Cardiac Treatments Flashcards
What is the initial care for ACS
324 MG’s aspirin
When do you check for right sided involvement in a stemi
St elevation in 2-3 and aVF
When to give metoprolol in an MI and how much?
25 milligrams PO if heart rate is over 80 and systolic blood pressure is over 120
What is the first intervention for an MI with right sided involvement
500 milliliter fluid bolus (Max one liter)
After giving a right sided MI patient a fluid bolus, what do you do next
Check MAP, if less than 60 go to shock algorithm, if over 60 give fentanyl for chest pain
What is the first intervention for an MI patient with no right sided involvement after giving aspirin
0.4 milligrams nitroglycerin up to three times (only if MAP is greater than 60 )
After giving nitroglycerin and aspirin to an MI patient, what do you do next
Treat chest pain with fentanyl or morphine (if MAP is over 60)
What do you do after treating the chest pain of an MI patient?
Check for nausea/vomiting and then treat underlying rhythm as long as the treatment does not contradict MI treatment
what is the initial care for an aortic emergency
Discontinue heparin or thrombolytics, and check map
What do you do after discontinuing thrombolytics in an aortic emergency if map is less than 60
Start 500 milliliter bolus, and go to shock algorithm
What to do in an aortic emergency where a map is greater than 60
Treat pain, followed by 10-20 MG labetalol every 10 min, max 300 MG
What to do in an aortic emergency if map is greater than 80
Treat with 10 to 20 milligrams of labetalol SIVP every 10 minutes (Max 300 milligrams). Titrate to keep map in between 60 and 80
How do you treat an unstable atrial fibrillation/ flutter patient with a sustained rate of over 150
Synchronized cardio version, ketamine or midazolam before if appropriate
How do you treat a stable atrial fibrillation/ flutter with a sustained rate of over 150
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
What is the initial care for bradycardia
Treat dyspnea and determine if stable or unstable
How to treat unstable bradycardia
1MG atropine Max 3G while preparing for transcutaneous pacing starting at 60 BPM and 40 mA
what to do when transcutaneous pacing is ineffective
Administer 2 to 10 MCG/minute epi and titrate to a map of greater than 60
What overdose should you consider in a bradycardia patient
Beta or calcium channel blocker overdose
Name the Hs & Ts
Hypovolemia, hypoxia, hypothermia, hydrogen ions, hypo and hyperkalemia, tension pneumothorax, toxins, tamponade, thrombus
What is initial care for a cardiogenic pulmonary edema patient
Solve any airway issues and administer 0.4 MG nitroglycerin every five minutes up to three times if map is greater than 60
What do you do in a severe cardiogenic pulmonary edema patient with an elevated heart rate, elevated blood pressure, and shortness of breath
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.
What do you do once you get ROSC
Make sure airway is secure and check for bradycardia and stemi
How do you treat post ROSC shock
500 milliliter fluid bolus, 2 to 30 MCG per minute of norepinephrine karma or 2 to 10 MCG per minute of epinephrine
Name what the check in a syncopal episode
Airway, blood sugar, cardiac rhythm, trauma, shock, drug overdose
What is the initial treatment for narrow complex tachycardia will the rate of under 150 with no pulmonary edema
500 milliliter fluid bolus
What is the first thing to know and a narrow complex tachycardia patient with a rate of over 150
Whether they are stable or unstable
How do you treat a patient in stable SVT
Vagal maneuvers, 500 milliliter fluid bolus, 6MG then 12MG adenosine, 0.25 MG/kg of diltiazem, 5MG metoprolol over 2 minutes
How do you treat unstable SVT
Synchronized cardio version at 100 J then 200, 300, 360. Give 2.5 to 5MG midazolam when appropriate
How do you treat stable monomorphic vtac
150MG amiodarone over 10 minutes or 0.5 -1.5 MG per KG lidocaine every 10 minutes
