ACLS

Question 1

HHHHAKTTTT

Answer 1

Hypovolemia
Hypothermia
Hypoglycemia
Hypoxia

Acidosis

K - Potassium

Tamponade
Tension Pnuemothorax
Thrombus - MI/PE
Toxins

Question 2

Define Unstable Patient

Answer 2

Ischemic Chest Pain > Acute Heart Failure > Hypotension > Shock > Altered Mental Status

Question 3

VOMIT

Answer 3

Vitals
O2
Monitor
IV/IO
Therapy/Transport

Question 4

Stable Brady

Answer 4

H&P, Monitor, Expert Consult

Question 5

Unstable Brady

Answer 5

VOMIT, ABCs, ECG

0.5 mg Atropine IVP q 3-5 mins
...then...
Transcutaneous Pacing.. or
2-20 ug/kg/min Dopamine
2-10 ug/kg/min Epinephrine

Question 6

Stable Regular Narrow Tachycardia (SVT)

Answer 6

VOMIT, ABCs, ECG

Vagal Manuevers -> 6 mg Adenosine slammed with 20cc NS Piggy Back… 1-2 mins… 12 mg Adenosine

Question 7

Stable Irregular Narrow Tachycardia (AF/Af)

Answer 7

VOMIT, ABCs, ECG

rate control with verapamil, diltiazem, b-blocker, digoxin

Question 8

Stable Wide Tachycardia (VT with Pulse)

Answer 8

VOMIT, ABCs, ECG + Antiarrythmic Infusions

Amio Load 150ml/100ccD5W/10mins -> Drip 1mg/min x 6 hrs, 0.5mg/min 18 hours

Procainamide 20-50 mg/min until (works/side effects/max dose)

Sotalol 100mg/5 mins (1.5mg/kg over 5 mins)

Question 9

Unstable Tachycardias

• Regular Narrow
• Irregular Narrow
• Regular Wide

Answer 9

**Synchronized cardioversion

Regular Narrow SVT - 50-100J
Irregular Narrow AF - 120-200J, Af (50-100J)
Regular Wide VTw/Pulse - 100J

Question 10

Wide Irregular

Answer 10

Torsades de Pointes

Mg 1-2g / 50-100cc D5W over 5-10 minutes
Defibrillate 120-200 biphasic or 300 monophasic

Question 11

Shockable Arrest Rhythms

Answer 11

VT/VF no pulse…VOMIT, ABCs, ECG

CPR … Defibrillate 120-200J/300J
1st Drug Epi 1 mg IVP q 3-5 mins
2nd Drug Amio 300 mg IVP 3-5 mins 150 mg (done)

PetCO2>10, Waveform Capnography

Question 12

Non Shockable Arrest Rhythms

Answer 12

PEA/Asystole … VOMIT, ABCs, ECG

CPR… Epi 1 mg q 3-5 mins

HHHHAKTTTT

Question 13

HHHHAKTTTT Interventions

Answer 13

IVF wide open, blood glucose, ABG, Bicarb, CaCO3, Blood products, CT Chest/US, PCI, CXR, BMP/CBC

Question 14

Post Arrest Care

Answer 14

A - SaO2 >94%
B - PETCO2 - 35-40 mmHg, Rescue Breaths every 5-6s
C - BP > 90 systolic, Fluids (NS/LR), 
Nor/Epi 0.1-0.5 ug/kg/min
Dopamine 5-10 ug/kg/min

ECG, TPA, Therapeutic Hypothermia