Algorithms Exam 1

Question 1

What are the defibrillation doses for a monophasic & biphasic defibrillator?

Answer 1

Monophasic: 360 joules
Biphasic: 120 - 200 joules

Question 2

What dose & frequency of epinephrine is used in an adult cardiac arrest?

Answer 2

1mg every 3-5 min

Question 3

What dose & frequency of amiodarone is used in an adult cardiac arrest?

Answer 3

Initial dose: 300mg
Subsequent doses: 150mg

Question 4

What dose and subsequent dose of lidocaine is used in an adult cardiac arrest?

Answer 4

1st dose: 1-1.5 mg/kg
2nd dose: 0.5-0.75 mg/kg

Question 5

Name all of the reversible causes of arrest that start with H (5)

Answer 5

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypokalemia/Hyperkalemia
Hypothermia

Question 6

Name all of the reversible causes of arrest that start with T.

Answer 6

Tension pneumo
Tamponade
Toxins
Thrombosis (coronary or pulmonary)

Question 7

What temperature range is necessary for TTM (targeted temperature management) on post-arrest patients?

Answer 7

32 - 36°C

Question 8

What is atropine dosing on a bradycardic adult patient?

Answer 8

1st dose: 1mg bolus
Subsequent doses every 3-5min
3mg max

Question 9

What is dopamine dosing for a bradycardic patient?

Answer 9

5 - 20 mcg/kg/min

Question 10

What is epinephrine infusion dosing for a bradycardic adult patient?

Answer 10

2 - 10 mcg/min

Question 11

If atropine is unsuccessful in the treatment of adult bradycardia, what are the next treatment options?

Answer 11

Transcutaneous pacing
Dopamine infusion 5-20 mcg/kg/min
Epinephrine infusion 2-10 mcg/min

Question 12

How should unstable and narrow-QRS adult tachycardia be treated?

Answer 12

Synchronized cardioversion
Adenosine (possibly)

Question 13

When would anti-arrhythmic infusions be given for an adult tachycardia patient? What anti-arrhythmics are a part of this algorithm?

Answer 13

If the patient had a stable, wide-QRS tachyarrhythmia.
Procainamide, Amiodarone, Sotalol

Question 14

What is the adenosine dosing for an adult tachy-arrhythmia patient?

Answer 14

1st dose: 6 mg
2nd dose: 12 mg

Question 15

What is the tachyarrhythmia dosing for Procainamide? What three results would cause one to stop the infusion?

Answer 15

20 - 50 mg/min
1. Arrhythmia is fixed
2. QRS durations increases by 50%
3. Max dose of 17 mg/kg is reached

Question 16

What is the maintenance dose of Procainamide?

Answer 16

1-4 mg/min
Avoid if prolonged QT or CHF

Question 17

What is the tachyarrhythmia dosing of amiodarone?

Answer 17

Bolus: 150mg
Maintenance: 1 mg/min for 6 hours

Question 18

What is the tachyarrhythmia dosing of sotalol?

Answer 18

100 mg (1.5 mg/kg) over 5 minutes
Avoid if prolonged QTi

Question 19

For a pregnant woman during cardiac arrest, how would one relieve aortocaval compression?

Answer 19

Lateral uterine displacement

Question 20

What are the possible etiologies of maternal arrest? (A through H)

Answer 20

Anesthetic complications
Bleeding
Cardiovascular
Drugs
Embolism
Fever
General H & T’s
Hypertension

Question 21

What epinephrine dosing would be utilized on a neonate?

Answer 21

0.01 mg/kg IV

Question 22

What is an Apgar score? What range of scores exist?

Answer 22

Newborn health evaluation score
0 (needs resuscitation) through 10 (healthy)

Question 23

What are the 5 criteria for the Apgar score?

Answer 23

Appearance (Skin Color):
0 - Blue or pale all over
1 - Body pink, extremities blue (acrocyanosis)
2 - Completely pink or normal color all over
Pulse (Heart Rate):
0 - Absent
1 - Below 100 beats per minute
2 - Above 100 beats per minute
Grimace (Reflex Irritability or Response):
0 - No response to stimulation
1 - Grimace/feeble cry when stimulated
2 - Cry or pull away when stimulated
Activity (Muscle Tone):
0 - Limp; no movement
1 - Some flexion of extremities
2 - Active motion, well-flexed
Respiration (Breathing Effort):
0 - Absent
1 - Weak, irregular, or gasping
2 - Strong, lusty cry

Question 24

What is the pediatric arrest/bradycardia dosing of epinephrine? What if no IV is present?

Answer 24

0.01mg/kg IV
Endotracheal dose: 0.1mg/kg

Question 25

What is the pediatric arrest dosing of amiodarone?

Answer 25

5 mg/kg bolus up to 3 doses

Question 26

What is the pediatric arrest dosing of lidocaine?

Answer 26

1mg/kg loading dose

Question 27

What is the initial **defibrillating** dose for a pediatric patient? What about subsequent defibrillations?

Answer 27

2 J/kg 4 - 10 J/kg

Question 28

When would one start compressions on a pediatric patient? (just based on HR)

Answer 28

When HR falls below 60

Question 29

What are the two most common causes of pediatric bradycardia?

Answer 29

Hypoxia Arrhythmia

Question 30

What is the dosing of atropine for a bradycardic pediatric patient? What are the minimum/maximum doses?

Answer 30

0.02 mg/kg **0.1mg min.** **0.5mg max.**

Question 31

What is the pediatric tachycardia **synchronized cardioversion** dose?

Answer 31

0.5 - 1 J/kg 2 J/kg max

Question 32

What is the pediatric tachycardia adenosine dose?

Answer 32

1st dose: 0.1 mg/kg (max 6mg) 2nd dose: 0.2 mg/kg (max 12mg)

Question 33

What are the pediatric **arrest** drugs and their doses? (3) What is the shock energy?

Answer 33

**Epinephrine** 0.01 mg/kg IV **Amiodarone** 5 mg/kg (max. 3 doses) **Lidocaine** 1 mg/kg **2 joules/kg (4 - 10 joules/kg)**

Question 34

What are the pediatric **bradycardia** drugs and their doses? (2)

Answer 34

Epinephrine 0.01 mg/kg IV Atropine 0.02 mg/kg IV, may repeat once (0.1 mg min. to 0.5 mg max)

Question 35

What is the pediatric **tachycardia** drug and the doses? Synchronized cardioversion energy?

Answer 35

1st: Adenosine 0.1 mg/kg (max 6mg) 2nd: Adenosine 0.2 mg/kg (max 12mg) 0.5-1 joule/kg (max 2 joules/kg)