ACLS exam 1

Question 1

epi dosage for cardiac arrest

Answer 1

1mg q 3-5 minutes

Question 2

Amio dosage for cardiac arrest

Answer 2

1st dose: 300mg bolus

2nd dose: 150 mg

Question 3

lidocaine dosage for adult cardiac arrest

Answer 3

1st dose: 1-1.5mg/kg

2nd dose: 0.5-0.75mg/kg

Question 4

If no advanced airway,
compression-ventilation ratio, adults

Answer 4

30:2

Question 5

with advanced airway,
compression-ventilation ratio?

Answer 5

or 1 breath every 6 seconds

Question 6

biphasic energy dose

Answer 6

120-200J

Question 7

options for non wide (narrow) QRS stable tachyarrhythmia

Answer 7

-vagal maneuvers (if regular)
-Adenosine (if regular)
* β-Blocker or calcium channel blocker
* Consider expert consultation

Question 8

options for stable tachyarrhythmia wide QRS

Answer 8

• Adenosine only if
  regular and monomorphic
• Antiarrhythmic infusion
• Expert consultation

Question 9

unstable tachyarrhythmia tx

Answer 9

Synchronized cardioversion
* Consider sedation
* If regular narrow complex,
consider adenosine

Question 10

Procainamide IV dose for tachyarrhythmia

Answer 10

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.

Question 11

Amiodarone IV dose
for tachyarrhythmia

Answer 11

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.

Question 12

Sotalol IV dose
for tachyarrhytmia

Answer 12

Sotalol IV dose:
100 mg (1.5 mg/kg) over 5 minutes. Avoid if prolonged QT.

Question 13

steps for unstable brady

Answer 13

Atropine
If atropine ineffective:
* Transcutaneous pacing
and/or
* Dopamine infusion
or
* Epinephrine infusion

Question 14

Atropine IV dose for brady adult

Answer 14

Atropine IV dose:
First dose: 1 mg bolus.
Repeat every 3-5 minutes.
Maximum: 3 mg.

Question 15

Dopamine IV infusion:
for brady

Answer 15

Dopamine IV infusion:
Usual infusion rate is
5-20 mcg/kg/min.
Titrate to patient response;
taper slowly

Question 16

Epinephrine IV infusion:
for brady

Answer 16

Epinephrine IV infusion:
2-10 mcg per minute infusion.
Titrate to patient response

Question 17

Resiratory parameters for ROSC

Answer 17

Start 10 breaths/min
Spo2 92%-98%
Paco2 35-45 mm Hg

Question 18

hemodynamic parameters
for ROSC

Answer 18

Systolic blood pressure >90 mm Hg
Mean arterial pressure >65 mm Hg

Question 19

parameters for TTM

Answer 19

TTM: If patient is not following
commands, start TTM as soon as
possible; begin at 32-36°C for 24
hours

Question 20

if HR<60 and pt is symptomatic in pediatrics, next step?

Answer 20

CPR

Question 21

Atropine IV/IO dose for pediatric brady

Answer 21

Atropine IV/IO dose:
0.02 mg/kg. May repeat once.
Minimum dose 0.1 mg and
maximum single dose 0.5 mg.

Question 22

steps after cpr initiation if brady persists in pediatrics

Answer 22

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

Question 23

steps if no to
term gestatin? good tone? breathing or crying?

NRP

Answer 23

Warm and maintain normal temperature,

position airway, clear secretions if
needed, dry, stimulate

Question 24

if neonate is apneic or gasping, or HR<100, what is are steps within 1 minute?

Answer 24

PPV
Spo2 monitor
Consider ECG monitor

Question 25

initial steps after 1 minute in neonate, if HR <100

Answer 25

Check chest movement

Ventilation corrective steps if needed

ETT or laryngeal mask if needed

Question 26

If neonate HR<60, initial steps?

Answer 26

Intubate if not already done
Chest compressions
Coordinate with PPV
100% O2
ECG monitor
Consider emergency UVC

Question 27

if neonate HR<60 persistently after steps

Answer 27

IV epinephrine
If HR persistently below 60/min
Consider hypovolemia
Consider pneumothorax

Question 28

rescure breaths for pediatric BLS

Answer 28

1 q 2-3 seconds

w/2 ppl:
15 compressions 2 breaths

Question 29

adenosine dose pediatric tachy

Answer 29

first dose: 0.1 mg/kg
rapid bolus (maximum:
6 mg)

• Second dose:
  0.2 mg/kg rapid bolus
  (maximum second
  dose: 12 m

Question 29

pediatric acls defib dose

Answer 29

First shock 2 J/kg
* Second shock 4 J/kg
* Subsequent shocks ≥4 J/kg,
maximum 10 J/kg or adult dose

Question 29

H’s

Answer 29

Hypovolemia
* Hypoxia
* Hydrogen ion (acidosis)
* Hypo-/hyperkalemia
* Hypothermia

Question 29

Ts

Answer 29

Tension pneumothorax
* Tamponade, cardiac
* Toxins
* Thrombosis, pulmonary
* Thrombosis, coronary

Question 29

pediatric cardiac arrest lidocaine dose

Answer 29

LidocaineIV/IOdose:
Initial: 1 mg/kg loading dose

Question 29

pediatric acls epi dose

Answer 29

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)

Question 29

QRS complex width pediatric tachy

Answer 29

0.09 sec

Question 29

pediatric cardiac arrest amio dose

Answer 29

Amiodarone IV/IO dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 3 total doses for refractory
VF/pulseless VT

Question 29

for cardiac arrest in prenancy, if receiving IV mag?

Answer 29

stop and give calcium chloride or gluconate

Question 29

PE physical findings

Answer 29

ultrasound: right heart enlarged

clear demarcation line of oxygenation on chest

refractory hypoxemia

Question 29

PE risks

Answer 29

woman, smokers, birth control, big bony surgeries

Question 30

when giving epi dose what to worry about?

Answer 30

amt of volume given

Question 30

most common rhythm cardiac arrest for pediatrics

Answer 30

asystole/PEA

Question 30

pediatric vfib/vt causes

Answer 30

electrocution and drowning

Question 30

leading cause of maternal death?

Answer 30

fetal death and vice versa

Question 30

clotting disorder for pregnant woman

Answer 30

Factor V Leiden and q6?

Question 31

week range for viability in neonates

Answer 31

21-22 weeks