ACLS ... Flashcards by ty osw

Epinephrine Dose (Adult)
Epi Interval:

1 mg IV, 2 mg ETT

Q3-5 minutes

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Amiodarone Dosing (Adult) - Cardiac Arrest

300 mg then 150 mg

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Lidocaine: Adult Cardiac Arrest

1-1.5 mg/kg IV ~~ 100mg
Then
0.5-0.75 mg/kg Q5-10
Max 3mg/kg

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Bradycardia:
Atropine Dosing (adult)

0.5mg
Q3-5min
Max 3mg

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Bradycardia:

Dopamine (adult) infusion range

2-10mcg/kg/min

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Bradycardia:
Epinephrine Infusion (adult)

2-10 mcg/min

No per kg infusion rate in adult

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Amiodarone Dosing Adult Tachycardia (w Pulse) (SVT)

150 mg over 10 minutes
Then
Infusion 1 mg/min for 6 hours

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Adenosine for Adult Tachycardia (w Pulse)

Used for SVT: Narrow regular, monomorphic tachycardia

6 mg IVpush
Then 12mg IV push

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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

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Pediatric Defibrillation Energies

2 J/kg
Then
4 J/kg

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Epinephrine Doses (pediatric Arrest)

0.01 mg/kg IV

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Amiodarone (Pediatric Arrest Dose)

5 mg/kg IV

Max 15 mg/kg or 300

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Lidocaine (Pediatric Arrest dose)

1 mg/kg IV
Infusion 20-50 mcg/kg/min
superior to amiodarone for for refractory shock

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Magnesium

Pediatric Arrest Dose

25-50mg/kg

For Torsades de Pointes

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Adenosine

(Pediatric Dosing) - SVT

0.1mg/kg
Then
0.2mg/kg second dose

Max 6/12 mg

Flush

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Amiodarone Pediatric Pulseless VT VF

5mg/kg

Up to 15mg/kg or 300mg MAX

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Amiodarone indication:

Pulseless VT, VF

ventricular arrhythmias-SVT

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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)

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CaCl (Pediatric ACLS)

20mg/kg
Max 2g
Hypocalcemia, Hypokalemia, Hypermagnesium

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Atropine dose leading to paradoxical bradycardia

Less than 0.1mg dose

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Dopamine (Pediatric)

1-20 mcg/kg

For hypotension

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Epinephrine (Pediatric Hypotension)

0.1 - 1 mg/kg/min

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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