ACLS exam 1 Flashcards by Mebin k

epi dosage for cardiac arrest

1mg q 3-5 minutes

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Amio dosage for cardiac arrest

1st dose: 300mg bolus

2nd dose: 150 mg

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lidocaine dosage for adult cardiac arrest

1st dose: 1-1.5mg/kg

2nd dose: 0.5-0.75mg/kg

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If no advanced airway,
compression-ventilation ratio, adults

30:2

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with advanced airway,
compression-ventilation ratio?

or 1 breath every 6 seconds

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biphasic energy dose

120-200J

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options for non wide (narrow) QRS stable tachyarrhythmia

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

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options for stable tachyarrhythmia wide QRS

Adenosine only if
regular and monomorphic
Antiarrhythmic infusion
Expert consultation

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unstable tachyarrhythmia tx

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

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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.

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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.

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Sotalol IV dose
for tachyarrhytmia

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

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steps for unstable brady

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

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Atropine IV dose for brady adult

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

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Dopamine IV infusion:
for brady

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

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Epinephrine IV infusion:
for brady

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

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Resiratory parameters for ROSC

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

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hemodynamic parameters
for ROSC

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

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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

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