ALS Flashcards
During Cardiac Arrest, what medication can you give first
Adrenaline
Cardiac arrest: When do you give Adrenaline
Immediately if no shockable rhythm or on the 2nd shock in a shockable rhythm
How frequently during an arrest can you administer Adrenaline
Every alternative loop
What dose of Adrenaline do you administer
1mg bolus
When else would you administer Adrenaline
Anaphylaxis
What dose do you administer for anaphylaxis
0.5mg IM
What 2 main medication do you give during Cardiac Arrest
Adrenaline and Amiodarone
What medication do you give for symptomatic Bradycardia
Atropine
What does of Atropine do you give in symptomatic Bradycardia
600mcg/ 0.6mg IV
What’s the Action of giving Adrenaline in cardiac arrest patients
Produces vasoconstriction, increasing cerebral and coronary perfusion
What are the Adverse reactions of giving adrenaline in CA patients
Tachyarrythmias, severe hypertension, tissue necrosis
When would you administer amiodarone during cardiac arrest
AFTER the 3rd shock, further 150mg after the 5th shock
What’s the dose of Amiodarone given and what’s it mixed with
300mg bolus in 20mls of 5% glucose
What’s the action of Amiodarone
Antiarrhythmic
What are the adverse reactions of Amiodarone
Hypotension, bradycardia, QT prolongation, Heart Block
When else outside of CA should you give Amiodarone and what dose
Tacharrhythmias, 300mg IV
What would you administer to treat:
Hyperkalemia (High K+)
Hypocalcaemia (Low calcium) or
Calcium channel blocker overdose?
Calcium Chloride
What’s the dose and how is it given of Calcium Chloride?
10mls of 10% (6.8mmol) Bolus
What’s the Action of Calcium Chloride
Increase myocardial cells response to a stimulus, increases heart contractions, increases peripheral resistances
Why’s the adverse reaction to Calcium Chloride
Tissue necrosis
What medication should be given for Hypokalaemia
Potassium
What’s the dose of Potassium given during a cardiac arrest ?
5mmol bolus from a 10mmol bag
What is the action of potassium
Essential electrolyte for membrane stability and contraction of cardiac, skeletal and smooth muscle
What are the adverse reaction of potassium
Hyperkalaemia, hypotension, bradycardia, flaccid paralysis, necrosis, cardiac arrest
Which drug should be given to treat: Hyperkalaemia, Tricyclic Antidepressant OD, Metabolic Acidosis, Prolonged Cardiac Arrest?
Sodium Bicarbonate
What’s dose of Sodium Bicarbonate do you administer
100mls of 8.4% or 1 mmol/kg
What’s the action of Sodium Bicarbonate
Alkalising solution
What are the adverse reactions of Sodium Bicarbonate
Conversation of CO2, worsening acidosis, metabolic alkalosis, Hypokalaemia
What is the action of administrating Atropine
Increases HR and improves the atrioventricular conduction
What are the Adverse reactions of Atropine
Anticholinergic effects: blurred vision, urinary retention, vasodilation
What is an alternative drug given during Cardiac Arrest when Amiodarone is unavailable or contraindicated
Lignocaine
What’s the dose and how do you administered Lignocaine during CA
1mg/kg bolus and 0.5mg/kg bolus during resus
What’s the action of Lignocaine
Membrane stabilising agent ( anti-arrhythmic and sodium channel blocker
What are the adverse reactions of Lignocaine
Seizures, agitation, ALOC, Hypotension, Bradycardia, Heart Block
What medication do you administer to treat: VT, Torsades de Pointes, SVT, Digoxin Toxicity and Hypomagnesamia
Magnesium
What dose of Magnesium do you give
5mmol bolus
What’s the action of Magnesium
Slows the rate of the SA node & prolongs conduction time, depresses skeletal, smooth and cardiac muscle activity
What are the Adverse reactions of Magnesium
Hypotension, flushing, diaphoresis, flaccid paralysis, diarrhoea
What are the 4 Hs?
Hypoxia
Hypovolaemia
Hypo/Hyperkalaemia
Hypo/Hyperthermia
What are the 4 Ts?
Toxins
Tension Pneumothorax
Tamponade
Thrombus
Shockable Rhythms are:
No pulse Ventricular Tachycardia (VT) + Ventricular Fibrillation (VF)
Non- Shockable Rhythms are:
PEA (Pulseless Electrical Activity) + Asystole
When planning to shock what is the voltage?
200j for 1st shock, 360j for all others
During CA: how much should you be flushing pre and post drugs & what drug requires glucose
20mls n/s & amiodarone requires glucose 20mls pre and post administration
What are 2 airway techniques that can be placed to assist airway?
OPA & NPA
