Acute Care

Question 1

Which are the shockable rhythms?

Answer 1

VT and VF

Question 2

Which are the non-shockable rhythms?

Answer 2

PEA and asystole

Question 3

What is the regimen for ALS?

Answer 3

2 min cycles of CPR, 30:2

Adrenaline every 2 cycles (10 mL 1:10, 000)

Question 4

Reversible causes of cardiac arrest

Answer 4

TREAT THESE AS PART OF ABCDE

Hypoxia
Hypovolaemia
Hypothermia
Hyperkalaemia (or hypokalaemia, or other metabolic probs)
Tension pneumothorax
Tamponade
Toxins
Thromboembolism (coronary or pulmonary - thrombolysis may take 90 mins)

Question 5

Resus guidelines:
TACHYCARDIA
unstable: shock, syncope, MI, HF

Answer 5

Synchronised DC shocks (up to 3 attempts)

Expert help:
300 mg IV amiodarone over 10-20 mins
repeat shock
Then give 900 mg amiodarone over 24h

Question 6

Resus guidelines:
TACHYCARDIA
stable: NO shock, syncope, MI, HF

BROAD QRS

Answer 6

Irreg: AF? - expert help

Reg: VT (or uncertain rhythm):
300 mg IV amiodarone over 10-20 mins
Then give 900 mg amiodarone over 24h

IF SVT WITH BBB TREAT AS FOR NARROW-COMPLEX

Question 7

Resus guidelines:
TACHYCARDIA
stable: NO shock, syncope, MI, HF

NARROW QRS

Answer 7

Irreg: AF - beta-blockers or diltiazem

Reg: vagal manoevres, adenosine 6 mg rapid IV bolus
give 12 and further 12 if no response
If works: prob re-entry paroxysmal SVT
if doesnt work: prob atrial flutter

Question 8

Resus guidelines:
BRADYCARDIA
unstable: shock, syncope, MI, HF

Answer 8

Atropine 500 mcg IV