ACLS Cards Flashcards
What is the biphasic energy amount for defibrillation?
120-200 J or factory recommended
What is the amount of energy for monophasic defibrillation?
360 J
How many breaths per minute should you start with for post cardiac arrest care?
10 / minute
What is the dose for epi infusion post cardiac arrest?
0.1- 0.5 mcg/kg per minute (7-35 mcg per min)
What is the dose for Norepi infusion post cardiac arrest?
0.1-0.5 mcg/kg per minute (7-35 mcg per min)
What is the dose of dopamine for IV infusion post cardiac arrest?
5-10 mcg/kg per min
What is the indication for TTI?
If patient remains comatoma after ROSC
What are the general steps for monitoring a bradycardic patient? (4)
IV
O2
Monitor
EKG
What is the treatment for a bradycardic patient without s/sx?
Observation
What is the treatment for a bradycardic patient with s/sx?
Transcutaneous pacing or atropine
What is the dopamine infusion rate for bradycardia?
2-20 mcg/kg per minute
What is the dose of epi for a symptomatic bradycardia patient?
2-10 mcg/ minute
What is the dose of electricity for synchronized cardioversion for a narrow, regular rhythm?
50-100
What is the dose of electricity for synchronized cardioversion for a narrow, Irregular rhythm?
120-200 J biphasic or 200 monophasic
What is the dose of electricity for synchronized cardioversion for a wide, regular rhythm?
100 J
What is the dose of electricity for synchronized cardioversion for a wide, Irregular rhythm?
Defibrillation
What is the dose of procainamide for antiarrhythmic?
20-50 mcg/min until arrhyhtmia suppressed
What are the side effects of procainamide?
Hypotension
QRS duration increases 50%
What is the maintenance infusion dose of procainamide?
1-4 mg/min
What are the two major contraindications to procainamide use?
CHF or QT prolongation
What is the infusion maintenance dose for amiodarone?
1 mg/min for first 6 hours
What is the IV dose for sotalol?
100 mg over 5 minutes
What is the major contraindication to procainamide?
Prolonged QT interval
What is the treatment for tachycardia if it is causing s/sx?
Cardioversion
What is the treatment for a stable, wide complex tachycardia?
- Consider adenosine if regular and monomorphic
- Antiarrthmics
When is adenosine indicated for the treatment of a wide complex tachycardia?
If monomorphic VT
What is the treatment for a polymorphic VT?
Shock
What is the treatment for a narrow complex tachycardia that is stable?
Vagal maneuvers
Adenosine
Beta blocker or CCB
What are the steps that an ACS patient should have within the first ten minutes of arriving in the ED?
- Vitals
- IV, O2 monitor
- Brief history
- Review fibrinolytic checklist
Within what timeframe is a CXR needed in the ED?
30 minutes
What EKG findings define a “high risk” patient for ACS?
T wave inversion or ST segment depression
What is the door to balloon time?
90 minutes
What is the door to needle time for fibrinolysis?
30 minutes
What are the drugs to avoid in patient with irregular, wide complex tachycardias, and why?
AV nodal blocking agents (e.g. CCBs, beta blockers, adenosine, dig)
Will send down accessory pathway.
True or false: adenosine is safe in pregnancy?
True
What two drugs alter the metabolism of adenosine, and require a halfdose?
Dipyridamole
Carbamazepine
patients with what disease should avoid adenosine?
Asthma (causes bronchospasm)
Why should you avoid using CCBs and beta blockers together?
Overlapping actions may cause profound bradycardia
What position should patients be placed in after ROSC? Why?
- 30 degrees elevated
- Reduce the risk of aspiration
Why should you avoid hyperventilation in ROSC pts?
Increased pressures in the lungs causes decreased CO
What is the goal PetCO2 for ROSC pts?
35-40
True or false: oral, but not axillary temperature are appropriate for monitoring cooled patients?
False–both wrong. Need cath
What are the two most common causes of PEA?
- Hypoxia
- Hypovolemia
What happens to SBP and DBP with hypovolemia?
Increased DBP
Decreased SBP
True or false: it is appropriate to administer fibrinolytics to cardiac arrest patients if PE is strongy suspected
true
What is the role of fluids in pericardial tamponade?
Helps while definitive therapy is arranged