Cardiac Emergencies

Question 1

Medication and dose of drug indicated in symptomatic bradycardia if TCP unavailable

Answer 1

Atropine 0.5-1mg

Question 2

At what heart rate should you begin CPR in a pediatric patient with bradycardia who is hemodynamically unstable?

Answer 2

HR less than 60

Question 3

In PEDIATRIC symptomatic bradycardia, which drug/dose should you try first?

Answer 3

Epi 1:10,000 0.01 mg/kg IV/IO q 3-5 min

Question 4

What are the 5 “H’s” in the H’s and T’s?

Answer 4

Hypovolemia, Hypoxia, Hydrogen Ion Acidosis, Hypo/Hyper-kalemia, Hypoglycemia, Hypothermia

Question 5

What are the 5 “T’s” in the H’s and T’s?

Answer 5

Toxins, Tamponade (cardiac), Tension Pneumothorax, Thrombus, Trauma

Question 6

In PEDIATRIC symptomatic bradycardia, which drug/dose would you attempt AFTER Epi 1:10,000?

Answer 6

Atropine 0.02 mg/kg, maximum single dose 0.5 mg

Question 7

Your adult patient is in A-fib with RVR at a rate of 200 with a blood pressure of 130/90. What is the drug/dose of choice in this patient?

Answer 7

Diltiazem (Cardizem) 10-20 mg over 2 min.

Question 8

What is the dose of Adenosine for a patient in SVT?

Answer 8

First dose: 6mg, Second dose: 12 mg, 3rd dose: 12 mg

RAPID IV PUSH due to very short half-life. Only move on to second/third dose if conversion does not happen.

Question 9

In a stable patient experiencing VT or a Wide Complex Tachycardia, what is the drug/dose you would use for treatment?

Answer 9

Amiodarone 150 mg over 10 minutes mixed in 50-100 ml of D5W. **Should not be mixed in Normal Saline*

Question 10

What dose of Magnesium Sulfate would you give in a patient presenting with Torsades de Pointes?

Answer 10

1-2 Grams IV/IO over 2 minutes

Question 11

What drug can you treat your patient who you’ve given Diltiazem to, but then becomes hypotensive from it?

Answer 11

Calcium Chloride 500 mg IV

Question 12

PEDIATRIC dose of Adenosine?

Answer 12

0.1 mg/kg RAPID IV/IO to a max of 6mg

Second and Third dose: 0.2 mg/kg RAPID IV/IO, max dose of 12 mg.

Question 13

PEDIATRIC dose of Amiodarone in symptomatic wide-complex tachycardia?

Answer 13

5 mg/kg IV/IO over 20 minutes. (Obtain 12-Lead EKG prior to administration)

Question 14

What dose/drug is given in Asystolic Cardiac Arrest?

Answer 14

Epinephrine 1:10,000 1 mg IV/IO every 4 minutes up to a max of 4 doses.

Question 15

How much Sodium Bicarbonate can be given in Asystolic Cardiac Arrest after consult?

Answer 15

1 mEq/kg

Question 16

PEDIATRIC dose of Epi 1:10,000 in cardiac arrest?

Answer 16

0.01 mg/kg to a max of 4 doses.

Question 17

PEDIATRIC defibrillation dose for VF/VT Cardiac Arrest?

Answer 17

2 J/kg, then 4 J/kg, then 6 J/kg, then 8 J/kg, then 10 J/kg

Question 18

PEDIATRIC Cardiac Arrest dose of Amiodarone in VF/VT Cardiac Arrest?

Answer 18

5 mg/kg to a max single dose of 300 mg, may repeat twice

Question 19

Epi dose in Adult PEA Cardiac Arrest?

Answer 19

1 mg every 4 min to a max of 4 doses. If arrest occurs after ROSC, an additional 2 doses may be administered.

Question 20

Amiodarone dose in pulseless VF/VT Adult Cardiac Arrest?

Answer 20

300 mg IV/IO, may give a second dose of 150 mg IV/IO

Question 21

How old must a patient be to treat with the Neuroprotective Induced Hypothermia Protocol after ROSC from a medical etiology Cardiac Arrest?

Answer 21

18 or older (GCS less than 8)

Question 22

What is the initial joule setting for cardioversion of an adult patient in SVT, VT, or Atrial Flutter?

Answer 22

100 J

Question 23

What is the initial joule setting for cardioversion of an adult patient in Atrial Fibrillation?

Answer 23

200 J

Question 24

Defibrillation dose for an adult patient on a biphasic (ProPaq) monitor?

Answer 24

120J, then 150 J, then 200 J

Question 25

Transcutaneous Pacing: Adult rate and Milliamperes that you start at?

Answer 25

80 bpm and start the milliamps as low as possible while gradually increasing until you can confirm mechanical and electrical capture. (Max 200 m.a.)

Question 26

What rate would you start TCP on a pediatric patient (1-12 years)?

Answer 26

100 bpm

Question 27

Inferior AMI - ST elevation in which leads?

Answer 27

II, III, aVF

Question 28

Septal AMI - ST elevation in which leads?

Answer 28

V1, V2

Question 29

Anterior AMI - ST elevation in which leads?

Answer 29

V3, V4

Question 30

Lateral AMI - ST elevation in which leads?

Answer 30

V5, V6, I, aVL