ACLS

Question 1

Sx: High heart rate + CP; AMS; SOB; HypoTension

Answer 1

Dx: Tachycardia + likely arrhythmia
Tx: Sync CardioVersion (apply the pads!!)

Question 2

Sx: High heart rate + wide QRS on EKG w/o CP; AMS; SOB; Hypotension

Answer 2

Dx: Wide SVT
Tx: Amiodarone 150mg in 100mL over 10 minute infusion
#2 dose: Infuse over 6 hours, use D5

Question 3

Sx: Rapid rate; narrow QRS on EKG

Answer 3

Dx: Thrombosis (pulmonary)
Tx: Fibrinolytics or embolectomy

Question 4

Epi dose orders during cardiac arrest

Answer 4

Epi 1mg IV/IO q3-5 min

Question 5

Sx: Flat T waves and appearance of U wave on EKG

Answer 5

Dx: HypoKalemia
Tx: Magnesium infusion

Question 6

Sx: Altered LOC; ? arrhythmias?

Answer 6

Dx: HypoGlycemia
Tx: Dextrose

Question 7

Sx: Slow heart rate; narrow QRS on EKG

Answer 7

Dx: Tension pneumothorax
Tx: Needle decompression

Question 8

Sx: Low amplitude QRS on EKG

Answer 8

Dx: H+ excess/acidosis
Tx: Hyperventilation; sodium bicarb

Question 9

Sx: Prolonged QT interval on EKG

Answer 9

Dx: Toxins
Tx: Antidote based on overdose agent

Question 10

Amiodarone dose orders during cardiac arrest

Answer 10

#1 dose: Amiodarone 300mg bolus IV/IO
#2 dose: Amiodarone 150mg IV/IO

Question 11

Sx: Low heart rate

Answer 11

Dx: Bradycardia ????
Tx: Epi 2-10mcg/min

Question 12

Sx: Low heart rate + CP; AMS; SOB; HypoTension

Answer 12

Dx: Bradycardia + likely MI
Tx: DATE
D= Dopa gtt
A= Atropine 0.5mg IVP q3-5min
T= TC, transcutaneous pacer
E= Epi gtt 2-10mcg/min

Question 13

Sx: Low blood pressure

Answer 13

Dx: HypoTension
Tx: Epi drip 0.1-0.5 mcg/kg/min

Question 14

Sx: rapid heart rate; narrow QRS

Answer 14

Dx: hypoVolemia
Tx: Normal Saline or LR bolus, 1-2 L over 5-10 min

Question 15

Sx: Slow heart rate; cyanosis

Answer 15

Dx: HypoXia
Tx: Airway and ventilation w O2

Question 16

Sx: Shivering; previous exposure to cold

Answer 16

Dx: HypoThermia
Tx: Rewarming

Question 17

Sx: High heart rate + CP; AMS; SOB; HypoTension

Answer 17

Dx: Tachycardia + likely arrhythmia
Tx: Sync CardioVert

Question 18

Vasopressin dose orders during cardiac arrest

Answer 18

Vasopressin 40 units IV/IO can replace #1 or #2 epi dose

Question 19

H’s

Answer 19

HypoVolemia
HypoXia
H+ydrogen ion excess (acidosis)
HypoGlycemia
HypoKalemia
HyperKalemia
HypoThermia

Question 20

T’s

Answer 20

Tension Pneumothorax
Tamponade (Cardiac)
Toxins
Thrombosis (Pulmonary)
Thrombosis (Acute MI)

Question 21

Sx: High heart rate w/o CP; AMS; SOB; Hypotension and narrow QRS on EKG

Answer 21

Dx: SVT
Tx: Vagal manuevers (cough, bear down)
Tx: Adenosine 6mg/12mg; 2 doses only
Use adenosine 6mg IVP only if rhythm is regular. #2 dose, use adenosine 12mg IVP; then no more

Question 22

Sx: Rapid rate; narrow QRS on EKG

Answer 22

Dx: Tamponade (cardiac)
Tx: Pericardiocentesis

Question 23

Sx: Abnormal EKG

Answer 23

Dx: Acute MI/thrombosis of coronary artery
Tx: STEMI checklist

Question 24

Sx: Peaked T waves; wide QRS on EKG

Answer 24

Dx: HyperKalemia
Tx: Calcium chloride; sodium bicarb; glucose w insulin

Question 25

Sx: High heart rate + narrow QRS on EKG w/o CP; AMS; SOB; Hypotension

Answer 25

Dx: SVT
Tx: Vagal manuevers (cough, bear down)
Tx: Adenosine 6mg/12mg; 2 doses only
Use adenosine 6mg IVP only if rhythm is regular. #2 dose, use adenosine 12mg IVP; then no more