Cardiac(41-50)

Question 1

Unstable with no block or w/ 1° or w/ 2° type I

Answer 1

• Atropine 1 mg q 3-5 max 3 mg
• Pacing or dopamine 5-20 or epi 2-10

Question 2

Unstable with 2° type II or 3°

Answer 2

Pacing

Question 3

Bradycarida treatable causes

Answer 3

BB OD: Glucagon 0.05 mg/kg(3-10)IV, stack zofran if able
CC OD: Ca glucanate 1g SIVP(1-1.5 mL/ min), no more than 200 mg/min

Question 4

CCB

Answer 4

Diltiazem, verapamil, nifedipine

Question 5

Epi for refractory bradycardia

Answer 5

2-10/ min OR 0.1-0.5 mcg/kg/min
1 mg in 250 mL om D5W/NS for 4 mcg/mL

Question 6

Discontinue CPR if

Answer 6

• Asystole following trauma
• > 15 min downtime w/o resuscitative efforts
• 3 rounds of medications or 30 min of resus with no response
• 1L, bilateral NCD

Question 7

Chest Pain what do?

Answer 7

• Aspirin 324 mg
• 400 mcg or 800 mcg q 5min x 3
• 500 IVF if hypotensive
• Morphine 1-5 or fentanyl 25-50

Question 8

Hold NTG for?

Answer 8

-Potential R-sided MI, pain-free, SBP<100, viagra/cialis/levitra within 48 hrs

Question 9

Post cardiac arrest SBP<90

Answer 9

• Norepi 0.1-0.5 mcg/kg/min or epi 2-10/min

Question 10

Post Cardiac Arrest Reperfusion

Answer 10

1-2 L IVF

Question 11

Suspected Stroke BGL trigger

Answer 11

<70

Question 12

Suspected stroke SBP>185 or DBP>110

Answer 12

Labetalol 10-20 mg over 1-2min, twice MAX

Question 13

Max reduction in MAP

Answer 13

20%

Question 14

MAP Formula

Answer 14

((2DBP)+SBP)/3

Question 15

Synchronized Cardioversion Joules

Answer 15

Narrow Irregular: 120-200
Narrow Regular: 50-100
Wide Regular: 100

Question 16

Tachy with a pulse: Narrow QRS

Answer 16

• Attempt Vagal Maneuver
• Consider Adenosine if regular rhythm
• Consider CCB/BB if regular and adenosine doesn’t work or rhythm returns

Question 17

Tachy with a pulse: Wide QRS

Answer 17

• Consider adenosine if regular and monomorphic
• Consider procainamide, amiodarone, or sotalol

Question 18

Torsades de Pointes

Answer 18

1-2g Mag ver 60 min, start at 0.5-1 g/hr and titrate

Question 19

Ped Bradycardia Triggers

Answer 19

<100 or age appropriate limits

Question 20

Persistent Bradycardia PED

Answer 20

Epi 0.01 mg/kg q3-5 max 1 mg
Atropine 0.02 mg/kg(Increased vagal tone or AV block) max 2 twice with max dose of 0.5 per dose

Question 21

Pacing Sedation Child

Answer 21

Midazolam 0.05-0.1 mg/kg

Question 22

Child Bradycardia: Hypoglycemia

Answer 22

D25 2mL/kg or glucagon 0.025mg/kg IM(max 1mg)

Question 23

Child Bradycardia: BB OD

Answer 23

Glucagon 0.05 mg/kg(3-10mg), pretreat with zofran 0.15mg/kg(2 mg max)

Question 24

Child Bradycardia: CCB OD

Answer 24

CaCl 0.2 mL/kg SIVP

Question 25

Child Bradycardia: Opiates

Answer 25

Naloxone 0.1mg/kg(max 2mg) q 2-3

Question 26

Rescue breathing rates newborn and child

Answer 26

40-60/min 1/3-5s

Question 27

Joules for shocking child

Answer 27

1st: 2J/kg 2nd: 4J/kg 3rd+: >4J/kg up to 10 J/kg

Question 28

Pediatric cardiac arrest amiodarone and lidocaine

Answer 28

Amio: 5 mg/kg x 2 Lido: 1mg/kg then 20-50 mcg/kg/min

Question 29

Child HR>180, no variability or abrupt changes between normal and tachy. Narrow QRS. Stable

Answer 29

- Probable SVT - Consider Vagal Maneuvers - Consider Adenosine(0.1mg/kg, followed by 0.2 mg/kg)

Question 30

Wide QRS Child Stable

Answer 30

- Regular and Monomorphic: Adenosine - Consider conversion with: Amiodarone 5mg/kg over 20-60 min or Procainamide 15 mg/kg over 30-60 min

Question 31

Unstable Child. Child HR>180, no variability or abrupt changes between normal and tachy. Narrow QRS.

Answer 31

- Adenosine - Sync Cardioversion: 0.5-1 then 2J/kg(midazolam 0.05-1 mg/kg if possible)

Question 32

Unstable Child. Wide QRS

Answer 32

- Synchronized cardioversion 0.5-1J/kg, up to 2J/kg if needed. Midazoloam(0.05-1 mg/kg)

Question 33

Unstable Child. Regular rhythm and monomorphic. You've already tried the cable.

Answer 33

Adenosine(.1/.2) then try amiodarone 5mg/kg(20-60 min) or procainamide 15 mg/kg(30-60 min)