Cardiac arrhythmia management Flashcards
1
Q
What is pulseless electrical activity (PEA)
A
- no pulse found -> Cardiac arrest 2. ECG shows electrical activity
2
Q
Management of PEA
A
- e.g. Asystole / normal electrical activity on ECG w/o pulse - No shock - CPR only - Adrenaline
3
Q
Ventricular tachycardia
A
- Fine VF - small amplitude, gets weaker and weaker 2. Coarse VF - greater amplitude 3. Originates from ventricles -> Broad complex tachycardia 4. Ventricular tachycardia - no P waves, broad and regular
4
Q
Cardiac causes of bradycardia
A
- Cardiac conduction blocks
2, no cardiac - drugs, toxins, metabolic ( beta blockers)
- electrolytes - K and Mg
- Hypothyroidism
5
Q
initial management of adult bradycardia
A
- Heart rate < 50 bpm
- A, B , C ( airway, breathing and circulation)
- Blood pressure and IV access
- ECG
6
Q
Which redflags identified in bradycardia management
A
- Hypotension 2, Altered mental state 3. Signs of shock 4. Ischaemic discomfort 5. Acute heart failure If no - MONITOR + OBSERVE
7
Q
Redflags have been identified in bradycardia
A
- Give atropine if ineffective ; 2. Transcutaneous pacing 3. Dopamine or epinephrine infusion
8
Q
atropine - use - MoA - contraindication
A
- used in the treatment of bradycardia 2, an ACh receptor antagonist to decrease Parasympathetic nervous system and increase sympathetic nervous system 3, Contraindic - patient is predisposed to narrow-angle glaucoma
9
Q
First degree heartblock
A
- PR interval is longer than expected 2. slower conduction mabe due to beta blocker use
10
Q
Second degree heart block ( Mobitz type I)
A
- PR interval gets longer and longer –> until QRS suddenly disappears
11
Q
Second degree heart block (Mobitz type II)
A
- QRS suddenly drops - no PR prolonging 2. Risk of deteriorating int o asystole
12
Q
Third degree heart block
A
- regular P waves and QRS but they do not talk to each other 2. SAN creates own rythm - atria contract but not contact via AV noe 3. No AVN firing - escape beats only 4. risk of asystole is high and pacemaker is needed
13
Q
Managment of atrial tachycardia
A
- Heart rate > 150 bpm 2. A, B , C 3. IV access and ECG 4. Check for red flags 1. Vagal manoeuvres - increase activity of Vagus nerve 2, Adenosine - to chemically cardiovert the heart
14
Q
Redflag in supraventricular tachycardia
A
- hypotension 2. acutely altered mental status 3. signs of shock 4. chest pain 5. heart failure –> NO 6. is QRS wider than > 0.12 secs? —>NO 1. Vagal maneuvers 2. Adenosine 3. Beta blocker/Calcium channel blockers
15
Q
management of Ventricular tachycardia
A
- Shock + CPR 2. Amiadorone