AHA ACLS Flashcards
Cardiac Arrest
pVT/VF) Repeated dos
Immediate Defib (initial 200J), CPR, Antiarrhythmic & EPI
Stable vs Medical PT assessment
ACS
NCT stable vs unstable
Stable} Vagal, medicate, SVT (Adeno & Diltiazem) other NCT (Diltiazem, Verapamil, Beta-Blockers)
Unstable} Cardiovert SVT 50-100 (AFib RVR 120-200)
WCT stable vs unstable
Stable} Med (Procain
Unstable} usually cardiovert 100-200
ROSC
Dopamine, Infusion if needed, TCP probably
Adult Bradycardia
Unstable) TCP
Stable) Medicate (atropine)
Bradycardia stable vs unstable
Stable} medicate (Atropine)
Unstable} TCP
Cardiovert dose
Inital 100J
200, 300, 360J
TCP) doing
- Turn Pacer on
- 80BPM
- mA sync till capture
- check mechanical
- Increase 2-5mA
Defib) Biphasic end max dose
Monophasic end max dose
= 120-200j
= 360j
CPR) simple cycle
- Rhythm pulse check
- Defib if needed
- CPR 30:2
- Medicate appropriately
- RHYTHM/PULSE CHECK
- SHOCK IF NEEDED IF NOT CPR
L)
L)
L)
L)
L)
L)
L)
L)
L)
Cardioversion/vert) Indication
Rhythms
intial & after Doses:
= UNSTABLE} SBP <90 & AMS
= Bradycardia, AF w/ SVR,
= 50-100J then 200J 300J 360J
Defib) indication
Contra:
Rhythms
Initial & after doses:
= “Dead fibers” TdP (only rhythm defib awake)
= Asystole VT w/ Pulse stable
= pVT, VF, TdP
= 100J 200J 300J 360J
Pacing) indication
Rhythms
Initial & after:
= “pick up the pace” <50BPM UNSTSBLE} SBP <90 & AMS
= BPM <50
= 80BPM mA till’ capture
Monophasic monitor Jules max
Biphasic monitor Jules max
360J
200J
Bradycardia Stable vs Unstable
Asystole & PEA 3 needs
CPR, NEVER SHOCK, EPI
ROSC
CPR tasks/delegating
2 people) 30:2, Airway, IO access, self scribe & timer
4-5 people) Pit crew, 2 rotating CPR, 1 BVM, partner checking pulse sites, Medicate, Self shock & admin
SVT treatment
Bradycardia treatment
AFib w/ RVR treatment
VT treatment
pVT/VF treatment
TCP
Defib
Cardiovert
= “pick up the pace” unstable bradycardias
= “for dead fibbers” pVT, VF, TdP
= “Convert to regular speed” Unstable Tachycardias
Defib initial dose:
Cardiovert initial dose:
TCP initial dose:
= 100-200
= 50-100 (120-200 AF RVR)
= 80BPM, mA till capture ~50 to 85mA (start 50mA like BP)
Procainamide)class:
Dynamics:
= 1a antiarrhythmic
= Blocks Na channels in cardiac cells which causes depolarization to slow & decrease automaticity
Procainamide) indications:
Contra:
=V-Tach w/ pulse, Pre-excitation rhythms (WPW)
=Shouldn’t admin to PTs received IV Ca channel blocker
Procainamide)effect:
4 ending points:
= Drowsy, Slurred speech, Confusion, Seizures, HypoBP
1. Termination of rhythm
2. HypoBP
3. Widening QRS>50%
4. Meet the max total dose (17mg/kg)
Procainamide) max dose:
Recurrent VF/VT:
Urgent situations:
Maintenance Infusion:
= (max total dose: 17mg/kg)
= 20mg/min (max total dose: 17mg/kg)
= up to 50mg/min may admin/ to total dose (max 17mg/kg)
= 1-4mg/min
Verapamil) class:
pharmacodynamics:
= IV antiarrhythmic Ca channel blocker
= Slows AP of autorhythmic cells in heart by blocking Ca channels
Cardioversion/vert) Indication
Rhythms
intial & after Doses:
= UNSTABLE} SBP <90 & AMS
= Bradycardia, AF w/ SVR,
= 50-100J then 200J 300J 360J
Defib) indication
Contra:
Rhythms
Initial & after doses:
= “Dead fibers” TdP (only rhythm defib awake)
= Asystole VT w/ Pulse stable
= pVT, VF, TdP
= 100J 200J 300J 360J
Pacing) indication
Rhythms
Initial & after:
= “pick up the pace” <50BPM UNSTSBLE} SBP <90 & AMS
= BPM <50
= 80BPM mA till’ capture
Monophasic monitor Jules max
Biphasic monitor Jules max
360J
200J
Procainamide)class:
Dynamics:
= 1a antiarrhythmic
= Blocks Na channels in cardiac cells which causes depolarization to slow & decrease automaticity
Procainamide) indications:
Contra:
=V-Tach w/ pulse, Pre-excitation rhythms (WPW)
=Shouldn’t admin to PTs received IV Ca channel blocker
Procainamide)effect:
4 ending points:
= Drowsy, Slurred speech, Confusion, Seizures, HypoBP
1. Termination of rhythm
2. HypoBP
3. Widening QRS>50%
4. Meet the max total dose (17mg/kg)
Procainamide) max dose:
Recurrent VF/VT:
Urgent situations:
Maintenance Infusion:
= (max total dose: 17mg/kg)
= 20mg/min (max total dose: 17mg/kg)
= up to 50mg/min may admin/ to total dose (max 17mg/kg)
= 1-4mg/min
Verapamil) class:
pharmacodynamics:
= IV antiarrhythmic Ca channel blocker
= Slows AP of autorhythmic cells in heart by blocking Ca channels
L)
L)
L)
L)
L)
L)
L)
L)
Propranolol, Labetalol, Metoprolol) class
Labetalol
Metoprolol
= class 2 Beta Blockers
= 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT’s w/elevated HR, Antihypertensive
= Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT
Procainamide & Lidocaine) class
= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width
Amiodarone class & indication
Class 3 K channel blocker> VF/Pulseless VT unresponsive to shock, CPR & Epi, BradyCs to include AV blocks, Recurrent, hemodynamically unstable VT w/ pulse
Procainamide & Lidocaine) class
= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width
Diltiazem & Verapamil) class
Diltiazem
Verapamil
= class 4 Ca channel blocker
= 1st line med for A-Fib/Flutter w/ RVR >150 bpm, 2nd line med for SVT
refractory to adenosine
= 2nd line med for A-Fib/Flutter w/ RVR. May use as alterative after adenosine, narrow QRS complex tachycardia w/ preserved LV fn.
