ACLS

Question 1

2 types of rhythms that indicated defibrillation

Answer 1

V-tach and V-fib

Question 2

2 types of rhythms that indicated defibrillation

Answer 2

V-tach and V-fib

Question 3

3 lead ECG lead placement

Answer 3

White goes to the right, Red goes to the ribs, Smoke over fire.
Right side of chest, just below right clavicle is lead I. Black lead is same thing but on the left side. Red pad goes left mid axillary line, just below PMI.

Question 4

normal PR

Question 5

Normal QRS

Question 6

the 6 H’s

Answer 6

Hypovolemia, Hypoxemia, H ion (acidosis) Hyper/hypokalemia, Hypoglycemia, Hypothermia

Question 7

The 5 T’s

Answer 7

Toxins, tamponade, Tension Pneumothorax, Thrombosis, Trauma

Question 8

Hyperkalemia tx

Answer 8

calcium chloride, sodium bicarb, insulin and glucose.

Question 9

Hyperkalemia from digitalis toxicity tx

Answer 9

give IV magnesium sulfate or Digibind

Question 10

Respiratory acidosis management

Answer 10

early intubation is key

Question 11

metabolic acidosis management

Answer 11

Good CPR can help. If severe can give sodium bicarb bolus, and repeat 1/2 the dose every 10-15 minutes

Question 12

Hypothermia management

Answer 12

gradual re-warming with blankets and warm IV fluids. Must get core body temp to 33C

Question 13

antidepressant OD management

Answer 13

give IV sodium bicarb

Question 14

suspect PE cause of cardiac arrest if

Answer 14

2 out of 3 signs: Pre-arrest respiratory distress, AMS and shock; arrest witnessed by MD or EMT, PEA is primary arrest rhythm.

Question 15

management post ROSC

Answer 15

get 12 lead ECG every 8 hrs or PRN. Target BP is MAP 65-100 mmHg. Target O2> 70%. Target temperature 32-36C. Target glucose 100-180

Question 16

function of epinephrine

Answer 16

it is a peripheral vasoconstrictor. Increased BP. Is a + chronotrope and inotrope. Also increases O2 demand

Question 17

Indication for epinephrine

Answer 17

first line cardiac arrest: 1 mg IV q 3-5 minutes

can also give IV drip of epic for severe symptomatic bradycardia.

Question 18

Vasopressin function

Answer 18

is a very good vasoconstrictor, increases blood flow o the brain and hear during CPR but does not increase ischemia

Question 19

Indications for vasopressin

Answer 19

persistent VF. Give 40 U IV bolus. Do not give in asystole or PEA.

Question 20

Amiodarone function

Answer 20

antiarrhthmetic, alpha and beta adrenergic blocker.

Question 21

Indications for amiodarone

Answer 21

Persistant Vfib or Vtach that hasnt responded to multiple shocks. Can give a 300mg IV push. 1/2 the 2nd dose. Do not exceed 2200mg.

Question 22

magnesium indications

Answer 22

treatment of choice for torsades. Also for severe refractory v-fib. give 1-2 g IV as bolus (for Vfib) or over 1-2 minutes

Question 23

magnesium SE

Answer 23

flushing, sweating, bradycardia, hypotension, depressed reflexes

Question 24

Atropine function

Answer 24

Parasympatholytic

Question 25

Atropine indications

Answer 25

First line for Symptomatic bradycardia - give 0.5-1 mg IVP q 5 mins. Can also give 1mg IV q-3-5 mins for ssystole

Question 26

Dopamine indications

Answer 26

For hypotension without hypovolemia. Response is dose dependent. Range 5-20 ug/kg/min

Question 27

Adenosine function

Answer 27

Slows AV conduction.

Question 28

Adenosine indication

Answer 28

PSVT and tachycardias. Give rapid 6 mg IV bolus. Repeat 12 mg IVP in 1-2 mins x 2

Question 29

Diltiazam function

Answer 29

CCB. Negative chronotrope and inotrope. Decreases AV conducion. Has direct effect on AV node

Question 30

Diltiazam indication

Answer 30

SVT, give 0.25 mg/kg IVP. Can repeat in 5-10 min, 0.35 mg/kg IVP

Question 31

Diltiazam C/I

Answer 31

IV beta blockers and severe heart failure

Question 32

Sodium bicarb indications

Answer 32

Metabolic acidosis, hyperkalemia, Tricyclic/phenobarbitol OD. Give 1 mEq/kg IV bolus

Question 33

3 lead ECG lead placement

Answer 33

White goes to the right, Red goes to the ribs, Smoke over fire.
Right side of chest, just below right clavicle is lead I. Black lead is same thing but on the left side. Red pad goes left mid axillary line, just below PMI.

Question 34

normal PR

Question 35

Normal QRS

Question 36

the 6 H’s

Answer 36

Hypovolemia, Hypoxemia, H ion (acidosis) Hyper/hypokalemia, Hypoglycemia, Hypothermia

Question 37

The 5 T’s

Answer 37

Toxins, tamponade, Tension Pneumothorax, Thrombosis, Trauma

Question 38

Hyperkalemia tx

Answer 38

calcium chloride, sodium bicarb, insulin and glucose.

Question 39

Hyperkalemia from digitalis toxicity tx

Answer 39

give IV magnesium sulfate or Digibind

Question 40

Respiratory acidosis management

Answer 40

early intubation is key

Question 41

metabolic acidosis management

Answer 41

Good CPR can help. If severe can give sodium bicarb bolus, and repeat 1/2 the dose every 10-15 minutes

Question 42

Hypothermia management

Answer 42

gradual re-warming with blankets and warm IV fluids. Must get core body temp to 33C

Question 43

antidepressant OD management

Answer 43

give IV sodium bicarb

Question 44

suspect PE cause of cardiac arrest if

Answer 44

2 out of 3 signs: Pre-arrest respiratory distress, AMS and shock; arrest witnessed by MD or EMT, PEA is primary arrest rhythm.

Question 45

management post ROSC

Answer 45

get 12 lead ECG every 8 hrs or PRN. Target BP is MAP 65-100 mmHg. Target O2> 70%. Target temperature 32-36C. Target glucose 100-180

Question 46

function of epinephrine

Answer 46

it is a peripheral vasoconstrictor. Increased BP. Is a + chronotrope and inotrope. Also increases O2 demand

Question 47

Indication for epinephrine

Answer 47

first line cardiac arrest: 1 mg IV q 3-5 minutes

can also give IV drip of epic for severe symptomatic bradycardia.

Question 48

Vasopressin function

Answer 48

is a very good vasoconstrictor, increases blood flow o the brain and hear during CPR but does not increase ischemia

Question 49

Indications for vasopressin

Answer 49

persistent VF. Give 40 U IV bolus. Do not give in asystole or PEA.

Question 50

Amiodarone function

Answer 50

antiarrhthmetic, alpha and beta adrenergic blocker.

Question 51

Indications for amiodarone

Answer 51

Persistant Vfib or Vtach that hasnt responded to multiple shocks. Can give a 300mg IV push. 1/2 the 2nd dose. Do not exceed 2200mg.

Question 52

magnesium indications

Answer 52

treatment of choice for torsades. Also for severe refractory v-fib. give 1-2 g IV as bolus (for Vfib) or over 1-2 minutes

Question 53

magnesium SE

Answer 53

flushing, sweating, bradycardia, hypotension, depressed reflexes

Question 54

Atropine function

Answer 54

Parasympatholytic

Question 55

Atropine indications

Answer 55

First line for Symptomatic bradycardia - give 0.5-1 mg IVP q 5 mins. Can also give 1mg IV q-3-5 mins for ssystole

Question 56

Dopamine indications

Answer 56

For hypotension without hypovolemia. Response is dose dependent. Range 5-20 ug/kg/min

Question 57

Adenosine function

Answer 57

Slows AV conduction.

Question 58

Adenosine indication

Answer 58

PSVT and tachycardias. Give rapid 6 mg IV bolus. Repeat 12 mg IVP in 1-2 mins x 2

Question 59

Diltiazam function

Answer 59

CCB. Negative chronotrope and inotrope. Decreases AV conducion. Has direct effect on AV node

Question 60

Diltiazam indication

Answer 60

SVT, give 0.25 mg/kg IVP. Can repeat in 5-10 min, 0.35 mg/kg IVP

Question 61

Diltiazam C/I

Answer 61

IV beta blockers and severe heart failure

Question 62

Sodium bicarb indications

Answer 62

Metabolic acidosis, hyperkalemia, Tricyclic/phenobarbitol OD. Give 1 mEq/kg IV bolus

Question 63

Treatment for SVT

Answer 63

vagel
6mg Adenosine
followed by 12 mg Adenosine if needed
synchronized cardioversion if needed

Question 64

wide complex tachycardia treatment

Answer 64

bicarb

calcium