ALS Flashcards
Overall cardiac arrest survival
10%
Capture voltage - transcutaneous pacing
50-100mA
Unstable tachy Tx
3x synchronised shocks
Amiodarone 300mg (10mins)
Further shocks
Severe hypokalaemia
<2.5
Replace K rate
Max 10-20mmol/h
ie 40mmol in 1L over 4/2h
Every 1 minute delay in defib reduces outcome by
10%
Incidence VF post MI
5%
If low K found check
Mg2+
Early defib =
W/I 5 mins resus call
Adrenaline every
3-5 mins
High calcium
> 2.6
Non technical skills
Situational awareness
Decision making
Team working/ leadership
Task management
Non technical skills
Situational awareness
Decision making
Team working/ leadership
Task management
Decisions during arrest
Diagnose rhythm
Choose shock energy
Reversible causes
How long to continue resus
Severe high calcium
> 3
Low calcium
<2.1
Tx low calcium
Calcium chloride 10ml 10%
Or calcium gluconate 30ml 10%
Tx high calcium
IV fluids
Pamidronate
High magnesium
> 1.1
Tx high magnesium
Check potassium
? Calcium gluconate
Low magnesium
<0.6
Tx low magnesium
1.2g-2g
4ml 8mmol Mg sulphate
20mmol
50mmol
Salicylate poisoning
Urine alkanisation
- bicarbonate
Tx LA toxicity
Intralipid
Tx digoxin toxicity
Digibind
Tx TCA OD
Sodium bicarbonate
Tx cocaine OD
Benzodiazepines
Life threatening asthma
<33% predicted Sats <92% PaO2 <8 Normal pCO2 Silent chest
Acute severe asthma
33-50% PEFR
RR >25
HR >110
Mast cell tryptase time to take
1-2h Post Sx and Baseline (after better)
High risk Bradycardias
Recent asystole
2nd degree mobitz type 2
Complete HB
Ventricular pause over 3s
Calcium resonium dose
15-30g
Irregular broad complex tachy
Likely rhythms
AF with BBB
TdP
Tx TdP
Stop drug prolonging QT
Treat electrolyte imbalance: K, Mg, Ca
Tx irregular broad complex tachycardia
Likely AF and BBB
?TdP
Consider amiodarone
Tx regular broad complex tachy
Likely VT
Amiodarone
Tx regular narrow complex tachy
Likely SVT
Modified valsalva
Adenosine 6,12,12mg
Tx irregular narrow complex tachy
Likely AF B blocker or CCB Dig Amiodarone LMWH ?>48h
Tx long QT syndrome
B Blocker
Absolute CI to fibrinolytic therapy
Active bleed Haemorrhagic stroke Ischaemic stroke w/i 6m CNS damage/ neoplasm Surgery w/i 3w GI bleed w/i 4w Head injury Aortic dissection