Cardiac Emergency Management

Question 1

Upslope of T wave is called?

Answer 1

Absolute refractory period; nothing inside or outside can affect this

Question 2

Downslope of T wave is?

Answer 2

Relative refractory period; affected by inside or outside forces

Question 3

Indications for synchronized cardioversion?

Answer 3

UNSTABLE, TACHYCARDIC PATIENT

Perfusing VT, PSVT, Rapid atrial fibrillation, 2:1 flutter

Question 4

What two rhythms are defibrillated?

Answer 4

VFIB and pulseless VTACH

Question 5

What are the joules settings for cardioversion?

Answer 5

100, 200, 300, then 360

Question 6

Transcutaneous Cardiac Pacing is indicated with?

Answer 6

Symptomatic bradycardias with or without high-degree AV blocks, Atrial fibrillation ,

Question 7

Both limb leads an pads have to hooked up in order to?

Answer 7

Pace patient

Question 8

What is the general starting pacing rate?

Answer 8

60

Question 9

Full capture of pacer spikes occurs when?

Answer 9

When a QRS follows every spike

Question 10

What are good signs pacing is working mechanically?

Answer 10

SPO2 is responding, CO2 is decreasing

Question 11

What can not be done before a 12 lead?

Answer 11

Morphine or Nitro

Question 12

What actions does morphine have that nitro does not have?

Answer 12

Pain

Reduces anxiety

Question 13

Treatment for heart failure patients include?

Answer 13

CPAP and Nitro (0.4 SL x3 if systolic stays above 90)

Question 14

Treatment for cardiac tamponade should be?

Answer 14

CALL MEDICAL DIRECTION

Question 15

PACING requires which leads?

Answer 15

Limb leads and pads

Question 16

Refraction to atropine and pacing requires?

Answer 16

Dopamine

Question 17

What is the treatment for a stable bradicardia rhythm?

Answer 17

Atropine (0.5mg IVP)
TCP
Dopamine (5-20mcg/kg/min)

Question 18

Treatment for SVT includes?

Answer 18

Valsalva maneuver
IV AC OR HIGHER
Adenosine (6mg - 12mg - 12mg IVP)
Versed (2-4mg ivp)
Cardioversion

Question 19

Treatment for unstable SVT?

Answer 19

MIDAZOLAM 0.1mg/kg IV

Cardioversion!! 100J, 200J, 300J, 360J

Question 20

Prinzmetal angina is indicated if?

Answer 20

ST elevation returns to normal after NTG

Question 21

What is the long term treatment for prinzmetals angina?

Answer 21

Calcium channel blockers and nitrates to prevent spasms

Question 22

QRS complexes of >120 (wide QRS) along with p waves represent?

Answer 22

Bundle branch block

Question 23

What is happening with ventricles during a bundle branch block?

Answer 23

Ventricles are not firing simultaneously

Question 24

Left of bundle branch block is determined by?

Answer 24

First deflection backwards from T wave is down

Question 25

Right bundle branch block is determined by?

Answer 25

First deflection backwards from T wave is up

Question 26

Lidocaine should not be used with which heart block?

Answer 26

Bifasicular block

Question 27

What is the treatment for sinus tachycardia?

Answer 27

Treat underlying cause only

Question 28

Which drug can replace the first or second dose of epinephrine in CPR?

Answer 28

Vasopressin 40 units

Question 29

How does adenosine treat SVT?

Answer 29

It decreases conduction of the electrical impulses throughout the AV node and interrupts AV re-entry pathways

Question 30

Which drug is known as the chemical cardioversion?

Answer 30

Adenosine

Question 31

What are the advantages of utilizing calcium channel blockers?

Answer 31

Reduces myocardial oxygen demand due to negative inotopic effects and coronary and peripheral vasodilation

Question 32

When should calcium channel blockers not be given?

Answer 32

When patients are receiving IV beta blockers

Question 33

How does amiodarone work inside the body?

Answer 33

It blocks sodium channels, inhibits symptomatic stimulation and blocks potassium/calcium channels

Question 34

______ slows conduction through the his-purkinje system and in patients with WPW.

Answer 34

Amiodarone

Question 35

____ inhibits both alpha and beta receptors and possesses both vagolytic and calcium channel blocking properties.

Answer 35

Amiodarone

Question 36

What art of the heart does lidocaine effect?

Answer 36

Ventricles

Question 37

How does lidocaine effect the ventricles?

Answer 37

Depresses depolarization and automaticity in the ventricles

Question 38

What is the treatment of choice for torsades?

Answer 38

Magnesium sulfate

Question 39

What is Lasix?

Answer 39

A diuretic that inhibits sodium and chloride reabsorption by the kidneys

Question 40

What does nitro glycerine do inside the body?

Answer 40

Reduces cardiac workload and dilates coronary arteries

Question 41

Medications best suited for treating broncoconstriction generally stimulate?

Answer 41

Beta 2 receptor sites