ACLS

Question 1

Afib

Answer 1

Stable - BB (esmolol 0.5mg/kg, metoprolol 1-2.5mg) or CCB (diltiazem 5-10mg) then amiodarone (150mg then infusion)

Unstable - call code, chest compressions, synchronized cardioversion (100-200J biphasic, 200J monophasic)

Question 2

Biphasic vs monophasic

Answer 2

Monophasic sends electrical current from one pad to the other; Biphasic sends current to one pad then back
Monophasic requires increased J
Biphasic requires less J therefore less risk for burns

Question 3

Defibrillation

Answer 3

aka unsynchronized cardioversion
risk of R on T phenomenon
monophasic - 360J
biphasic - 120-200J

Question 4

Synchronized cardioversion:

Answer 4

Done on patients with SVT

Question 5

Adenosine

Answer 5

Given for stable SVT (6mg then 12mg) and may convert convert, treat, or help in diagnosis of arrhythmia.

Question 6

Amiodarone

Answer 6

Given for stable SVT (150mg then infusion), specifically narrow/irregular (afib) and wide/regular
Given for unstable VT/VF (300mg then 150mg)

Question 7

Arrhythmias unlikely to respond to synchronized cardioversion

Answer 7

polymorphic VT, Torsades, multifocal atrial tachycardia (MAT), junctional tachycardia, automatic atrial tachycardia

Question 8

Procainamide

Answer 8

Used in sustained VT NOT in VF