Advances Cardiac Life Support Flashcards
What medications are used for VT/VF (shockable rhythms) without a pulse?
- Epi
- Amiodarone (K+: class 3)
- Lidocaine (Na+: class 1b)
How are medications administered when in cardiac arrest?
IV or IO
What medications are used for PEA/ asystole (non-shockable rhythms) without a pulse?
Epi
What is the dosing of Epi for cardiac arrest (no pulse)?
1 mg IV Q 3-5 min for as long as the code lasts (no max dose)
What is the dosing of Amiodarone for VT/VF without a pulse?
1st dose: 300mg IV push
2nd dose (if still in shockable rhythm): 150mg IV push
What is the dosing of Lidocaine for VT/VF without a pulse?
1st dose: 1-1.5 mg/kg (usually given as 100mg dose)
Cumulative max dose: 3mg/kg
When is Magnesium Sulfate used as an adjunct in ACLS?
Torsades de Pointe
When is Dextrose used as an adjunct in ACLS?
Hypoglycemia
When is Calcium Chloride used as an adjunct in ACLS?
Hypo/ Hyperkalemia
When is sodium bicarb used as an adjunct in ACLS?
severe acidosis, hyperkalemia, toxidromes
When should Epi be started in VF/VT without a pulse?
After the second shock delivered
When should Amiodarone and/or Lidocaine be given in VF/VT without a pulse?
After 3rd shock delivered
When should Epi be started in PEA/ asystole (non-shockable rhythms) without a pulse?
As soon as rhythm is determined to be unshockable
What are reversible factors for cardiac arrest?
Hs and Ts:
Hypovolemia
Hypoxia
Hydrogen (acidosis)
Hypo/erkalemia
Hypothermia
Tension pneumothorax
Tamponade cardiac
Thrombosis, pulmonary/cardiac
What is 1st-degree AV block?
Prolonged PR interval but no missed beats
What are the types of second degree AV block?
Wenckebach Mobitz I - Progressively increasing PR interval then dropped beat
Mobitz II- PR interval consistent then dropped beat
What is 3rd degree AV block?
Atria impulses do not reach ventricles, ventricle pacemaker takes over
What medications are used for bradycardia with a pulse if Atropine is ineffective?
- Dopamine
- Epi/NE
What is dosing of Atropine for bradycardia with a pulse?
1st dose: 1mg bolus repeat Q 3-5 min
max dose: 3mg
When should the first dose of Atropine be given?
when the patient becomes symptomatic
What are the symptoms of brady cardia?
- hypotension
- acute altered mental status
- signs of shock
- ischemic chest discomfort
- acute heart failure
What treatments are used for asymptomatic tachycardia with a pulse and narrow QRS?
- vagal maneuvers
- Adenosine
- beta-blocker or CCB
What treatments are used for asymptomatic tachycardia with a pulse and wide QRS?
- Procainamide IV
- Amiodarone IV
- Sotalol IV
What is dosing of Adenosine for asymptomatic narrow-QRS tachycardia?
1st dose: 6mg
2nd dose: 12mg
What is the treatment for symptomatic tachycardia with a pulse?
Synchronized cardioversion
What is a wide QRS?
> /= 0.12 sec
