ACLS ... Flashcards
Epinephrine Dose (Adult) Epi Interval:
1 mg IV, 2 mg ETT
Q3-5 minutes
Amiodarone Dosing (Adult) - Cardiac Arrest
300 mg then 150 mg
Lidocaine: Adult Cardiac Arrest
1-1.5 mg/kg IV ~~ 100mg
Then
0.5-0.75 mg/kg Q5-10
Max 3mg/kg
Bradycardia: Atropine Dosing (adult)
0.5mg
Q3-5min
Max 3mg
Bradycardia:
Dopamine (adult) infusion range
2-10mcg/kg/min
Bradycardia: Epinephrine Infusion (adult)
2-10 mcg/min
No per kg infusion rate in adult
Amiodarone Dosing Adult Tachycardia (w Pulse) (SVT)
150 mg over 10 minutes
Then
Infusion 1 mg/min for 6 hours
Adenosine for Adult Tachycardia (w Pulse)
Used for SVT: Narrow regular, monomorphic tachycardia
6 mg IVpush
Then 12mg IV push
Tachycardia (w Pulse)
Adult synchronized cardioversion Energy:
Narrow Regular: 50-100 J
Narrow Irregular: 120-200 J
Wide Regular: 100 J
Wide Irregular: Defibrillation Doses, Consider dropping sync. Consider Consultation
Pediatric Defibrillation Energies
2 J/kg
Then
4 J/kg
Epinephrine Doses (pediatric Arrest)
0.01 mg/kg IV
Amiodarone (Pediatric Arrest Dose)
5 mg/kg IV
Max 15 mg/kg or 300
Lidocaine (Pediatric Arrest dose)
1 mg/kg IV
Infusion 20-50 mcg/kg/min
superior to amiodarone for for refractory shock
Magnesium
Pediatric Arrest Dose
25-50mg/kg
For Torsades de Pointes
Adenosine
(Pediatric Dosing) - SVT
0.1mg/kg
Then
0.2mg/kg second dose
Max 6/12 mg
Flush
Amiodarone Pediatric Pulseless VT VF
5mg/kg
Up to 15mg/kg or 300mg MAX
Amiodarone indication:
Pulseless VT, VF
ventricular arrhythmias-SVT
Atropine (Pediatric Bradycardia)
0.02mg/kg q5min
Max 1 mg for child
X2 for ETT
Do not give less than 0.1mg doses (no minimum in 2016 PALS)
CaCl (Pediatric ACLS)
20mg/kg
Max 2g
Hypocalcemia, Hypokalemia, Hypermagnesium
Atropine dose leading to paradoxical bradycardia
Less than 0.1mg dose
Dopamine (Pediatric)
1-20 mcg/kg
For hypotension
Epinephrine (Pediatric Hypotension)
0.1 - 1 mg/kg/min
Epinephrine (Pediatric Anaphylaxis)
0.01 mg/kg q20min
Epinephrine (Pediatric Arrest)
0.01 mg/kg
Naloxone (Pediatric)
Full reversal dosing
Under 5 yrs or 20 Kg == 0.1 mg/kg
Over 5 yrs or 20 Kg == 2 mg
Dobutamine indication:
Beta only, no peripheral effect
Systolic heart failure
Bicarbonate (Pediatric)
Arrest: 1 mEq/kg
Metabolic Acidosis = Base deficit * wt * 0.3
Dobutamine - Pediatric Dosing
2.5-15 mcg/kg/min
For systolic heart failure
Dobutamine pediatric dose
2.5-15 mcg/kg/min
Naloxone pediatric dose
0.1mg/kg full reversal <5, or <20kg
2mg if over the above
Adult compression ventilation ratio:
30:2
Does not change with 2 rescuers
Child 1 rescuer compression ventilation ratio
30:2
Child 2 rescuer ventilation compression ratio
15:2
Magnesium adult torsades
1-2 g IV
Amiodarone (adult) for unstable tachdysrhytmia (not arrest)
150mg over 10 min
Then
1mg/min
Epinephrine Dose: anaphylaxis
10-100 mcg initial dose.
Dilute to either 10 or 100 mcg/mL
Staff suggests Bolus >50 for HoTN
Epinephrine Pediatric Anaphylaxis
IM: 10 mcg/kg/dose max 300 mcg/dose
IV: 1-10 mcg/kg
Infusion: 0.02-0.2 mcg/kg/min
Anaphylaxis H1 antagonist:
Adult
Diphenhydramine 25-50mg IV
Anaphylaxis H2 antagonist:
Adult
Ranitidine 50mg IV
Anaphylaxis Steroid:
Adult
Methylprednisone
125 mg
Anaphylaxis interventions
On hand vasopressors
100% O2
IV Bolus
Declare emergency
Remove trigger
Control the airway
Epinephrine Epinephrine infusion Salbutamol H1-H2 Steroids for biphasic reaction
ICU
Esmolol for Rate Control
0.5mg/kg over 1 min
Infusion 50 mcg/kg/min
Metoprolol for Rate Control
1-2.5 mg
Can repeat second dose after 2.5 minutes
Dilitazem for Rate Control
5-10 mg IV over 2 ,imbues
Q20 minutes
Slower onset
PALS Infant and Children Fluid Bolus
20 mL/kg
Atropine for Pre-Intubation
0.02 mg/kg with no minimum
Verapamil dosing Pediatric SVT
0.1-0.3 mg/kg
Can be considered in older children
Do not use in infants without expert consultation
Pediatric SVT: Carioversion Energy
Start 0.5-1 J/kg increasing to 2 J/Kg
Max 10 J/kg or adult limit
Amiodarone Pediatric SVT
5 mg/kg IV/IO over 20-60 minutes
if other methods ineffective
Consultation
Wide Complex Tachycardia QRS criteria
> 0.09 seconds
4 Phases of Cardiac Arrest (PALS)
Pre Arrest
No-Flow
Low-Flow
Post-Resuscitation
Pediatric CPR for bradycardia: Rate Criteria
<60 BPM with poor perfusion
Ensure good oxygenation and ventilation
Epinephrine Pediatric Dosing Short Cut
1 mL of premix per 10kg
1:10 000
HR differentiation of Sinus vs SVT (Pediatric)
Infants >220
Children >180
with compatible history
Procainamide Pediatric SVT dosing
15 mg/kg over 30-60 minutes
Expert Consultation
Do not give with Amiodarone
Pediatric Urine Output target
1 mL/kg/h
Pediatric Hypoglycemia treatment
Newborn: D10W 5-10 mL/kg
Infant and Child: D25W 2-4 mL/kg
Adolescent Adult: D50W 1-2 mL/kg