Arrhythmias (1*)

Question 1

What is it?

What are the Cardiac causes?

What are the Non-cardiac causes?

How can it be investigated?

Answer 1

➊ Abnormal heart rhythms resulting from a disruption to the normal electrical signals that coordinate myocardial contraction

➋ IHD, Cardiomyopathy, Pericarditis, Myocarditis, Disrupted conduction pathways e.g. post-MI

➌ Caffeine, Smoking, Alcohol, Drugs, Electrolyte imbalance

➍ 24 hr ECG monitor

Question 2

Cardiac Arrest:
What is this defined as?

What are the 2 shockable rhythms?
→ How is this managed?
→ What can be done if rhymn persistent after 3 shocks?

What are the 2 non-shockable rhythms?
→ How is this managed?

Answer 2

➊ Pulseless and Unresponsive

➋ ● Pulseless Ventricular Tachycardia
● Ventricular Fibrillation
→ CPR 30:2 + Unsynchronised shock
→ Give Amiodarone 300mg IV + Adrenaline 1mg IV (1:10,000) at the same time. Adrenaline can then be repeated after every other cycle following a shock (i.e. cycles 3, 5, 7 etc.).

➌ ● Pulseless electrical activity (normal ECG w/o a pulse)
● Asystole (no QRS complexes)
→ CPR 30:2 + IV Adrenaline 1mg

N.B. Unsynchronised shock is the same as a Defibrillation