ACLS (ADULT):

Question 1

BRADY

Atropine

Answer 1

Atropine1mg IV q3-5min to total dose 3mg

Question 2

BRADY

CaCl

Answer 2

CaCl 1gm IV (in case of hyper K or CCB/BB overdose)

Question 3

BRADY

Dopamine

Answer 3

Dopamine 2-10mcg/kg/min gtt

Question 4

BRADY

Epinephrine

Answer 4

Epinephrine 2-10mcg/min gtt

Question 5

PULSELESS VT/VF:

Defibrillate biphasic

Answer 5

120-200J

Question 6

PULSELESS VT/VF:

Epinephrine

Answer 6

1mg (10mL of 1:10,000) IV/IO q3-5mins

Question 7

PULSELESS VT/VF:

Amiodarone

Answer 7

300mg IV/IO x1, then 150mg x1, then gtt

Question 8

PULSELESS VT/VF:

Magnesium

Answer 8

1-2g IV/IO load if torsades

Question 9

PEA/ASYSTOLE

Epi

Answer 9

1mg IV/IO q3-5min

Question 10

REG NARROW COMPLEX (SVT)

Adenosine

Answer 10

6mg IV, repeat 12mg dose x 2 if needed

Question 11

REG NARROW COMPLEX (SVT)

Synch Cardioversion

Answer 11

100J to start

Question 12

REG NARROW COMPLEX (SVT)

Diltiazem

Answer 12

20mg (0.25mg/kg), additional doses 25mg q15, then 5-15mg/hr gtt (may go above if tolerated)

Question 13

REG NARROW COMPLEX (SVT)

Esmolol

Answer 13

500mcg/kg load over 1 min, If effective start infusion at 50mcg/kg/min May titrate up by 50mcg/kg/min increments q4mins to max 200mcg/kg/min

Question 14

IRREG NARROW COMPLEX TACHY (Afib, flutter, MAT)
Diltiazem

Answer 14

20mg (0.25mg/kg), additional doses 25mg q15, then 5-15mg/hr gtt (may go above if tolerated)

Question 15

IRREG NARROW COMPLEX TACHY (Afib, flutter, MAT)
Metoprolol

Answer 15

5mg IV q5mins

Question 16

IRREG NARROW COMPLEX TACHY (Afib, flutter, MAT)
Esmolol

Answer 16

500mcg/kg over 1 min, then 100mcg/kg/min

Question 17

IRREG NARROW COMPLEX TACHY (Afib, flutter, MAT)
Amiodarone

Answer 17

150mg IV over 10mins then 1mg/min gtt x 6hrs, then 0.5mg/min x 18hrs (good in acute CHF, but may convert to NSR)

Question 18

IRREG NARROW COMPLEX TACHY (Afib, flutter, MAT)

Synch cardioversion:

Answer 18

100J to start, if unstable or <48hrs

Question 19

IRREG WIDE (Afib +WPW aka prexcitation, Afib + BBB aka abberancy, torsades/polymorphic VT)
DO NOT give adenosine, BB, CCB, digoxin. Can cause VF
Magnesium

Answer 19

1-2g IV/IO load if torsades

Question 20

IRREG WIDE (Afib +WPW aka prexcitation, Afib + BBB aka abberancy, torsades/polymorphic VT)
DO NOT give adenosine, BB, CCB, digoxin. Can cause VF
Procainamide

Answer 20

20-50mg/min until arrhythmia stops, hypotension, QRS >50%, max dose 17mg/kg. maint gtt 1-4mg/min.

Question 21

REG WIDE TACH w PULSES (VT, SVT + BBB aka aberrancy, ST + BBB) *Reg, wide (QRS>120ms) tach can also be SVT w abberancy aka BBB; IF regular, monomorphic AND stable may give adenosine: will either slow down or tx. Check old EKGs for BBB.

Amiodarone

Answer 21

150mg IV over 10mins then 1mg/min gtt x 6hrs, then 0.5mg/min x 18hrs (good in acute CHF, but may convert to NSR)

Question 22

REG WIDE TACH w PULSES (VT, SVT + BBB aka aberrancy, ST + BBB) *Reg, wide (QRS>120ms) tach can also be SVT w abberancy aka BBB; IF regular, monomorphic AND stable may give adenosine: will either slow down or tx. Check old EKGs for BBB.

Procainamide

Answer 22

20-50mg/min until arrhythmia stops, hypotension, QRS >50%, max dose 17mg/kg. maint gtt 1-4mg/min