Cardiac Treatments

Question 1

What is the initial care for ACS

Answer 1

324 MG’s aspirin

Question 2

When do you check for right sided involvement in a stemi

Answer 2

St elevation in 2-3 and aVF

Question 3

When to give metoprolol in an MI and how much?

Answer 3

25 milligrams PO if heart rate is over 80 and systolic blood pressure is over 120

Question 4

What is the first intervention for an MI with right sided involvement

Answer 4

500 milliliter fluid bolus (Max one liter)

Question 5

After giving a right sided MI patient a fluid bolus, what do you do next

Answer 5

Check MAP, if less than 60 go to shock algorithm, if over 60 give fentanyl for chest pain

Question 6

What is the first intervention for an MI patient with no right sided involvement after giving aspirin

Answer 6

0.4 milligrams nitroglycerin up to three times (only if MAP is greater than 60 )

Question 7

After giving nitroglycerin and aspirin to an MI patient, what do you do next

Answer 7

Treat chest pain with fentanyl or morphine (if MAP is over 60)

Question 8

What do you do after treating the chest pain of an MI patient?

Answer 8

Check for nausea/vomiting and then treat underlying rhythm as long as the treatment does not contradict MI treatment

Question 9

what is the initial care for an aortic emergency

Answer 9

Discontinue heparin or thrombolytics, and check map

Question 10

What do you do after discontinuing thrombolytics in an aortic emergency if map is less than 60

Answer 10

Start 500 milliliter bolus, and go to shock algorithm

Question 11

What to do in an aortic emergency where a map is greater than 60

Answer 11

Treat pain, followed by 10-20 MG labetalol every 10 min, max 300 MG

Question 12

What to do in an aortic emergency if map is greater than 80

Answer 12

Treat with 10 to 20 milligrams of labetalol SIVP every 10 minutes (Max 300 milligrams). Titrate to keep map in between 60 and 80

Question 13

How do you treat an unstable atrial fibrillation/ flutter patient with a sustained rate of over 150

Answer 13

Synchronized cardio version, ketamine or midazolam before if appropriate

Question 14

How do you treat a stable atrial fibrillation/ flutter with a sustained rate of over 150

Answer 14

500 milliliter fluid bolus, if rate stays over 150 treat with 0.25 milligrams per kilogram of diltiazem as well as 5mg metoprolol over 2 minutes with a Max of 15 MG

Question 15

What is the initial care for bradycardia

Answer 15

Treat dyspnea and determine if stable or unstable

Question 16

How to treat unstable bradycardia

Answer 16

1MG atropine Max 3G while preparing for transcutaneous pacing starting at 60 BPM and 40 mA

Question 17

what to do when transcutaneous pacing is ineffective

Answer 17

Administer 2 to 10 MCG/minute epi and titrate to a map of greater than 60

Question 18

What overdose should you consider in a bradycardia patient

Answer 18

Beta or calcium channel blocker overdose

Question 19

Name the Hs & Ts

Answer 19

Hypovolemia, hypoxia, hypothermia, hydrogen ions, hypo and hyperkalemia, tension pneumothorax, toxins, tamponade, thrombus

Question 20

What is initial care for a cardiogenic pulmonary edema patient

Answer 20

Solve any airway issues and administer 0.4 MG nitroglycerin every five minutes up to three times if map is greater than 60

Question 21

What do you do in a severe cardiogenic pulmonary edema patient with an elevated heart rate, elevated blood pressure, and shortness of breath

Answer 21

Treat with 0.4 MG nitroglycerin, start 20 MCG per minute Nitro drip with a Max of 400 MCG per minutes if map is greater than 60. Also administer morphine if map is greater than 60. Also administer labetalol 10 TO20MG over 2 minutes if map is greater than 80. IF IN SHOCK treat as cardiogenic shock.

Question 22

What do you do once you get ROSC

Answer 22

Make sure airway is secure and check for bradycardia and stemi

Question 23

How do you treat post ROSC shock

Answer 23

500 milliliter fluid bolus, 2 to 30 MCG per minute of norepinephrine karma or 2 to 10 MCG per minute of epinephrine

Question 24

Name what the check in a syncopal episode

Answer 24

Airway, blood sugar, cardiac rhythm, trauma, shock, drug overdose

Question 25

What is the initial treatment for narrow complex tachycardia will the rate of under 150 with no pulmonary edema

Answer 25

500 milliliter fluid bolus

Question 26

What is the first thing to know and a narrow complex tachycardia patient with a rate of over 150

Answer 26

Whether they are stable or unstable

Question 27

How do you treat a patient in stable SVT

Answer 27

Vagal maneuvers, 500 milliliter fluid bolus, 6MG then 12MG adenosine, 0.25 MG/kg of diltiazem, 5MG metoprolol over 2 minutes

Question 28

How do you treat unstable SVT

Answer 28

Synchronized cardio version at 100 J then 200, 300, 360. Give 2.5 to 5MG midazolam when appropriate

Question 29

How do you treat stable monomorphic vtac

Answer 29

150MG amiodarone over 10 minutes or 0.5 -1.5 MG per KG lidocaine every 10 minutes