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Question 1

Stable bradycardia

Answer 1

1. Get a 12 lead and call an expert

Question 2

Unstable Bradycardia (including AV blocks)

Answer 2

1. Atropine .5mg and repeat evert 3-5 min up to 3 mg
2. If first dose didn’t do anything, subsequent doses wont either
3. Proceed to transcutaneous pacing and/or dopamine drip 2-20mcg/kg/min or epinephrine drip 2-10mcg/min

Question 3

Unstable bradycardia that didn’t improve with atropine

Answer 3

1. Transcutaneous pacing and/or dopamine drip (2-20mcg/kg/min) or epinephrine drip (2-10mcg/min)

Question 4

Unstable tachycardia (with a pulse)

Answer 4

1. Synchronized cardioversion at 100 J unless it’s Atrial Fibrillation in which case you would do 120-200 J

Question 5

Stable tachycardia with NARROW QRS (SVT)

Answer 5

1. 12 lead ECG and vagal maneuvers
2. Adenosine 6mg
3. Adenosine 12 mg (Adenosine needs to be slammed. It will stop the heart for a few seconds)

Question 6

Stable tachycardia with WIDE QRS (V Tach with a pulse)

Answer 6

1. Antiarrhythmic such as Amiodarone 150mg diluted in 100mL D5W
2. Try adenosine if they have monomorphic, stable, regular tachycardia

Question 7

When is the only time you can try adenosine for stable tachycardia with a wide QRS

Answer 7

Monomorphic

Stable

Regular

Question 8

Stable irregular tachycardia with narrow QRS (Atrial fibrillation or atrial flutter)

Answer 8

1. Control rate with calcium channel blockers

Question 9

Wide irregular tachycardia (Polymorphic VT/Torsade de Pointes)

Answer 9

1. Defibrillate

2. Magnesium 1-2g diluted in 100mL D5W

Question 10

PULSELESS WITH SHOCKABLE RHYTHM (VFib or PULSELESS V Tach)

Answer 10

1. CPR
2. ⚡️Shock as soon as AED available
3. CPR 2 min
4. ⚡️Shock
5. Epinephrine after 2nd shock (repeat every 3-5 min)
6. CPR 2 min
7. ⚡️Shock
8. Amiodarone 300mg after 3 shocks. give 2nd dose 150mg in 3-5 min. Don’t give more than 2 doses of amiodarone

Question 11

When do you use amiodarone?

Answer 11

When someone has a shockable rhythm and you’ve already given them 3 shocks (between 1st and 2nd doses of Epinephrine)

OR

Stable tachycardia with wide QRS (VT with pulse)

Question 12

Amiodarone dosage during shockable rhythm:

First dose

Second dose

Answer 12

First: 300mg

Second: 150mg

Question 13

PULSELESS WITH NONSHOCKABLE RHYTHTM (PEA or Asystole)

Answer 13

1. CPR
2. Epinephrine
3. Go back and forth between CPR and Epi
4. After 10 minutes start talking to your team members about terminating resuscitation efforts

Question 14

POST CARDIAC ARREST CARE

Answer 14

1. Maintain airway and breathing
2. Keep BP over 90mmHg using IV fluids, and if necessary, try vasopressors
3. 12 lead ECG to r/o STEMI. If STEMI, go to cath lab
4. If patient is unresponsive, do Targeted temperature management (maintain 32-34° for 24 hrs)

Question 15

What is the correct temperature for TTM in post cardiac arrest care for an unresponsive patient?

Answer 15

32-36°C

Question 16

If you look at the monitor and someone has 3rd° heart block (an unstable bradycardia), and then you notice that they don’t have a pulse, what drug do they need?

A.) atropine

B.) Epinephrine

Answer 16

Epinephrine (and CPR….this is PEA)

Question 17

What does it mean if youre doing CPR and the ETCO2 jumps up to 30-40

Answer 17

You got ROSC

Question 18

An unstable patient has a systolic BP less than ____

Answer 18

90mmHg

Question 19

If someone has a BP, it means they have a _____

Answer 19

Pulse

Question 20

Steps for Acute Coronoary Syndrome

Answer 20

1. ECG
2. O2 if their spO2 is less than 90% (2-4 lpm)
3. Aspirin 160-325mg
4. Nitro 0.4mg
5. HOLD nitro if: Right sided MI, BP less than 90, tachycardia, bradycardia, or viagra in last 48hrs
6. Morphine 2-4mg every 5 min for pain that wasn’t relieved with nitro
7. Go to a hospital with a PCI unit within 90 minutes
8. If no PCI unit is possible, give tPA within 30 minutes

Question 21

When should you give Oxygen when a patient is having an MI

Answer 21

If their SPO2 falls below 90%

Question 22

Dosage of aspirin for someone having an MI

Answer 22

160-325mg

Question 23

Dosage of nitro

Answer 23

0.4mg

Question 24

If someone is having a heart attack, they need to be at a hospital with a PCI unit within ______ minuets

Answer 24

90

Question 25

If someon is having an MI and getting them to a hospital with a PCI unit (cath lab) is not possible, what should you do>?

Answer 25

TPA within 30 minutes

Question 26

How long after someon has a stroke can you give fibrinolytic therapy

Answer 26

3 to 4.5 hrs

Question 27

What is the only way to diagnose a stroke:

A.) contrast CT

B.) non-contrast CT

C.) MRI

D.) no imaging

Answer 27

B.) non contrast CT

Question 28

How do you confirm ET tube placement?

Answer 28

Waveform capnography

Question 29

True or false:

Waveform capnography, ETCO2 and PETCO are all the same thing

Answer 29

True

Question 30

If someone is intubated during CPR, you give 1 breath every ____ seconds and you (do/don’t) stop compressions for breaths

Answer 30

6

Don’t

Question 31

If someone is not intubated during CPR, you give one breath every ______seconds

Answer 31

5-6

Question 32

Agonal or gasping respirations means:

Answer 32

Cardiac arrest

Question 33

An ETCO2 less than ____mm during compressions means you’re doing a bad job with Compressions

Answer 33

10

Question 34

Normal ETCO2 is:

Answer 34

35-40mm