ACLS PALS Flashcards

1
Q

BLS Compressions depth adult

A

At least 2 inches

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2
Q

BLS Compression rate adult

A

100-120 compressions per minute

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3
Q

Treatment for stable SVT

A

Adenosine 6-12-12

Rapid push with NS flush

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4
Q

SVT EKG characteristic

A

Narrow complex tachycardia

No p waves

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5
Q

Narrow complex tachycardia
No p waves
dx?

A

SVT
Tx if stable: Adenosine 6-12-12
Tx if unstable: immediate synchronized cardioversion

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6
Q

Treatment for unstable SVT

A

Immediate synchronized cardioversion

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7
Q

In BBB, look for R-R’ only in these leads

A

V1, V2, V5, V6

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8
Q

Widened QRS is >

A

0.12 seconds (120 ms)

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9
Q

Persistent unstable bradycardia steps

A
  1. Atropine
  2. If 1 doesn’t work, epinephrine or dopamine or transcutaneous
    After, transvenous pacing
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10
Q

Atropine IV doses for bradycardia

A

1st dose 0.5 mg bolus
Repeat every 3-5 min
Up to 3 mg

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11
Q

Dose for dopamine IV infusion for bradycardia

A

2-10 mcg/kg per minute

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12
Q

Dose for epinephrine IV infusion for bradycardia

A

2-10 mcg per minute

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13
Q

Unshockable rhythms

A

PEA

Asystole

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14
Q

Shockable rhythms

A

VF

VT

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15
Q

Dose of synchronized cardioversion for narrow regular tachycardia

A

50-100 J

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16
Q

Dose of synchronized cardioversion for narrow irregular tachycardia

A

120-200 J biphasic or

200 J monophasic

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17
Q

Dose of synchronized cardioversion for wide regular tachycardia

A

100 J

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18
Q

Dose of cardioversion for wide irregular tachycardia

A

Defibrillation dose unsynchronized

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19
Q

Persistent tachycardia causing instability, next step:

A

Synchronized cardioversion

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20
Q

Persistent stable tachycardia, next step in management

A

Is QRS wide?

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21
Q

Stable, wide QRS tachycardia chemical cardioversion options

A

Adenosine if regular and monomorphic;
Procainamide
Amiodarone
Sotalol

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22
Q

Sotalol dose for stable wide QRS tachycardia

A

100 mg (1.5 mg/kg) over 5 minutes. Do not use in prolonged QT

23
Q

Amiodarone dose for stable wide QRS tachycardia

A

1st dose: 150 mg over 10 minutes; repeat as needed in VT returns
Maintenance infusion 1mg/min for first 6 hours

24
Q

Procainamide dose for stable wide QRS tachycardia

A

20-50 mg/min until: arrhythmia is suppressed, hypotension ensues, QRS duration increases by 50%;
Max dose 17 mg/kg
Maintenance dose 1-4mg/min
Do not use with long QT or pregnant

25
Q

Avoid procainamide if:

A

Long QT

Pregnant

26
Q

Avoid sotalol if

A

Long QT

27
Q

5H Reversible causes of cardiac arrest

A
Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypothermia
Hypo/hyperkalemia
(H for hypoglycemia added in kids)
28
Q

5T Reversible Causes of adult cardiac arrest

A
Tension PTX
Tamponade
Toxins
Thrombosis, pulmonary
Thrombosis, coronary
29
Q

Amiodarone IV/IO dose for adult cardiac arrest

A

1st dose 300 mg bolus

2nd dose: 150 mg bolus

30
Q

Epinephrine IV/IO dose for adult cardiac arrest

A

1 mg every 3-5 min

31
Q

Monophasic shock dose for adult cardiac arrest (VF/VT)

A

360 J

32
Q

Biphasic shock dose for adult cardiac arrest (VF/VT)

A

120-200 J

Subsequent doses can be the same or higher

33
Q

Vasopressin dose for adult cardiac arrest

A

40 units can replace first or second dose of epi

34
Q

Tx pediatric bradycardia first step

A
IV/IO
O2
Airway
EKG
Vitals
35
Q

If HR <60 in peds with poor perfusion despite oxygenation/ventilation, next step

A

CPR

36
Q

If CPR does no improve pediatric bradycardia, next step

A

Epinephrine
Atropine - for increased vagal tone or primary AV block
Consider transthoracic or transvenous pacing
Treat underlying causes

37
Q

Epinephrine dose in pediatric bradycardia

A

0.01 mg/kg (0.01 ml/kg of 1:10,000 [ ] )
Repeat q 3-5 min
If no IV/IO access, can give in ET tube 0.1 mg/kg or 0.1 ml/kg of 1:1000

38
Q

Atropine dose in pediatric bradycardia

A

0.02 mg/kg
May repeat once
Maximum single dose 0.5 mg

39
Q

Adult chest compressions: breathing ratio if no advanced airway

A

30:2

40
Q

Pediatric chest compressions: breathing ratio if no advanced airway

A

15:2

41
Q

Shock energy for defibrillation in PALS

A

1st shock 2 J/kg
2nd shock 4 J/kg
Subsequent shocks 4 or more J/kg
Maximum 10 J/kg or adult dose

42
Q

Epinephrine dose in PALS for cardiac arrest

A

0.01 mg/kg (0.01 ml/kg of 1:10,000 [ ] )
Repeat q 3-5 min
If no IV/IO access, can give in ET tube 0.1 mg/kg or 0.1 ml/kg of 1:1000

43
Q

Amiodarone bolus in PALS for cardiac arrest

A

5 mg/kg bolus

May repeat up to 2 times for refractory VF/pulseless VT

44
Q

Cutoff for wide QRS complex in kids

A

0.09s (90 ms)

45
Q

Adenosine dose for SVT in PALS

A

1st dose 0.1 mg/kg bolus (max 6 mg)
2nd dose 0.2 mg/kg (max 12 mg)
0.1-0.2-0.2 mg/kg

46
Q

Tx for SVT in PALS

A
  1. Adenosine

2. If not IV/IO access, or no response to adenosine, synchronized cardioversion

47
Q

Treatment for probable sinus tachycardia in PALS

A

Find and treat underlying cause

48
Q

Tachycardia rates in PALS

A

< 220 infant

< 180 kiddo

49
Q

Probable VT in kiddo, unstable, next step

A

Synchronized cardioversion

50
Q

Probable VT in kiddo, stable, next step

A

Consider adenosine if regular rhythm and monomorphic QRS

Followed by expert consultation, amio OR procainamide (not both)

51
Q

Synchronized cardioversion doses for PALS

A

Begin with 0.5-1 J/kg
Then increase to 2 J/kg
+/- sedation but do not delay cardioversion

52
Q

Amiodarone dose for PALS VT

A

5 mg/kg over 20-60 min

53
Q

Procainamide dose for PALS VT

A

15 mg/kg over 30-60 min