Causes and Treatment

Question 1

What are the H’s of cardiac arrest??

Answer 1

Hypothermia, Hypo/Hyperkalemia, Hypovolemia, Hyperglycemia, and Hydrogen (acidosis)

Question 2

What are the T’s of cardiac arrest??

Answer 2

Tension (pneumothorax), Thrombosis (ACS or PE), Tamponade, and toxins

Question 3

Drugs that can be given by ETT?

Answer 3

Naloxone
Atropine
Vasopressin
Epinephrine
Lidocaine

Question 4

What are the types of defibrillations regarding the energy

Answer 4

Monophasic (360 J)

Biphasic (120-200 J)

Question 5

Dose of Epinephrine in cardiac arrest?

Answer 5

1 mg IV/IO every 3 to 5 minutes or 2-2.5 mg ET (dilute wit 5-10 ml NS)

Question 6

What are the optimal Hemodynamic parameters Post-ROSC?

Answer 6

1. MAP 65-100
2. CVP 8-12 mmHg
3. ScvO2 > 70%
4. U/O > 1 ml/kg/hr.
5. Normal serum lactate

Question 7

Targeted Temperature Management (TTM): When should be ideally started and for how long should it be maintained?

Answer 7

Started within 2 hours after ROSC in comatose
Achieve goal within 6-8 hours
Maintain 32-36 °C for at least 12 h, optimal 24 hours

Question 8

What are the drugs that reduce shivering threshold (33.5 °C) in TTM?

Answer 8

Acetaminophen
Buspirone
Magnesium Sulfate
Meperidine
Dexmedetomidine (Hypotension)
Propofol (Hypotension)
Clonidine (Hypotension)

Question 9

Drugs/measures that stop shivering in TTM?

Answer 9

Paralytics
Chilled fluids
Surface warming

Question 10

Beta blocker induced brady cardia treatment?

Answer 10

Glucagon

Question 11

CCB-Bradycardia treatment?

Answer 11

IV calcium

Question 12

Digoxin antidote?

Answer 12

Anti-Digoxin Fab

Question 13

What is the agent of choice in case of refractory symptomatic bradycardia secondary to MI with AV block?

Answer 13

Aminophylline

Question 14

What is the agent of choice in case of refractory symptomatic bradycardia not secondary to MI with AV block?

Answer 14

Beta Agonist

Question 15

What is the agent of choice in case of refractory symptomatic bradycardia or when there is hemodynamic instability?

Answer 15

Transcutaneous Pacing

Question 16

Drug of choice for sinus bradycardia when there is moderate to severe symptoms

Answer 16

Atropine

Question 17

What are the drugs that have their pharmacokinetics affected by TTM?

Answer 17

Fentanyl
Morphine
Propofol
Midazolam
Rocuronium
Vecuronium
Cisatracurium (Hofmann elimination, enzymatic)
Phenytoin