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Advanced Life Support (ALS) > Appendices > Flashcards

Appendices Flashcards

1
Q

Anaphylaxis guidelines:

A
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2
Q

Adrenaline - Shockable (VF/pVT) - how to dose:

A
  1. Dose: 1 mg (10 mL 1:10 000 or 1 mL 1:1000) IV
  2. Given after the 3rd shock once compressions have resumed
  3. Repeated every 3-5 min (alternate cycles)
  4. Given without interrupting compressions
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3
Q

Adrenaline - Non-Shockable (PEA/Asystole) - how to dose:

A
  1. Dose: 1 mg (10 mL 1:10 000 or 1 mL 1:1000) IV
  2. Given as soon as IV access achieved
  3. Repeated every 3-5 min (alternate cycles)
  4. Given without interrupting compressions
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4
Q

What are the alpha-adrenergic effects of ADR?

A
  1. Systemic vasoconstriction
  2. Increases coronary perfusion pressures
  3. Increases cerebral perfusion pressures
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5
Q

What are the beta-adrenergic effects of ADR?

A
  1. +ve Inotropic
  2. +ve Chronotropic
  3. May increase coronary blood flow
  4. May increase cerebral blood flow

Increases myocardial O2 demand

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6
Q

Amiodarone - Shockable (VF/pVT) - how to dose:

A
  1. Dose: 300 mg bolus IV diluted in 5% dextrose (or other suitable solvent) to a volume of 20 ml
  2. Given during compressions after 3 shocks
  3. Further dose of 150 mg if VF/pVT persists after 5 shocks
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7
Q

Amiodarone - Non-Shockable (PEA/Asystole) - how to dose:

A
  1. Not indicated
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8
Q

MOA of amiodarone:

A
  1. Membrane-stabilising drug
  2. Increases the duration of the action potential & refractory period in atrial & ventricular myocardium
  3. AV conduction is slowed
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9
Q

What to flush amiodarone with?

A
  1. 0.9% sodium chloride
  2. Or 5% dextrose
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10
Q

Indications for NaHCO3:

A
  1. Cardiac arrest ass. w/ HyperK
  2. TAD OD
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11
Q

What dose of NaHCO3 is used?

A
  1. 50 mmol (50 ml of 8.4% soln.) IVI
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12
Q

Is NaHCO3 used routinely in cardiac arrest?

A
  1. NO

Only when HyperK present

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13
Q

Adverse effects of using NaHCO3:

A
  1. Produces CO2
  2. Worsens intracellular acidosis
  3. Negative inotrope
  4. Produces large osmotically active Na load to brain
  5. Shifts O2 dissociation curve to the left - inhibiting O2 release
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14
Q

When are fibrinolytics used in cardiac arrest?

A
  1. NOT used routinely
  2. ONLY when suspected or proven acute PE
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15
Q

Dosage of fibrinolytics when suspecting / Dx acute PE:

A
  1. Alteplase 50 mg IV bolus
  2. or Tenecteplase 500 - 600 mcg/kg IV bolus
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16
Q

Indication for adenosine:

A
  1. Paroxysmal SVT

6mg - 12mg - 18mg as rapid IV bolus + rapid flush (short half life)

17
Q

Indications for Adrenaline apart from cardiac arrest:

A
  1. Bradycardia
  2. Anaphylaxis
18
Q

Dose of adrenaline for bradycardia:

A
  1. 2-10 mcg/min
19
Q

Dose of adrenaline for anaphylaxis:

A
  1. 0.5 mg IMI (repeat every 5 min)
  2. 50 mcg IV bolus titrated to effect while awaiting infusion
  3. 1 mg ADR in 100 ml 0.9% NaCl starting @ 0.5 - 1.0 ml/kg/hr IVI titrated to clinical response
20
Q

Indications for amiodarone other than shockable rhythm cardiac arrest:

A
  1. Rx of haemodynamically stable monomoprhic VT, polymorphic VT & wide-complex tachycardia of uncertain origin
  2. Rate control &/or chemical cardioversion of pre-excited atrial arrhythmias (AF)
  3. To increase liklihood of electrical cardioversion
21
Q

Dosage of amiodarone for Rx of arrhythmias:

A
  1. 300 mg IVI over 10-60 min
  2. Followed by 900 mg infusion over 24 hrs
22
Q

Indications for atropine:

A
  1. Unstable sinus, atrial or nodal bradycardia
  2. Unstable AV block
23
Q

Dose of atropine:

A
  1. 500 mcg IVI stat
  2. Repeated up to 6 doses for max of 3 mg
24
Q

Indications for B-Blockers:

A
  1. Stable regular narrow complex tachycardias unresponsive to vagal manoeuvres or Adenosine
  2. Rate control AF & atrial flutter
25
Q

Indications for Verapamil:

A
  1. Stable regular narrow complex tachycardias unresonsive to vagal manoeuvres or Adenosine
  2. Rate control AF & atrial flutter when duration < 48 hrs
26
Q

Indications of digoxin:

A
  1. AF w/ fast ventricular response
27
Q

Indications for inotropes & vasopressors:

A
  1. Hypotension in absence of hypovolaemia
  2. Cardiogenic shock
28
Q

Dosages of Noradrenaline & Dobutamine:

A
  1. Noradrenaline 0.05 - 1 mcg/kg/min
  2. Dobutamine 5 - 20 mcg/kg/min
29
Q

Indications for Mg:

A
  1. Polymorphic VT - Torsades de Pointes
  2. Digoxin toxicity
  3. Rx of hypoMg
30
Q

Dosage of Mg:

A
  1. 2 g IV over 10 min
31
Q

Indications for Nitrates:

A
  1. Prevention or relief of angina
  2. ACS
  3. Acute & chronic LVF

Advanced Life Support (ALS) (13 decks)

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