Cardiac

Question 1

Indications for Adult Bradycardia algorithm

Answer 1

-Slow HR, less than 60 bpm

Question 2

What serious signs and symptoms may bradycardic patients present with?

Answer 2

• Chest pain or shortness of breath
• Altered/decreased level of consciousness
• Hypotension or hypoperfusion
• Congestive heart failure or pulmonary congestion
• Acute myocardial infarction

Question 3

Treatment of adult bradycardia with serious signs and symptoms

Answer 3

• Transcutaneous pacing
• Atropine 0.5 - 1 mg IVP if TCP is unavailable or ineffective
• Epinephrine 1 mL/min using approved epi infusion

Question 4

Treatment of adult bradycardia without serious signs and symptoms

Answer 4

Second-degree Type II AV Block or Third-degree AV Block present?
- Yes: Prepare for TCP
- No: Observe

Question 5

Indications for pediatric bradycardia algorithms

Answer 5

Slow HR

Question 6

Treatment of pediatric bradycardia in the hemodynamically unstable

Answer 6

• Begin CPR if HR less than 60 with poor perfusion despite oxygenation and ventilation
• If bradycardia persists:
  
  • Epinephrine IV/IO 0.01mg/kg (0.1mg/mL); Repeat every 3-5 min
  • Atropine IV/IO 0.02 mg/kg, Max single dose 0.5 mg
  • Consider TCP
  • If pulseless arrest develops go to Pediatric Arrest Algorithm

Question 7

Possible causes of bradycardia in the pediatric patient

Answer 7

Hs & Ts
- hypovolemia
- hypoxia
- hydrogen ion (acidosis)
- hyperkalemia
- hypoglycemia
- hypothermia
- toxins
- tamponade, cardiac
- tension pneumothorax
- thrombus
- trauma

Question 8

Treatment of adult tachycardia in the hemodynamically unstable

Answer 8

Perform synchronized cardioversion

Question 9

Treatment of Narrow QRS A-fib or A-flutter

Answer 9

Diltiazem 0.25 mg/kg (10-20 mg) IV/IO over 2 min

Question 10

Treatment of Wide QRS A-fib or A-flutter with abberancy

Answer 10

Amiodarone 150 mg IV/IO over 10 min
Repeat if necessary

Question 11

Treatment of Polymorphic wide QRS complex tachycardia (Torsades)

Answer 11

Magnesium sulfate 1-2 grams IV/IO over 2 minutes

Question 12

Treatment of adult stable Narrow QRS (SVT)

Answer 12

• Valsalva
• Adenosine 6mg rapid IVP
• Adenosine 12mg rapid IVP
  Repeat x1 in 1-2 minutes

Question 13

Treatment of stable adult Monomorphic wide QRS complex tachycardia (V-Tach)

Answer 13

-Amiodarone 150 mg IV/IO over 10 min
Repeat if necessary

Question 14

Treatment of stable pediatric SVT

Answer 14

• Consider vagal maneuvers
• Consider Adenosine
• Consider cardioversion

Question 15

Treatment of unstable pediatric VT

Answer 15

• Cardiovert 1 J/kg
• Cardiovert 2 J/kg
• IV/IO access
• Amiodarone

Question 16

Treatment of