ACLS PHARM

Question 1

monophasic shock energy

Answer 1

360 J

Question 2

Epinephrine IV/IO dose

Answer 2

1 mg every 3-5 minutes

Question 3

vasopressin IV/IO dose

Answer 3

40 units can replace 1st or 2nd dose of epinephrine

Question 4

amiodarone IV/IO dose

Answer 4

first dose 300 mg bolus

second dose 150 mg bolus

Question 5

reversible causes of adult cardiac arrest (H5T5)

Answer 5

Hypoxia, hypovolemia, hydrogen ion (acidosis) hypo/hyperkalemia, hypothermia
Tension pneumothorax, tamponade, toxins, thrombosis pulmonary, thrombosis coronary

Question 6

atropine IV dose

Answer 6

first dose 0.5 mg bolus
repeat every 3-5 minutes
max does 3 mg (6 boli, 18-30 minutes)

Question 7

dopamine IV infusion

Answer 7

2-10 mcg/Kg per minute

Question 8

epinephrine IV infusion

Answer 8

2-10 mcg per minute

Question 9

synchronized cardioversion

initial doses

Answer 9

narrow regular: 50-100 J
Narrow irregular: 120-200 J biphasic; 200 J monophasic
wide regular: 100 J
wide irregular: defibrillation dose (not synchronized)

Question 10

adenosine IV dose

Answer 10

first dose: 6 mg rapid push followed by saline

second dose: 12 mg if needed

Question 11

procainamide IV Dose

Answer 11

antiarrhythmic infusion for stable wide QRS tachycardia
20-50 mg/minute until arrhythmia suppressed, hypotension ensues, QRS duration increases >50% or max does 17 mg/KG given
Maintenance infusion: 1-4 mg/minute
avoid if long q-t or CHF

Question 12

amiodarone IV dose

antiarrhythmic infusion for stable wide QRS tachycardia

Answer 12

first dose 150 mg over 10 minutes
repeat as needed if VT recurs
follow with maintenance infusion of 1 mg/min for 6 hours

Question 13

sotalol IV dose

Answer 13

antiarrhythmic infusion for stable wide QRS tachycardia
100 mg (1.5 mg/kg) over 5 minutes
avoid if prolonged QT

Question 14

prehospital firbrinolytic checklist

step 2

Answer 14

systolic bp> 180-200 or diastolic >100-110
right vs left arm systolic difference >15 mmhg
hx of structural central nervous system disease
significant closed head/facial trauma w/in 3 weeks
stroke >3 h

Question 15

prehospital fibrinolytic checklist

step 3

Answer 15

heart rate >100/min and systolic

Question 16

ventilation/oxygenation

post cardiac arrest care

Answer 16

avoid excessive ventilation
start 10-12 breaths/minute (every 5-6 seconds)
titrate to target PETCO2 35-40, SPO2 >94%

Question 17

IV bolus

post cardiac arrest care

Answer 17

1-2 L NS or lactated ringers

if inducing hypothermia, 4 C

Question 18

epinephrine IV infusion

post cardiac arrest care

Answer 18

0.1-0.5 mcg/kg per minute (in 70 Kg adult= 7-35 mcg per minute)

Question 19

Norepinephrine IV infusion

post cardiac arrest care

Answer 19

0.1-0.5 mcg/kg per minute (in 70 Kg adult= 7-35 mcg per minute)

Question 20

dopamine IV infusion

post cardiac arrest care

Answer 20

5-10 mcg/Kg per minute

Question 21

biphasic shock energy

Answer 21

120-200 J