Algorithms Exam 1 Flashcards
What are the defibrillation doses for a monophasic & biphasic defibrillator?
Monophasic: 360 joules
Biphasic: 120 - 200 joules
What dose & frequency of epinephrine is used in an adult cardiac arrest?
1mg every 3-5 min
What dose & frequency of amiodarone is used in an adult cardiac arrest?
Initial dose: 300mg
Subsequent doses: 150mg
What dose and subsequent dose of lidocaine is used in an adult cardiac arrest?
1st dose: 1-1.5 mg/kg
2nd dose: 0.5-0.75 mg/kg
Name all of the reversible causes of arrest that start with H (5)
Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypokalemia/Hyperkalemia
Hypothermia
Name all of the reversible causes of arrest that start with T.
Tension pneumo
Tamponade
Toxins
Thrombosis (coronary or pulmonary)
What temperature range is necessary for TTM (targeted temperature management) on post-arrest patients?
32 - 36°C
What is atropine dosing on a bradycardic adult patient?
1st dose: 1mg bolus
Subsequent doses every 3-5min
3mg max
What is dopamine dosing for a bradycardic patient?
5 - 20 mcg/kg/min
What is epinephrine infusion dosing for a bradycardic adult patient?
2 - 10 mcg/min
If atropine is unsuccessful in the treatment of adult bradycardia, what are the next treatment options?
Transcutaneous pacing
Dopamine infusion 5-20 mcg/kg/min
Epinephrine infusion 2-10 mcg/min
How should unstable and narrow-QRS adult tachycardia be treated?
Synchronized cardioversion
Adenosine (possibly)
When would anti-arrhythmic infusions be given for an adult tachycardia patient? What anti-arrhythmics are a part of this algorithm?
If the patient had a stable, wide-QRS tachyarrhythmia.
Procainamide, Amiodarone, Sotalol
What is the adenosine dosing for an adult tachy-arrhythmia patient?
1st dose: 6 mg
2nd dose: 12 mg
What is the tachyarrhythmia dosing for Procainamide? What three results would cause one to stop the infusion?
20 - 50 mg/min
1. Arrhythmia is fixed
2. QRS durations increases by 50%
3. Max dose of 17 mg/kg is reached
What is the maintenance dose of Procainamide?
1-4 mg/min
Avoid if prolonged QT or CHF
What is the tachyarrhythmia dosing of amiodarone?
Bolus: 150mg
Maintenance: 1 mg/min for 6 hours
What is the tachyarrhythmia dosing of sotalol?
100 mg (1.5 mg/kg) over 5 minutes
Avoid if prolonged QTi
For a pregnant woman during cardiac arrest, how would one relieve aortocaval compression?
Lateral uterine displacement
What are the possible etiologies of maternal arrest? (A through H)
Anesthetic complications
Bleeding
Cardiovascular
Drugs
Embolism
Fever
General H & T’s
Hypertension
What epinephrine dosing would be utilized on a neonate?
0.01 mg/kg IV
What is an Apgar score? What range of scores exist?
Newborn health evaluation score
0 (needs resuscitation) through 10 (healthy)
What are the 5 criteria for the Apgar score?
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
What is the pediatric arrest/bradycardia dosing of epinephrine? What if no IV is present?
0.01mg/kg IV
Endotracheal dose: 0.1mg/kg
What is the pediatric arrest dosing of amiodarone?
5 mg/kg bolus up to 3 doses
What is the pediatric arrest dosing of lidocaine?
1mg/kg loading dose
What is the initial defibrillating dose for a pediatric patient? What about subsequent defibrillations?
2 J/kg
4 - 10 J/kg
When would one start compressions on a pediatric patient? (just based on HR)
When HR falls below 60
What are the two most common causes of pediatric bradycardia?
Hypoxia
Arrhythmia
What is the dosing of atropine for a bradycardic pediatric patient? What are the minimum/maximum doses?
0.02 mg/kg
0.1mg min.
0.5mg max.
What is the pediatric tachycardia synchronized cardioversion dose?
0.5 - 1 J/kg
2 J/kg max
What is the pediatric tachycardia adenosine dose?
1st dose: 0.1 mg/kg (max 6mg)
2nd dose: 0.2 mg/kg (max 12mg)
What are the pediatric arrest drugs and their doses? (3)
What is the shock energy?
Epinephrine 0.01 mg/kg IV
Amiodarone 5 mg/kg (max. 3 doses)
Lidocaine 1 mg/kg
2 joules/kg (4 - 10 joules/kg)
What are the pediatric bradycardia drugs and their doses? (2)
Epinephrine 0.01 mg/kg IV
Atropine 0.02 mg/kg IV, may repeat once (0.1 mg min. to 0.5 mg max)
What is the pediatric tachycardia drug and the doses?
Synchronized cardioversion energy?
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)
