Arrhythmias Flashcards
AV block
increased PR interval
Second degree AVB Type I
PR interval delay increases until a QRS complex is dropped
Other names for second degree AVB type I
Mobitz I, Weckebach
Second degree AVB Type II
no progressive delay, dropped QRS occurs in a 2:1 or 4:1 ratio
Third degree AVB
Complete disassociation between SA node and ventricles
Treatment for SVT
vagal x 2
adenosine
SCV p.217
Post arrest survival rate
3-10%
Defibrillation amounts
2j /kg
4j /kg
>4-10 j /kg
How often do you reassess rhythms?
After 2 min of CPR p.236
Criteria for terminating code
ETCO2 <10mm/hg after 20 min of CPR
To what temp. do you actively rewarm
> 32 C p.242
Goals for PCAS
preserve neurological function, minimize organ injury
Brain effects from PCAS
impaired blood flow
edema
neuron degenertion
Heart effects from PCAS
muscle dysfunction
low CO
Five Systemic effects of PCAS
tissue 02
inflammation
^ coagulation
adrenal suppression
increased infection rate p.246
How is PCAS myocardial dysfunction treated
fluids and inotropes
Adequate urine output
1.5-2 ml/kg infant/child
1 ml/kg adolescents
How often does seizure occur in ROSC patients
15%
What level on temp rise increases mortality
1 degree C
Hypothermia temp. goals
32-34C 89-93.2 F p.254
How can hypothermia effect metabolism
reduces insulin sensitivity, increasing BGL
Location of fingers for child CPR
just below nipple line
Location of encircling thumbs
just below nipple line
What is the most common SYMPTOMATIC pedi arrhythmia?
SVT p. 211
Differences between ST and SVT
ST <180 bpm, p waves present
SVT >180 bpm no P waves present
Drug of choice for stable VT of SVT w/A?
Adenosine 0.1mg/kg (MAX 6mg) p. 218
Treatment for stable bradycardia?
Identify cause and treat (Hs/Ts) p. 219
Treatment for UNSTABLE bradycardia?
- CPR x 2 min.
- Epi 0.01mg/kg Q 3-5 min
- Atropine 0.02 mg/kg Q 3-5 min p. 219
- Pacing
Treatment for stable narrow complex tach?
- Vagal x 2
- Adenosine 0.1mg/kg (max 6 mg) may repeat at 0.2mg/kg
- SCV at 1j/kg
- Consider Amiodarone 5mg/kg or Procainamide 15mg/kg both over 30 minutes p.219
Measurement criteria for narrow complex tach
QRS = 0.09 s p.223
Measurement criteria for wide complex tach
QRS >/= 0.09 s p.223
Treatment for unstable tach (narrow or wide?
- Adenosine 0.1mg/kg (max 6mg) , may repeat at 0.2mg/kg
- SCV at 1j/kg
Major cause of asystole?
respiratory failure p. 226
Major cause of PEA?
hypoxia and hypovolemia p.226
