ACLS Tafreshi

Question 1

Which patients are potentially good patients for IO administration? (Tafreshi)

Answer 1

Pediatrics/Babies

Burn patients

Question 2

What is a problem with administering medications via the endotracheal tube? (Tafreshi)

Answer 2

Lungs should not normally have fluid

Medications are diluted to contain a max of 10 mL

Question 3

What is the max volume to administer via endotracheal tube? (Tafreshi)

Answer 3

10 mL

Question 4

Does the epinephrine dose ever change with weight in ACLS? (Tafreshi)

Answer 4

No, cardiac size is relatively the same in obese patients

Question 5

How much volume to flush after epi and other drugs in ACLS? (Tafreshi)

Answer 5

20 mL

Question 6

What is the MOA of vasopressin in ACLS? (Tafreshi)

Answer 6

Nonadrenergic peripheral vasoconstrictor

Question 7

What is the dose of vasopressin in ACLS? (Tafreshi)

Answer 7

40 units

Question 8

What is the wait time to repeat vasopressin in ACLS? (Tafreshi)

Answer 8

Typically only given one time in ACLS

Question 9

What class of antiarrhythmic is lidocaine? (Tafreshi)

Answer 9

Class 1B

Question 10

What are the class IB antiarrhythmics? (Tafreshi)

Answer 10

Lidocaine

Mexiletine

Question 11

How is lidocaine supplied in the crash cart? (Tafreshi)

Answer 11

50 mg/5mL (1%)

100 mg/5mL (2%)

Question 12

What type of arrhythmia is lidocaine used for in ACLS?

Tafreshi

Answer 12

Alternative to amiodarone for VF or pulseless VT (ventricular tachycardia)

Question 13

What is the dose for magnesium in ACLS? Dilution? (Tafreshi, Lexi)

Answer 13

1-2 g of magnesium sulfate diluted in 10 mL of D5W or NS

5-10 g have been used

Question 14

What is Wolff-Parkinson White syndrome? (Tafreshi)

Answer 14

Abnormal accessory pathway (bundle of Kent)
Exists between atria and ventricle
Early depolarization results

Question 15

Is atropine considered a sympathomimetic or a parasympatholytic? What does this mean? (Tafreshi)

Answer 15

Parasympatholytic

Instead of pressing on the gas, you remove the brakes

Question 16

What is the maximum dose of atropine? How supplied in crash cart? (Tafreshi)

Answer 16

3 mg, 3 boxes

1 mg amps in crash cart

Question 17

If you have an elderly patient, can you give 0.3-0.4 mg of atropine to prevent anticholinergic syndrome? (Tafreshi)

Answer 17

No, doses less than 0.5 mg have a paradoxical effect

Question 18

What is anticholinergic syndrome with atropine? (Tafreshi)

Answer 18

1. Can occur with excessive doses

2. Symptoms of delirium, ataxia, blurred vision, tachycardia, coma

Question 19

When is adenosine used? (Tafreshi)

Answer 19

SVT

Question 20

What is common after adenosine administration? (Tafreshi)

Answer 20

Asystole

Can last up to 15 seconds

Question 21

What is the antidote for adenosine if too much is given? (Tafreshi)

Answer 21

The half life is ~5 seconds, an antidote is not needed

Question 22

What is the dose of adenosine in ACLS? (Tafreshi)

Answer 22

1. 6 mg PUSH followed quickly by 20 mL NS

2. 12 mg can be used if no response within 1-2 minutes

Question 23

What dose consideration for adenosine can be made for heart transplant patients and central line access? (Tafreshi)

Answer 23

Reduction of dose to 3 mg

Question 24

What type of CCB is more specific to cardiac tissue? (Tafreshi)

Answer 24

Non-DHP
Diltiazem
Verapamil

Question 25

What are the units for a diltiazem drip? Dose? (Tafreshi)

Answer 25

5-15 mg/hr

Question 26

Which Non-DHP is preferred in arrhythmias? (Tafreshi)

Answer 26

Diltiazem

Verapamil has more negative inotropic effects

Question 27

What is unique about the pharmacokinetics of esmolol? (Tafreshi)

Answer 27

Half life = 9 minutes

Question 28

What are options for treatment of AF/Aflutter with RVR? (Tafreshi)

Answer 28

1. BB

2. Non-DHP CCB

Question 29

What occurs with long term procainamide use? (Tafreshi)

Answer 29

Drug induced lupus