ACLS exam 1 Flashcards
epi dosage for cardiac arrest
1mg q 3-5 minutes
Amio dosage for cardiac arrest
1st dose: 300mg bolus
2nd dose: 150 mg
lidocaine dosage for adult cardiac arrest
1st dose: 1-1.5mg/kg
2nd dose: 0.5-0.75mg/kg
If no advanced airway,
compression-ventilation ratio, adults
30:2
with advanced airway,
compression-ventilation ratio?
or 1 breath every 6 seconds
biphasic energy dose
120-200J
options for non wide (narrow) QRS stable tachyarrhythmia
-vagal maneuvers (if regular)
-Adenosine (if regular)
* β-Blocker or calcium channel blocker
* Consider expert consultation
options for stable tachyarrhythmia wide QRS
- Adenosine only if
regular and monomorphic - Antiarrhythmic infusion
- Expert consultation
unstable tachyarrhythmia tx
Synchronized cardioversion
* Consider sedation
* If regular narrow complex,
consider adenosine
Procainamide IV dose for tachyarrhythmia
Procainamide IV dose:
20-50 mg/min until arrhythmia suppressed, hypotension ensues,
QRS duration increases >50%, or maximum dose 17 mg/kg given.
Maintenance infusion: 1-4 mg/min. Avoid if prolonged QT or CHF.
Amiodarone IV dose
for tachyarrhythmia
Amiodarone IV dose:
First dose: 150 mg over 10 minutes. Repeat as needed if VT recurs.
Follow by maintenance infusion of 1 mg/min for first 6 hours.
Sotalol IV dose
for tachyarrhytmia
Sotalol IV dose:
100 mg (1.5 mg/kg) over 5 minutes. Avoid if prolonged QT.
steps for unstable brady
Atropine
If atropine ineffective:
* Transcutaneous pacing
and/or
* Dopamine infusion
or
* Epinephrine infusion
Atropine IV dose for brady adult
Atropine IV dose:
First dose: 1 mg bolus.
Repeat every 3-5 minutes.
Maximum: 3 mg.
Dopamine IV infusion:
for brady
Dopamine IV infusion:
Usual infusion rate is
5-20 mcg/kg/min.
Titrate to patient response;
taper slowly
Epinephrine IV infusion:
for brady
Epinephrine IV infusion:
2-10 mcg per minute infusion.
Titrate to patient response
Resiratory parameters for ROSC
Start 10 breaths/min
Spo2 92%-98%
Paco2 35-45 mm Hg
hemodynamic parameters
for ROSC
Systolic blood pressure >90 mm Hg
Mean arterial pressure >65 mm Hg
parameters for TTM
TTM: If patient is not following
commands, start TTM as soon as
possible; begin at 32-36°C for 24
hours
if HR<60 and pt is symptomatic in pediatrics, next step?
CPR
Atropine IV/IO dose for pediatric brady
Atropine IV/IO dose:
0.02 mg/kg. May repeat once.
Minimum dose 0.1 mg and
maximum single dose 0.5 mg.
steps after cpr initiation if brady persists in pediatrics
Continue CPR if HR<60/min
* IV/IO access
* Epinephrine
* Atropine for increased vagal
tone or primary AV block
* Consider transthoracic/
transvenous pacing
* Identify and treat underlying
causes
steps if no to
term gestatin? good tone? breathing or crying?
NRP
Warm and maintain normal temperature,
position airway, clear secretions if
needed, dry, stimulate
if neonate is apneic or gasping, or HR<100, what is are steps within 1 minute?
PPV
Spo2 monitor
Consider ECG monitor
initial steps after 1 minute in neonate, if HR <100
Check chest movement
Ventilation corrective steps if needed
ETT or laryngeal mask if needed
If neonate HR<60, initial steps?
Intubate if not already done
Chest compressions
Coordinate with PPV
100% O2
ECG monitor
Consider emergency UVC
if neonate HR<60 persistently after steps
IV epinephrine
If HR persistently below 60/min
Consider hypovolemia
Consider pneumothorax
rescure breaths for pediatric BLS
1 q 2-3 seconds
w/2 ppl:
15 compressions 2 breaths
adenosine dose pediatric tachy
first dose: 0.1 mg/kg
rapid bolus (maximum:
6 mg)
- Second dose:
0.2 mg/kg rapid bolus
(maximum second
dose: 12 m
pediatric acls defib dose
First shock 2 J/kg
* Second shock 4 J/kg
* Subsequent shocks ≥4 J/kg,
maximum 10 J/kg or adult dose
H’s
Hypovolemia
* Hypoxia
* Hydrogen ion (acidosis)
* Hypo-/hyperkalemia
* Hypothermia
Ts
Tension pneumothorax
* Tamponade, cardiac
* Toxins
* Thrombosis, pulmonary
* Thrombosis, coronary
pediatric cardiac arrest lidocaine dose
LidocaineIV/IOdose:
Initial: 1 mg/kg loading dose
pediatric acls epi dose
Epinephrine IV/IO dose:
0.01 mg/kg (0.1 mL/kg of the
0.1 mg/mL concentration).
Max dose 1 mg.
Repeat every 3-5 minutes.
If no IV/IO access, may give
endotracheal dose: 0.1 mg/kg
(0.1 mL/kg of the 1 mg/mL
concentration)
QRS complex width pediatric tachy
0.09 sec
pediatric cardiac arrest amio dose
Amiodarone IV/IO dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 3 total doses for refractory
VF/pulseless VT
for cardiac arrest in prenancy, if receiving IV mag?
stop and give calcium chloride or gluconate
PE physical findings
ultrasound: right heart enlarged
clear demarcation line of oxygenation on chest
refractory hypoxemia
PE risks
woman, smokers, birth control, big bony surgeries
when giving epi dose what to worry about?
amt of volume given
most common rhythm cardiac arrest for pediatrics
asystole/PEA
pediatric vfib/vt causes
electrocution and drowning
leading cause of maternal death?
fetal death and vice versa
clotting disorder for pregnant woman
Factor V Leiden and q6?
week range for viability in neonates
21-22 weeks
