ALS--> defib & CPR

Question 1

what are the shockable rhythms?
and how many shocks do you give?
what joule do you start with?
how long do u wait between each shock?

Answer 1

VT & VF
3 shocks
Start with 200–> 260–> 300
after every shock, continue CPR for 2 minutes-, then re-access rhythm

Question 2

What is the ratio of chest compressions to breaths?
what if you put an igel in?
Depth?
Rate?

Answer 2

30:2
continuous oxygen 10 breaths in 1 minute?
5-6 cm
100–> 120

Question 3

so you checked rhythm and it showed a sawtooth appearance, what do you do next?

Answer 3

VT

1) check for pulse (carotid)
2) no pulse–> SHOCK
3) 2 mins of CPR
4) then reaccess

Question 4

so you accessed rhythm & it showed VT but there was a pulse, how do you manage now?

Answer 4

VAGAL manoeuvres

1) valsalva maneuver
2) carotid sinus massage

ADENOSINEEE 6mg IV RAPID BLOLUS (adeelooooo, rg9eely 6x)
unsuccessful–> 12mg—> 18mg

Question 5

if your rhythm shows VF, how do you manage?

Answer 5

This is a shockable rhythm

1) administer first shock
2) continue CPR for 2 mins
3) re-access

Question 6

you access the rhythm and PEA comes up, what do you do next?

Answer 6

1) check for central pulse
2) NO pulse–> NONshockable rhythm-
3) ADRENILINE 1mg (1 :10,000)
4) Repeat adrenaline after every 3-5 mins once given

Question 7

you access the rhythm & straight line comes up, what do you do next?

Answer 7

This is a non-shockable rhythm

1) Give IV adrenaline 1mg (1: 10,000) immediately
2) continue CPR–> re-access after 2 minutes

Question 8

if you get polymorphic VT (Torsades de pointes), how would you manage it?

Answer 8

Magnesium 2g over 10 mins

Question 9

when is amiodarone given? and how much?

Answer 9

given for VF and pulseless VT
300mg IV
given only after 3 shocks have been administered

Question 10

If amiodarone is not available, what can we give instead?

Answer 10

lidocaine

Question 11

if someone has bradycardia mobitz 1 or 2 or complete heart block, what do you give?
what’s the max dose you can give? how do u give it?
what if you have done that and it failed?

Answer 11

ATROPINE 500mcg IV
max of 3 mg

TRANSCUTANEOUS PACING (on the Defibb machine there a pacing button)

Question 12

which drugs are given IO

and when is it CI?

Question 13

what are the 4 H’s and 4’T

how do you check for them?

Answer 13

4 H's
Hypoxia--> no point checking O2 sats cuz they r doing CPR, so ask the person ventilating the ptx "how is is doing w/ ventilation)
Hypothermia--> check temp & feel skin
Hydration--> fluid status and BP
Hypo/hyperkaleamia--> VBG

4 T’s
Thrombus–> check calves
Tension pneumothorax–> check trachea central, Resp exam
Tamponade–> ECHO? muffles heart sounds? raised BP?
Toxins –> ask Hx

Question 14

what is a reversible cause of PEA caused by treat trauma?