ACLS

Question 1

Tachycardia with Pulse

Adenosine doses:

Amio doses:
Amio maintenence dose:

Procainamide dose:
Procainamide maintenence dose:

Sotalol dose:

When to avoid procainamide and sotalol?

Answer 1

Adenosine:
6 mg then 12 mg

Amiodarone:
150 mg over 10 mins– Repeat as needed VT
1mg/min for first 6 hours

Procainamide: Avoid with prolong QT
20-50 mg
maintain: 1-4 mg/min

Sotalol dose: Avoid with prolong QT
100mg (1.5mg/kg) over 5 mins

Question 2

Tachycardiac with Pulse

Treatment for WIDE QRS
Treatment for NOT WIDE QRS

Answer 2

1 Synchronized cardiovert

Wide QRS:
Adenosine– if regular QRS
Amio, Procainamide, sotalol– if not reg QRS

NOT wide QRS
Vagal, CCB, BB, Adenosine if reg, consult

Question 3

Bradycardia

Atropine dose:
Dopamine dose:
Epi dose:

Answer 3

Atropine: 1mg q 3-5 (max 3 doses)

Dopamine: 5-20 mcg/kg/min (titrate)

Epi: 2-10 mcg/min (titrate)

Transcutaneous Pacing

Question 4

Cardiac Arrest

Epi dose:
Amio dose #1/#2
OR Lidocaine dose #1/#2

Biphasic Shock:
Mono phasic Shock:

Answer 4

Epi: 1 mg q 3-5mins

Amio:
300 bolus then 150 bolus

Lidocaine:
1-1.5mg/kg then 0.5-0.75 mg/kg

Biphasic: 120-200 J
Monophasic: 360 J

Question 5

Pediatric Tachycardia w pulse

Narrow QRS Treatment (<0.12s)
vs
Wide QRS Treatment (>0.12s)

Answer 5

Narrow QRS: SVT
-No symptoms: Vagal/ Adenosine
-Symptoms narrow QRS:
ADENOSINE: (0.1mg/kg with 6 mg max) then (0.2mg/kg with 12 mg max)
-Synchronized cardioversion

Wide QRS: VT
Synchronized cardioversion at 0.5-1J/kg up to 2J/kg

If VT regular and QRS Monomorphic: Adenosine

Question 6

Peds Tachycardia w pulse

Adenosine dose:

How much to synchronize cardiovert:

Answer 6

Adenosine:
(0.1mg/kg with 6 mg max) then
(0.2mg/kg with 12 mg max)

Synchronized Cardiovert:
0.5-1J/kg up to 2J/kg

Question 7

Peds Cardiac Arrest

Epi dose:
Epi ETT dose:

Amio dose:

Lidocaine dose:

Answer 7

Epi dose:
0.01mg/kg
Max 1 mg q 3-5 mins

Epi ETT:
0.1mg/kg

Amio:
5mg/kg BOLUS
Up to 3 doses for VT/Pulseless VT

Lidocaine:
1mg/kg loading dose

Question 8

Ped Cardiac Arrest

Shock doses:
#1
#2
#3

Answer 8

1.) 2J/kg

#2.) 4J/kg
#3.) > or equal 4J/kg
max 10J/kg or adult dose

Question 9

Post cardiac arrest

TTM Temp goal:

Respiratory parameters?
RR, SpO2, PaCo2 goals

Hemodynamics?

Answer 9

TTM: being 32-36 celcius for 24 hours

Start 10 bmp
SpO2: 92-98%
PaCo2: 35-45 mmHg

Hemodynamics:
Give crystalloids, vasopressors, inotropes

Question 10

H and Ts (5 each)

H
H
H
H
H

T
T
T
T
T

Answer 10

Hypovolemia
Hypoxia
Hydrogen ions (acidosis)
Hypokalemia/ hyperkalemia
Hypothermia

Tension Pneumothorax
Tamponade cardiac
Toxins
Thrombosis Pulmonary
Thrombosis Coronary

Question 11

Pregnancy Cardiac Arrest Causes?

A
B
C
D
E
F
G
H

Answer 11

Anesthetic complications
Bleeding
Cardiovascular
Drugs
Embolic
Fever
General non-OB cause (H and Ts)
Hypertension

Question 12

Pregnancy Cardiac Arrest
C-Section within ___ mins

Interventions for mom:

Interventions for baby

Answer 12

Mom:
-Airway/ vent/ O2
-*IV above diaphragm
-**If getting MAG –> STOP! GIVE Ca+ Gluconate
-Normal ACLS/defib/epi

Baby:
-C-section within 5 mins with no ROSC
-Continuous lateral uterine displacement
-Detal fetal monitors- get rdy for C-section