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Arrhythmias Flashcards

1
Q

Bradycardia

A

<60 HR

w/ Cardiopulmonary Compromise

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2
Q

What is Cardiac Compromise

A

Cardiopulmonary Compromise = hypotension, AMS, DLOC, Shock

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3
Q

Primary Bradycardia

A

Result of congenital heart condition

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4
Q

Primary Bradycardia examples

A

Myocarditis
Cardiomyopathy
Surgical injury to the pacemaker
Congenital abnormality

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5
Q

Secondary Bradycardia

A

Result of noncardiac conditions

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6
Q

Secondary Bradycardia examples

A 
Hypoxia
Acidosis
Hypotension
Hypothermia
Drug Effects
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7
Q

STUDY AV BLOCKS

A

STUDY AV BLOCKS

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8
Q

Narrow QRS

A

<0.09 seconds

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9
Q

Wide QRS

A

> 0.09 seconds

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10
Q

Narrow Complex Tachycardia

A

Sinus taachy
Supraventricular tachy
Atrial flutter

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11
Q

Wide Complex Tachycardia

A

Ventricular tachycardia

SVT

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12
Q

Etopic atrial focus

A

abnormal pacemaker sites within the heart
normally suppressed by SA node
occur in atria or ventricles

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13
Q

HR in ST

A

Infants <220 min

Chldren <180 min

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14
Q

ST Hx

A

Gradual Onset

Fever, pain, dehydration, hemorrhage

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15
Q

ST PE

A

Crackles, fever, hypovolmeia, anemia

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16
Q

HR in SVT

A

Infants >220

Children >180

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17
Q

SVT Hx

A

Abrupt onset

Infant: CHF
Child: Palpitations

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18
Q

SVT PE

A

CHF

Rales, hepatomegaly, edema

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19
Q

Ventricular Tachycardia

A

Wide QRS complex

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20
Q

2 Forms of VT

A 
Monomorphic
Polymorphic (Torsades de pointes)
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21
Q

Atropine dosage

A

0.02 mg/kg - May repeat dose ONCE
Minimum dose 0.1 mg
Max single dose 0.5 mg

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22
Q

<60 HR w/ cardiopulmonary compromise?

23
Q

<60 Hr w/ cardiopulmonary compromise persisting with CPR…

A

Epi
Atropine
Transthoracic/Transvenous Pacing

24
Q

What is increased vagal tone

A

Vagal Nerve
Activates parasympathetic nervous tone
Your body relaxes faster after stress

25
What is atropine used for
increased vagal tone AV block Cholinergic drug toxicity (epi can cause ventricular arrhythmias during these circumstances)
26
Epi has both
alpha and beta adrenergic activity
27
What does Beta adrenergic do
Increases HR & cardiac contractility
28
What does Alpha adrenergic do
Causes vasoconstriction
29
The effects of epi and other catecholamines can be reduced by
acidosis and hypoxia
30
What is a parasympatholytic
Reduces the activity of the parasympathetic nervous system
31
Atropine what type of drug
parasmypatholytic (anticholinergic)
32
How does atropine work on the body
It accelerates sinus or atrial pacemakers and enhances AV conduction
33
What does cholinergic do?
Mimics acetylcholine
34
What is acetylcholine
Primary transmitter of nerve impulses in the parasympathetic nervous system
35
What can be used for tx of Mobitz I & II, and third-degree AV block?
Atropine
36
Atropine dose in ET
0.04 to 0.06 mg/kg
37
What do cholinesterase inhibitors do
Prevent the breakdown of acetylcholine or butyrylcholine
38
Vagal maneuvers to terminate SVT
Ice on the face for 15 to 20 seconds Blow through a straw Carotid sinus massage in older children Do not apply ocular pressure - retinal injury
39
When are unsynchronized shocks used
For defibrillation because the cardiac arrest rhythms have no QRS
40
synchronized shocks are used
from SVT and VT
41
When does the synchronized shock hit
R wave
42
What happens if you don't hit the synchronized shock
it could lead to VF because you could hit the vulnerable period of the T wave
43
Cardioversion dosage
Start w/ 0.5 to 1 J/Kg inc 2 J/kg 0.5 - 1 - 2
44
Drug choice for tx f SVT
Adenosine
45
What is Adenosine dosage
RAPID IV BOLUS 0. 1 mg/kg (max first 6mg) 0. 2 mg/kg (max second 12mg)
46
Decrease the dose of Adenosine for those w/
transplanted hearts
47
Adenosine MOA
Blocks conduction through the AV node temporarily
48
Atrioventricular node reentry
Causes the heart to beat prematurely
49
Amiodarone Dosage
5 mg/kg loading dose over 20 - 60 minutes Max single dose 300mg Max 15 mg/kg a day (Not exceed adult dose of 2.2g over 24 hours)
50
Why is a slower rate of Amio advised?
Because it can cause hypotension and decreased cardiac contractility
51
Drug that can terminate SVT that is resistant to other drugs
Procainamide
52
How does procainamide work?
Blocks the sodium channel | Prolongs the effective refractory period of the atria and ventricles
53
Procainamide dose
Infuse a loading dose of 15mg/kg over 30 - 60 mins
54
What drug should you not use in infants for SVT
Verapmil - CCB | Has caused refractory hypotension and cardiac arrest

PALS (9 decks)

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