cardiac adrenergic and
output alpha-adrenergic
receptors of
sympathetic
nervous system
Beta-blockers Metoprolol -Hypetension -Reduces -hypotension
Propanolol -Angina pectoris myocardial oxygen -bradycardia
consumption, -dizziness
myocardial
contractility and
heart rate by
inhibiting the beta
adrenergic site
Calcium channel Diltiazem -Angina -Inhibits calcium -headeache
blockers -Hypertension ion influx across -bradycardia
-Afib/Aflutter cardiac and smooth N/V
muscle cells -hypotension
decreasing
myocardial
contractility
demand; dilating
coronary arteries
Vasodilators Nitroglycerin -Angina -Reduces cardiac -h/a
oxygen demand -orthostatic
decreasing preload hypotension
and afterload -tachycardia
increasing blood
flow through
coronary vessels
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1
ABAD, ANGELICA JOY N.
BSN IV-B1

PREGNANCY INDUCED HYPERTENSION MANAGEMENT

 Definition: PIH is defined as hypertension (blood pressure ≥ 140/90 mmHg) with or without proteinuria
( ≥ 300 mg/24 hours) emerging after 20 weeks gestation, but resolving up to 12 weeks postpartum.1–10)
PIH is also defined as new onset proteinuria ( ≥ 300 mg/24 hours) in hypertensive women who exhibit
no proteinuria before 20 weeks gestation
 Signs and symptoms
 Hypertension - An increase in the usual blood pressure of the woman is the first indicator of this
disease.
 Proteinuria - Protein leaks out during this condition and can be detected in the urine.
 Edema - Since protein has already leaked out and it is responsible for containing water inside the
vessels, edema starts to occur.
 Classifications:
1. Gestational Hypertension
 BP reaches ≥ 140/90 mmHg for the first time during pregnancy (after 20 weeks gestation), but
without proteinuria. Blood pressure normalizes by 12 weeks postpartum
 Perinatal mortality is not increased with simple gestational hypertension, so no drug therapy is
necessary.
 BP returns to normal after birth.
2. Mild Preeclampsia
 Hypertension (blood pressure ≥ 140 / 90 mmHg) accompanied with proteinuria of 1+ or 2+
on a reagent test strip on a random sample but both symptoms normalize by 12 weeks
postpartum.
 A weight gain of more than 2 lbs/week in the second trimester or 1 lb/week in the third
trimester usually indicates abnormal tissue fluid retention.
3. Severe Preeclampsia
 BP is 160 mmHg systolic and 110 mmHg diastolic or above on at least two occasions 6 hours
apart at bed rest.
 Proteinuria. 3+ or 4+ on a random urine sample or more than 5 g in a 24-hour sample and
extensive edema are also present.
 Extreme edema will be noticeable as puffiness in a woman’s face and hands.
 May manifest oliguria (altered renal function), elevated serum creatinine (more than 1.2
mg/dL); cerebral or visual disturbances (blurred vision); thrombocytopenia and epigastric
pain.
4. Eclampsia
 Onset of convulsions in a woman with PIH that cannot be attributed to other causes. The
seizures are generalized and may appear before, during, or after labor
 Management
 Activity restriction
 Quiet environment
 Anticonvulsive therapy
 Antihypertensive therapy
 Delivery of fetus