ACLS/PALS Algorithms Flashcards by Mary Munoz

Unstable bradycardia and tachycardia S/S

hypotension
acutely ams
shock
ischemic chest discomfort
acute hf

How well did you know this?

Not at all

Perfectly

If bradycardia is unstable what do we do.

Atropine
if atropine is ineffective try transcutaneous pacing and or dopamine infusion or epi infusion.

How well did you know this?

Not at all

Perfectly

What should we consider while doing interventions for bradycardia

expert consultation
transvenous pacing

How well did you know this?

Not at all

Perfectly

Atropine dose for bradycardia

1st dose; 1mg bolus
repeat every 3-5 min
max= 3mg

<0.5 mg-> worsen brady

How well did you know this?

Not at all

Perfectly

Dopamine IV infusion rate for bradycardia

Usual infusion rate is 5-20 mg/kg/ min titrate to patient response; taper slowly

How well did you know this?

Not at all

Perfectly

Epi infusion rate for bradycardia

2-10 mcg/ min infusion. titrate to patient response

How well did you know this?

Not at all

Perfectly

Possible causes and treatment for bradycardia

MI
OD/ toxicity; CCB, BB/ DIG
hypoxia
Electrolyte abnormality (hyperK; 8-12 brady -> sinewaves)

BB-> glucagon
CCB-> ca+
Dig-> Digibind

How well did you know this?

Not at all

Perfectly

HR less than what is a bradyarrhythmia

<50bpm

How well did you know this?

Not at all

Perfectly

Tachyarrhthmia is hr of what

> 150 bpm

How well did you know this?

Not at all

Perfectly

Treatment for unstable tachycardia

Synchronized cardioversion
if narrow complex consider adenosine

How well did you know this?

Not at all

Perfectly

treatment for refractory tachycardia

find underlying cause
increase energy level for next cardioversion
additional anti-arrhythmic drug
expert consultation

How well did you know this?

Not at all

Perfectly

Wide QRS tachycardia tx stable

adenosine only if regular and monomorphic
anti-arrhythmic infusion (procainamide, amio, sotalol)
expert consultation

> 0.12

How well did you know this?

Not at all

Perfectly

Narrow QRS tachycardia tx stable

vagal maneuvers
adenosine
BB / CCB
expert consult

How well did you know this?

Not at all

Perfectly

Adenosine dose for tachycardia

1st dose = 6mg IV push w/ flush
2nd dose = 12 mg if required

How well did you know this?

Not at all

Perfectly

Procainamide dose for tachycardia

20-50mg/min until arrhythmia suppressed, hypotension ensues, qrs duration increased >50% or max dose 17mg/kg given.
maint infusion 1-4mg/min. avoid if prolonged qt or chf.

How well did you know this?

Not at all

Perfectly

Amiodarone dose for tachycardia

first dose 150 mg over 10 min. repeat as needed if VT recurs. Folllow by maintenance infusion of 1mg/min for first 6 hours

How well did you know this?

Not at all

Perfectly

Sotalol IV dose for tachycardia

100 mg (1.5mg/kg) over 5 min. avoid if prolonged QT.

How well did you know this?

Not at all

Perfectly

characteristic of high quality cpr

2 inch depth and 100-120 bpm, allow recoil
no interruptions
if petco2 >15

How well did you know this?

Not at all

Perfectly

Shock energy for defib

Biphasic; 120-200 J. if unknown use max available
monophasic; 360J

How well did you know this?

Not at all

Perfectly

Epi dose for cardiac arrest

1mg every 3-5 min

How well did you know this?

Not at all

Perfectly

Amio dose for cardiac arrest

first dose 300 mg. second dose 150 mg

How well did you know this?

Not at all

Perfectly

lidocaine dose for cardiac arrest

first dose= 1-1.5mg/kg
second dose= 0.5-0.75mg/kg

How well did you know this?

Not at all

Perfectly

Breaths per min after advanced airway placed for cardiac arrest

1 breath every 6 seconds
10 breaths/ min

ROSC s/s

pulse
bp
art line wave form
PETCO2 > 40 mmhg

H's

Hypovolemia hypoxia hydrogen ions hypo K hyper K Hypothermia

T's

tension pneumothoax tamonade toxins thrombosis; pulm or coronary

Post Rosc respiratory parameters

start 10 breaths. min titrate spo2 to 92-98% titrate CO2 35-45 mmhg

Post ROSC hemodynamic parameters

SBP > 90 mmhg MAP >65 manage with cystalloids and or vasopressor or inotrope

Post rosc interventions for comatose patient

TTM- 32-36 for 24 hrs Head CT EEG critical care

Maternal interventions for cardiac arrest

airway management (have to intubate) admin 100% O2/ avoid excess ventilation IV above the diaphragm stop mag and give calcium chloride or gluconate

Perform OB interventions for cardiac arrest

lateral uterine displacement detach fetal monitors prep for perimortem c section (5 min post arrest)

Potential etiology of maternal cardiac arrest

anesthetic complications bleeding cardiovascular drugs embolic fever general nonOB causes (h and t) Hypertension

When to start chest compressions on neonate

HR < 60bpm intubate if not done already

If HR is persistently below 60 what other interventions can we do for neonate

epi consider hypovolemia consider pneumothorax narcan?

unstable Pediatrics s/s

acutely ams s/s of shock hypotension

Interventions for neonate gasping/ apnea and HR <100

PPV clear secretions SPO2 monitor ECG monitor

Pediatric compressions are initiated when hr is at?

60bpm

interventions if neonate hr <60/min

intubate chest compressions PPV 100% o2 ect monitor consider emergency UVC (umbilical vein cannulation)

Persistent bradycardia for peds patients interventions

continue cpr if hr less than 60 iv/io epi atropine (for inc vagal tone/ primary av block) transthoacic/ transvenous pacing ID cause

Possible causes for peds bradycardia

hypothermia hypoxia medications

Epi dose for ped bradycardia and cardiac arrest

0.01mg/kg (0.1ml/kg of the 0.1mg/ml concentration) repeat every 3-5 min

Atropine dose for peds bradycardia

0.02mg/kg. may repeat once max dose 0.1mg and max single dose 0.5mg

Infant tachycardia rate

>220

Child tachycardia rate

>180

treatment for SVT (qrs <0.09) in unstable peds

adenosine sychronized cardioversion

treatment for V tach (qrs > 0.09) in unstable peds

sychronized cardioversion

treatment for SVT (qrs <0.09) in stable peds

Vagal maneuvers adenosine

treatment for V tach (qrs >0.09) in stable peds

regular and monomorphic qrs = adenosine consult expert

Synchronized cardioversion dose in peds

Start with 0.5-1J/kg if not effect, increase to 2 J/kg. sedate if needed but dont delay cardioversion

Adenosine dose for peds tachycardia

first dose 0.1mg/kg rapid bolus (max; 6mg) second dose; 0.2mg/kg rapid bolus (max 2nd dose; 12 mg)

Amio dose for kids cardiac arrest

5mg/kg during arrest may repeat up to 3 doses

Lidocaine dose for peds cardiac arrest

1mg/kg loading dose

Defibrillation dose for peds cardiac arrest

First shock 2J/kg Second shock 4J/Kg Subsequent shocks > 4 J/kg max 10 J/kg or adult dose

PEDS quality CPR characteristics

>1/3 of anteroposterior diameter of chest 100-120bpm allow recoil no airway; 15;2 compression/ventilation ration advanced airway; breath every 2-3 seconds

Amniotic fluid embolism treatment

atropine ondansetron ketorolac

APGAR score

0-10 activity pulse grimas respiration