ACLS Tx and Considerations

Question 1

Epinephrine

Answer 1

A: 1 mg IV/IO or 2 mg ET (Q 4 min, no max).
T: 0.01 mg/kg IV/IO or 0.1 mg/kg ET (0.1 ml/kg 1:10 000, or 0.1 ml/kg 1:1000, Q 4 min, no max).
P: &laquo_space;0.01 mg/kg IV/IO or 0.1 mg/kg ET (0.1 ml/kg 1:10 000, or 0.1 ml/kg 1:1000, Q 4 min, no max)&raquo_space;.

Question 2

Dialysis Arrest

Answer 2

A: &laquo_space;Calcium Gluconate 10% - 10 mL IV/IO, Sodium Bicarb - 50 mEq IV/IO, D50W - 50 mL IV/IO, Insulin - 10 u IV/IO&raquo_space;.

Fistula can be used as last resort.
Peritoneal - SBGH
Hemo - HSC or SBGH (closest)

Question 3

Amiodarone

Answer 3

A: 300 mg IV/IO (Q 4 min) 150 mg IV/IO.
T: 5 mg/kg IV/IO (max 300 mg) (Q 4 min) 5 mg/kg IV/IO (max 150 mg).
P: &laquo_space;5 mg/kg IV/IO (max 300 mg) (Q 4 min) 5 mg/kg IV/IO (max 150 mg)&raquo_space;.

Question 4

Lidocaine (VF/PVT)

Answer 4

A: 1.5 mg/kg IV/IO (Q 4 min) 0.75 mg/kg IV/IO (Q 4min, X2) or 3 mg/kg ET (Q 4 min, X2).
T: 1 mg/kg IV/IO (Q 4 min, X3) or 2 mg/kg ET (Q 4 min, X2).
P: 1 mg/kg IV/IO (Q 4 min, X3) or 2 mg/kg ET (Q 4 min, X2).

Question 5

Atropine

Answer 5

(Symptomatic Bradycardia)
A: Atropine 0.5 mg IV (Q 3 min, max 0.04 mg/kg or 3 mg).
T: Atropine 0.02 mg/kg IV (min 0.1 mg max 0.5 mg) (Q 3 min, max 0.04 mg/kg or 3 mg).
P: &laquo_space;If +Vagal tone or AV block - Atropine 0.02 mg/kg IV (min 0.1 mg max 0.5 mg) or 0.04 mg/kg ET (min 0.2 mg max 1 mg) (Q 3 min, max 0.04 mg/kg or 3 mg)&raquo_space;.

Question 6

Defibrilation

Answer 6

VF/PVT: (A) 200 J, (T/P) 2 J/kg (X1) 4 J/kg.
Narrow R Tach Unstable: (A) sync 50 J (X1) sync 100 J.
Narrow IR Tach Unstable: (A) sync 200 J.
Wide R Tach: (A) sync 100 J (X1) sync 200 J, (T) sync 1 J/kg (X1) sync 2 J/kg, &laquo_space;(P) sync 1 J/kg (X1) sync 2 J/kg&raquo_space;.

Question 7

Lidocaine (VTach w/ pulse)

Answer 7

A: 1.5 mg/kg IV (Q 10 min, X2).
T: 1 mg/kg IV (Q 10 min, X2).
P: 1 mg/kg IV (Q 10 min, X2).

Question 8

Naloxone

Answer 8

Suspected Overdose Arrest
A: 2 mg IV/IO/IM or 4 mg ET (Q 4 min, no max)
T: 2 mg IV/IO/IM or 4 mg ET (Q 4 min, no max)
P: &laquo_space;0.1 mg/kg IV/IO/IM or 0.2 mg/kg ET (Q 4 min, no max)&raquo_space;.

Question 9

Hypothermia

Answer 9

<35C mild <30C severe
One shock only (200 J or 4 J/kg)
Limit intubation for VF, asystole.
If <30C ventilate at 8-10 resp/min.
No pharma Tx, no IO.
A: SBGH
T/P: HSCC (or closest if no ALS).