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Protocol > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Intervention by ems for bradycardia rhythm may not be necessary unless the pt is?

A

Symptomatic

S/s such as hypotensive, altered loc with inadequate perfusion, chest pain

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2
Q

Bradycardia can be caused from? List 5

A

Hypoxia, mi, sick sinus syndrome, heart blocks, other ectopy not producing a pulse

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3
Q

In bradycardia the palpable pulse is?

A

Below 50 bpm

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4
Q

Treatment for symptomatic brady with b/p below #⃣#⃣?

A

90 systolic

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5
Q

Atropine dose for bradycardia is?

A

0.5 mg ivp, io. Max 3 mg

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6
Q

Epi drip for bradycardia is?

A

2-10 mcg/ min

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7
Q

Dopamine dose for bradycardia is?

A

5-20 mcg/ kg/ min

Weight, drop the zero, subtract 2

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8
Q

External transcutaneous pacing dose is?

A

Set rate at 70 bpm
Conscious: 5ma and increase by 5ma
Unconscious: 20ma increase by 20ma

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9
Q

Sedation for pacing?

A

Versed
2-4 mg ivp, io
4 mg MAD

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10
Q

What is sick sinus syndrome

A

Sick sinus syndrome is a collection of heart rhythm disorders that include:
•
Sinus bradycardia – slow heart rates from the natural pacemaker of the heart

•
Sinus pauses or arrest – when the natural pacemaker of the heart stops working for periods of time

People with these disorders may also have other abnormal heart rhythms, such as:
•
Atrial tachycardia – fast heart rate that starts in the upper chambers of the heart (atria)

•
Bradycardia-tachycardia – alternating slow and fast heart rhythms

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11
Q

In cardiac arrest what are the two most important things to accomplish?

A

CPR and Defibrillation

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12
Q

What is the Compression/Respiration ratio of a non intubated patient in cardiac arrest?

A

30:2

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13
Q

What is the Compression/Respiratory ratio for a intubated patient in cardiac arrest?

A

100 compressions/min

8-10 breaths/min

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14
Q

Unless extenuating circumstances onscene time for a chest pain/MI should be?

A

15 minutes or less

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15
Q

OPQRST?

A 
Onset/Origin
Provokes
Quality
Region
Severity
Time
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16
Q

12 other important symptoms/factors relating to Chest Pain?

A

SOB, Dizziness, Arm pain, Neck pain, Back pain, Jaw pain, n/v, Syncope, Sweating, Skin color, Weakness, Past medical history

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17
Q

Treatment for Inferior or RV Infarct with hypotension, JVD and clear lung sounds?

A

NS bolus of 300-500ml
Oxygen
324mg of asprin

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18
Q

Preferred type of IV cath with a STEMI?

A

Twin Cath

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19
Q

Dose of NTG Spray/Tab

A

.4mg SL every 5 Mins if B/p is above 90 Systolic and IV established (max dose 3)

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20
Q

When is nitro paste indicated?

A

For all normotensive (> 90 systolic) or Hypertensive patients with chest pain when

  1. Chest pain persists despite 3 doses of SL NTG or
  2. Chest pain gone after 1 or more doses of SL NTG whether given by medic or patient self medicated.
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21
Q

All nitrates should be used with caution with?

A

Acute inferior STEMI (Normotensive: B/P above 90 systolic

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22
Q

For pain control of chest pain consider this drug and dose?

A

Fentanyl 1mcg/kg IVP/IO every 3-5 mins. (100mcg max per dose, 200mcg total max)

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23
Q

In a patient with suspected MI and PVC’s present, if the heart rate is 60 or above, and no 2ed or 3rd degree block is present, institue the following?

A

Amiodarone Mix 150mg in 100ml of 0.9NS over 10 minutes (15mg/min)

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24
Q

What is a potential cause of cardiac arrest in dialysis pt’s?

A

Hyperkalemia

25
Q

2 drugs that should be considered in a Dialysis patient that is in cardiac arrest?

A

Sodium Bicarbonate and Calcium Chloride

26
Q

What is the dose of Sodium Bicarbonate while a Dialysis patient is in Cardiac arrest?

A

100mEq IVP, IO

And flush with 50-100ml of NS

27
Q

What is the dose of Calcium Chloride while a Dialysis patient is in Cardiac arrest?

A

1gm IVP, IO

28
Q

Borderline Hypertension is */. Elderly?

A
29
Q

Explain Nitro spray/tabs use in Hypertension?

When is treatment not indicated?

A

NTG Spray/tabs .4mg Max 3 doses or until

  1. Pt diastolic is less than or equal to 100mmhg
  2. Pt becomes hypotensive
  3. Pt develops severe headache
30
Q

While treating hypertension, if a pt’s diastolic pressure remains above 100mmHg after 3 NTG sprays what is your treatment?

A

1” Nitro Paste

31
Q

After giving NTG if a patient develops a systolic b/p of less then 90mmHg what is their treatment?

A

300-500ml NS bolus

32
Q

SVT can originate from where?

A
33
Q

Treatment for stable SVT?

A
34
Q

Preferred IV site to administer adenosine

A

Ante cubical site

35
Q

Treatment for unstable SVT?

A

Synchronized cardio version

50, 100, 200, 300, 360

36
Q

Med/dose used for sedation prior to synchronized cardio version?

A
37
Q

Post resuscitation hypotension treatment?

A
38
Q

Consider in all ROSC situations unless contraindicated?

A

Induced hypothermia

39
Q

When is Amiodarone indicated in post resusitation?

Whats the dose?

A
40
Q

What are the indications for amiodarone in relation to PVCs?

A

Heart rate above 60 and

41
Q

Treatment for stable v-tach with a pulse?

A
42
Q

Treatment for unstable vtach with a pulse?

A
43
Q

What is the first action of a witnessed and unwitnessed arrest?

A

Witnessed-Defib 200j

Not Witnessed- CPR for 2 mins then Defib 200j

44
Q

Dose of Epi in V-fib, Pulseless V tach

A

1:10,000 1mg IVP repeat every 3-5 mins

2-2.5mg ET

45
Q

Dose of Vasopression in V-fib, Pulseless V tach

A

40 Units to replace 1st or second dose of epi

46
Q

Dose of Amiodarone in V-fib, Pulseless V Tach

A

300mg, CPR,Defib,Epi, 150mg

47
Q

Dose for Sodium Bicarb in V-fib, Pulselss V tach and when to consider

A

1meq/kg, prolonged down time

48
Q

Mag Sulfate Cardiac indications and Dose

A

Torsades de pointes 1-2g

49
Q

Defib dose for V-Fib, Pulseless V Tach

A

200, 300, 360 joules NOT STACKED

50
Q

Proper placement of Defib Pads

A

Right of sternum at the 2nd intercostal space and anterier axillary line at the 5th intercostal space

51
Q

Placement of V1-V6 leads

A

V1-4th intercostal space at right sternal border
V2-4th intercostal space at left of sternal border
V3-Directly between V2 and V4
V4-5th intercostal space at midclavicular line
V5-Level with V4 at left anterior axillary line
V6-Level with V5 at left midaxillary line

52
Q

CPR Sequence

A

C-A-B Circulation, Airway, Breathing

53
Q

CPR Depth of Compressions

A

Adults- At least 2 inches

Pedi-1/3 of chest

54
Q

To interrupt pacing and view the patients intrinsic rhythm do this?

A

Press the pause button- this causes the pacer to pace at 25% of the set rate. Press pause again to resume pacing at the set rate

55
Q

Eligible patients for Induced hypothermia

A
  • Adult 16 year or greater
  • Intubation
  • Non traumatic etiology with endotracheal tube
  • ROSC
  • Not pregnant
  • Pt is not responding to pain
56
Q

Ventilations During ROSC induced hypothermia

A

10resp/min or maintain Spco2 between 35-35mmhg

57
Q

Fluid dose during induced hypothermia?

A

40ml/kg or max od 2L

58
Q

Sedation during induced hypothermia?

A

Versed 1-2mg

Vecuronium 0.1 mg/kg max of 10mg

59
Q

Contraindications to using Adenosine?

A

2nd and 3rd degree blocks, Sick sinus syndrome, Us caution with asthma patients, may cause bronchospasms.

Protocol (1 decks)

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