ACLS

Question 1

Bradycardia

Answer 1

1. Vital Signs (BP, P, R, SpO2, ETCo2), Palpate Pulse
2. Start IV and 12-Lead
3. Decide if pt is stable or unstable
4. Stable: Atropine 1mg, repeated 3-5 min. (max. 3mg)
5. Unstable: Pacing

Do not delay pacing for Atropine

Mobitz 2 and 3rd Degree HB: Straight to pacing no matter what pt condition looks like.

Consider if pt is a cardio based athlete making this their norm.

HR<60

Question 2

Stable

SVT

Tachycardia

Answer 2

Vagal Stimulus
* Bare down & clench like your trying to poop
* Blow through straw/plunger

Adenosine
* 6mg Rapid IV Push
* Rapid 10cc flush immediatly after
* Repeat 12mg Rapid IV Push if no change
* Rapid 10cc flush immediately after

Diltiazem
* 0.25mg/kg over 2 min (max. 10mg)
* Repeat at 15 min.
* 0.35mg/kg over 2 min (max. 20mg)

If pt is >65yo cut dose in half

Question 3

SVT Unstable

Answer 3

Synchronized Cardioversion
* 100J, 200J, 300J, 370J