ADVANCED CARDIAC LIFE SUPPORT

Question 1

Initial drugs for ventricular fibrillation (VEMAL)

Answer 1

VEMAL
INITIAL
Vasopressin 40U once
Epinephrine 1mg q 3-5 min

OTHERS
Amiodorone 300 mg once, then 150 mg once, or
Lidocaine 1 – 1.5 mg/kg initially, then 0.5 – 0.75 mg/kg to max of 3 mg/kg
Mag 1-2 g for torsades

Question 2

Drugs for Pulseless Electrical Activity and asystole

Answer 2

EVA
Epinephrine 1mg q 3-5min
Vasopressin 40u once
Atropine 1mg f

Question 3

Drug for PEA with slow rate

Answer 3

Atropine 1 mg

Question 4

Type of AV block

Answer 4

1st dreegree
2nd DegreeType 1 (Mobitz I-Wenkenbach)
2nd Degree Type II (Mobitz II)
3rd Degree

Question 5

Causes of PEA

Answer 5

6H’s and 5T’s

Question 6

Which arrythmias require pacing

Answer 6

2nd Degree type II block
3rd Degree AV block

Question 7

Types of pacing

Answer 7

Transcutaneous
Transvenous pacing

Question 7

Pacemaker vs Defibrillator

Answer 7

Pacing involves using a pacemaker to stimulate the heart’s electrical activity, correcting slow heart rhythms or conduction issues. Defibrillation uses a high-energy shock to halt life-threatening arrhythmias.

Question 8

Transcutaneous pacing

Answer 8

Transcutaneous pacing involves placing external pacing pads or electrodes on the patient’s chest, usually in the anterior-posterior position.

Question 9

Transvenous pacing

Answer 9

Transvenous pacing involves placing one or more pacing leads (electrodes) through a vein and guiding them to the heart’s chambers, typically the right ventricle

Question 9

Are patients with asystole shocked

Answer 9

NO

Question 10

Is vasopressin given for heart block

Answer 10

NO

Question 11

Drugs for AV block

Answer 11

Atropine 0.5-1mg, max 3mg
Dopamine 2-20mc/kg/min
Epinephrine 2-10mcg/min

Question 11

Drugs for PSVT

Answer 11

Adenosine 6mg IV push
Repeat with 12mg by 2

Question 12

Management of an unstable PSVT patient

Answer 12

Synchronized cardioversion with 50 Joules

Question 12

Initiam management of PSVT

Answer 12

Vagal maneuvers

Question 13

Treatment of unstable A-fib or A-flutter

Answer 13

Cardioversion with 50-100J

Question 13

Rhythm control drugs in A-fib and A-flutter

Answer 13

< 48 hrs – Cardioversion or Amiodarone
> 48 hrs – Anticoagulate x 3 wks, then cardiovert, then anticoagulate for 4 more weeks

Question 13

Rate control drugs in A-fib and A-flutter

Answer 13

Normal LV fx – Ca (Diltiazem) or Beta blocker
Impaired LV fx – Digoxin, Amiodarone

Question 13

Parameters to check for in A-fib and A-flutter before treatment

Answer 13

Stable/Unstable
Rhythm duration (Greater or equal to 48 hours)
Impaired Systolic function (<40%)
WPW syndrome

Question 14

Drugs to avoid in WPW
(Wolff-Parkinsin-White Syndrome)

Answer 14

Adenosine
CCB
BB
Digoxin