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ACLS > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

What can result from blockage of the RCA?

A

Inferior wall MI and/or disturbances in AV nodal conductions

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2
Q

Occlusion of what artery is called the widow maker?

A

Occlusion of the left main coronary artery

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3
Q

What can result from blockage of the circumflex artery?

A

lateral wall MI

in some patients, occlusion of the circumflex can also lead to a posterior wall MI

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4
Q

increased blood concentration of what electrolytes will decrease automaticity?

A

Decreased sodium, potassium and calcium

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5
Q

decreased concentrations of what electrolytes will increased automaticity?

A

K+ and Ca2+

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6
Q

What is the term that describes the ability of cardiac muscle cells to respond to an external stimulus, such as that from a chemical, mechanical or electrical source?

A

Excitability (irritability)

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7
Q

What is the term that describes the ability of a cardiac cell to receive and electrical impulse and conduct it to an adjoining cardiac cell?

A

Conductivity

Via intercalated disks

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8
Q

What’s the term that describes the ability of myocardial cells to shorten, thereby causing cardiac muscle contraction, in response to electrical stimuli

A

Contractility

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9
Q

The state when the inside of a cell is more negative than the outside of the cell

A

Polarized state

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10
Q

What causes depolarization

A

movement of sodium into the cell

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11
Q

Where does depolarization occur in the heart

A

depolarization proceeds from innermost later of the heart to the outermost layer (endocardium –> Epicardium)

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12
Q

What on the ECG represents ventricular repolarization?

A

ST segment and T wave

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13
Q

what occurs after the relative refractory period and allows a weaker-than-normal stimulus to cause cardiac cells to depolarize?

A

Supranormal period

seen at the end of the T wave
- because the cell is more excitable than normal, dysrhythmias can develop during this period

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14
Q

What’s the primary pacemaker and what’s its intrinsic rate?

A

SA node, 60-100 bpm

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15
Q

What are the bpm of the different pacemakers?

A

SA node: 60 - 100 bpm
AV junction: 40 - 60 bpm
Purkinje fibers: 20 - 40 bpm

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16
Q

What heart surface is viewed from the three standard limb leads?

A

Lead I - lateral heart

Leads II and III - inferior heart

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17
Q

What heart surface is viewed from each of the augmented leads?

A

aVR - non
aVL - lateral
aVF - inferior

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18
Q

Where is lead V1 placed?

A

4th intercostal space on the R next to the sternum

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19
Q

Where is lead V2 placed?

A

4th intercostal space on the L next to the sternum

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20
Q

Where is lead V4 placed?

A

left midclavicular line in the 5th intercostal space

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21
Q

If time doesn’t permit obtaining all of the R chest leads, which is the lead of choice?

A

V4R

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22
Q

What leads view the inferior surface of the heart?

A

II, III, aVF

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23
Q

What leads view the septal surface of the heart?

A

V1, V2

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24
Q

What leads view the anterior surface of the heart?

A

V3, V4

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25
Q

What leads view the lateral surface of the heart?

A

I, aVL, V5, V6

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26
Q

how much time does a 1mm box stand for?

A

0.04 second

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27
Q

how much time does a large box stand for?

A

0.2 seconds (contains 5 x 1 mm boxes)

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28
Q

how many mV does the height of one block correspond to?

A

0.1 mV for each 1 mm box

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29
Q

What signifies a pathological Q wave?

A

Abnormal Q waves are more than .04 s in duration or more than one-third the height of the following R wave in that lead

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30
Q

What length of WRS time signifies and incomplete or complete BBB?

A

normal - 0.11 s
incomplete - .10 - .12
complete - more than or equal to .12

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31
Q

What causes a wide QRS?

A

When an electrical impulse doesn’t follow the normal ventricular conduction pathway it takes longer to depolarize the myocardium = delay in conduction through the ventricle

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32
Q

What interval represents total ventricular activity?

A

QT interval

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33
Q

What’s the normal length of a PR interval?

A

0.12 to 0.20 seconds

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34
Q

What is the normal rate?

A

60-100 bpm

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35
Q

In respiratory sinus arrhythmia, when does HR increase and when does it decrease?

A

HR increase during inspiration

HR decrease during expiration

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36
Q

when would you use synchronized cardioversion in tachycardia?

A

When the patient is unstable and they have a pulse and serious signs and symptoms due to the tachycardia

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37
Q

what rhythms are included in supraventricular arrhythmias?

A

Rhythms that being in the SA node, atrial tissue or the AV junction

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38
Q

What heart rate is considered tachycardic in adults, children and infants?

A

Adults 101 - 180bpm
Children >160 bpm
infants >200 bpm

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39
Q

How should you treat a tachycardia?

A

Never shock a sinus tachycardia! treat the cause of the tachycardia

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40
Q

What are the 3 types of supraventricular tachycardias?

A
  1. Atrial tachycardia
  2. AV nodal reentrant tachycardia (AVNRT)
  3. AV reentrant tachycardia (AVRT)
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41
Q

What can cause palpitations that occur regularly and with a sudden onset and end?

A

AVNRT or AVRT

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42
Q

What can cause irregular palpitations?

A

premature complexes, atrial fibrillation, or multifocal atrial tachycardia

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43
Q

What is considered a sustained rhythm?

A

When it lasts more than 30 seconds

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44
Q

Whats the DOC for patients with atrial tachycardia when vagal maneuvers don’t work?

A

Adenosine

do not use in patietns with severe asthma

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45
Q

What type of CCB are diltiazem and verapamil?

A

non-dihydropyridines

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46
Q

What type of CCB are nifedipine and amlodipine?

A

Dihydropyridines

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47
Q

CCBs that affect the peripheral vasculature resulting in peripheral vasodilation with little or no effect on the SA or AV nodes

A

Dihydropyridines

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48
Q

CCBs that decrease HR and myocardial contractility, slow conduction through the AV node and have some peripheral arteral dilatory effects as well.

A

Non-dihydropyridines

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49
Q

What are the major adverse effects of CCBs?

A

hypotension, worsening heart failure, bradycardia, and AV block

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50
Q

what’s the most common type of supraventricular tachycardia?

A

AVNRT

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51
Q

If you have a stable but symptomatic patient with AVNRT that is not responding to vagal maneuvers, what treatment should you use?

A

Adenosine

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52
Q

If you have an unstable symptomatic patient with AVNRT how should you treat them?

A

oxygen, IV access and sedation (if the patient is awake and time permits), followed by synchronized cardioversion

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53
Q

What is a regular, narrow-QRS tachycardia that starts or ends suddenly called?

A

Paroxysmal supraventricular tachycardia

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54
Q

What is called when rhythms originate from about the ventricles but in which the impulse travels via a pathway other than the AV node and bundle of His?

A

pre-excitation

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55
Q

What pre-excitation syndromes are prone to Atrioventricular reentrant tachycardia?

A

Wolff-Parkinson-White syndrome and Lown-Ganong-Levine syndrome

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56
Q

what is the accessory pathway in WPW syndrome?

A

Kent bundle

Connects the atria directly to the ventricles

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57
Q

What is the accessory pathway in Lown-Ganogn-Levine syndrome?

A

James bundle

Connects the atria directly to the lower portion of the AV node (bypassing the AV node)

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58
Q

What arrhythmia is associated with a short PR interval, a delta wave and widening of the QRS?

A

WPW syndrome

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59
Q

What is a common cause of junctional tachycardia?

A

Digitalis toxicity

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60
Q

What duration of the QRS is considered a wide-QRS tachycardia?

A

0.12 s or more

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61
Q

What is the first drug you should give a stable patient with a regular rhythm and a monomorphic wide QRS tachycardia but you are unsure of the origin?

A

Adenosine

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62
Q

if the rhythm is Ventricular Tachycardia, what effect will Adenosine have?

A

No effect in most cases

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63
Q

If a wide-QRS rhythm is actually a SVT with aberrancy, what will adenosine administration do?

A

Adenosine will usually result in transient slowing or conversion to a sinus rhythm

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64
Q

What pharmacological therapies can you use for pharmacologic termination of a stable wide-QRS tachycardia that is most likely VT?

A

Procainamide, Amiodarone, or Sotalol

These drugs are considered first line antiarrhythmics for monomorphic VT

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65
Q

If a patient presents with serious signs and symptoms caused by a tachycardia, should you make a specific diagnosis of the origin of the tachycardia?

A

No, the diagnosis of the origin of the tachycardia is irrelevant, the patient requires immediate electrical therapy (synchronized cardioversion)

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66
Q

What’s the most common cause of delayed ventricular conduction?

A

BBB

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67
Q

What are the criteria for a Right BBB?

A
  • The QRS must have an abnormal duration
  • The QRS complex must arise as the result of supraventricular activity (excluding ventricular beats and paced ventricular complexes)
  • Look at lead V1
  • Check the last .04 seconds of the QRS and it should be positive for a R BBB
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68
Q

What are the criteria for a Left BBB?

A
  • The QRS must have an abnormal duration
  • The QRS complex must arise as the result of supraventricular activity (excluding ventricular beats and paced ventricular complexes)
  • Look at lead V1
  • Check the last .04 seconds of the QRS and it should be negative for a L BBB
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69
Q

What is the rhythm when three or more ventricular beats occur in a row at a rate of 41 - 100 beats/min

A

Accelerated idioventricular rhythm

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70
Q

When do you see an accelerated idioventricular rhythm?

A

It occurs most often in the setting of acute MI, most often during the first 12 hours. particularly common after successful reperfusion therapy

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71
Q

What is seen with 3 or more premature ventricular complexes occurring in immediate succession at a rate greater than 100 bpm?

A

Ventricular tachycardia

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72
Q

A rapid, wide QRS rhythm associated with pulselessness, shock or heart failure should be presumed to be what until proven otherwise?

A

Ventricular tachycardia

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73
Q

do patients with sustained monomorphic VT often have underlying heart disease?

A

Yes, particularly myocardial ischemia. It rarely occurs in patients without underlying heart disease

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74
Q

T or F: sustained VT does not always produce signs of hemodynamic instability

A

TRUE

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75
Q

How do you treat a pulseless patient with VT?

A

Cardiopulmonary resuscitation (CPR) and defibrillation

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76
Q

How should you treat patients with stable but symptomatic VT?

A
  • Oxygen (if indicated)
  • IV access
  • Ventricular antiarrhythmics like procainamide, sotalol or amiodarone

note: don’t use procainamide in patients with prolonged QT or signs of heart failure. Don’t use sotalol in patients with prolonged QT interval

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77
Q

How should you treat patients with unstable VT?

A
  • oxygen
  • IV access
  • sedation (if awake and time permits) followed by synchronized cardioversion
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78
Q

What rhythms are considered irregular tachycardias?

A

Multifocal atrial tachycardia
Atrial flutter
Atrial Fibrillation
Polymorphic ventricular tachycardia

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79
Q

What is the name for when you have a wandering atrial pacemaker where the size, shape and direction of the P waves vary and the rate is greater than 100 bpm?

A

Multifocal atrial tachycardia

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80
Q

Patients who experience atrial fibrillation are at increased risk of having what?

A

A stroke

81
Q

What is the typical rate that is seen with a polymorphic ventricular tachycardia?

A

150 - 300 bpm, typically 200-250bpm

82
Q

How long is the QT interval in torsades de pointes?

A

more than .45 s, often .5 s or more

83
Q

what are some acquired causes of torsades de pointes?

A

an antiarrhythmic drug
hypokalemia
typically associated with bradycardia

84
Q

what type of polymorphic ventricular tachycardia is triggered by stress or exercise and occurs in the absence of QT prolongation or structural heart disease?

A

Catecholaminergic PMVT

85
Q

what type of polymorphic ventricular tachycardia is associated with an EKG pattern consisting of a RBB-like conduction and ST elevation in the right chest leads without evidence of QT prolongation or structural heart disease?

A

Brugada syndrome

86
Q

T or F: A patient with sustained PMVT is rarely hemodynamically stable

A

True

87
Q

If a patient is symptomatic as a result of a polymorphic ventricular tachycardia, how should you treat them?

A
  • Treat ischemia if it’s present
  • correct electrolyte abnormalities
  • discontinue any medications that the patient may be taking that prolong the QT interval
88
Q

If a patient is stable with a polymorphic ventricular tachycardia, how should you treat them?

A

Use IV amiodarone (if the QT interval is normal), magnesium, or beta blockers

89
Q

If a patient is unstable or has no pulse with a polymorphic ventricular tachycardia, how should you treat them?

A

defibrillation as you would for VF

90
Q

Can you use amiodarone, procainamide or sotalol with torsades de pointes?

A

No - these drugs prolong the QT interval

91
Q

What’s the equation for cardiac output?

A

CO = stroke volume x heart rate

92
Q

what is an absolute bradycardia?

A

a heart rate less than 60 bpm

93
Q

what is a relative bradycardia?

A

the heart rate may be more than 60 bpm

94
Q

At what heart rate with bradycardia do patients become symptomatic ?

A

less than 50 bpm

95
Q

what should the initial treatment of any patient with a symptomatic bradycardia be?

A

support of airway and breathing

96
Q

What is the first line drug recommended for symptomatic bradycardia?

A

Atropine

Note that Atropine won’t work for certain bradycardias like complete AV blocks or wide-QRS AV blocks

97
Q

What are some interventions that can be used for bradycardia?

A

Atropine (1st line)

others: epinephrine, dopamine, isoproterenol IV infusions or transcutaneous pacing

98
Q

What rate is considered a sinus bradycardia?

A

less than 60 bpm

99
Q

What rhythm can result from the following: adults while sleeping, well conditioned athletes, some younger people while at rest, some MIs, with stimulation of the vagus nerve (coughing, vomiting, straining/valsalva, carotic sinus pressure, cold water to the face), hyperkalemia, hypoxia, hypothermia

A

Sinus bradycardia

100
Q

If a patient is symptomatic with sinus bradycardia, what would your initial treatment include?

A

Supplemental oxygen if needed, starting an IV, and giving IV atropine

101
Q

What’s the intrinsic rate of the AV junction?

A

40-60 bpm

102
Q

what type of acute coronary syndrome can commonly cause a junctional rhythm ?

A

inferior wall MI

103
Q

What is a substance that affects the heart rate called?

A

a Chronotrope

Positive chronotrope: increases heart rate

104
Q

What is a substance that affects the AV conduction velocity called?

A

a Dromotrope

Positive dromotrope: increased AV conduction velocity

105
Q

What is a substance called that affects myocardial contractility?

A

an Inotrope

Positive inotrope: increased force of contraction

106
Q

Where are alpha 1 receptors found and what is the result when they are stimulated?

A

Alpha 1 are found: in the eyes, blood vessels, bladder and male reproductive organs

Stimulation results in constriction

107
Q

Where are alpha 2 receptors found and what is the result when they are stimulated?

A

Alpha 2 receptors are found: in parts of the digestive system and on presynaptic nerve terminals in the peripheral nervous system

Stimulation results in decreased secretions, decreased peristalsis and suppression of norepinephrine release

108
Q

Where are beta 1 receptors found and what is the result when they are stimulated?

A

Beta 1 receptors are found: in the heart and kidneys.

stimulation results in increased heart rate and increased contractility. in the kidneys it results in renin release in the blood leading to vasoconstriction (via angiotensin)

109
Q

Where are Beta 2 receptors found and what is the result when they are stimulated?

A

Beta 2 receptors are found in the arterioles of the heart, lungs and skeletal muscles.

Stimulation results in smooth muscle dilation in the bronchi

110
Q

Where are dopamine receptors found and what is the result when they are stimulated?

A

Dopamine receptors are found in the renal, mesenteric and visceral blood vessels

Stimulation results in dilation

111
Q

How do you determine the infusion rate for dopamine?

A

Dopamine depends on the patients weight and its dose range is 5-10 mcg/kg/min

112
Q

How do you determine the infusion rate for isoproterenol?

A

Isoproterenol infusion is NOT based on the patients weight and it’s infused at 2-10 mcg/min

113
Q

how do you determine the infusion rate for epinephrine?

A

in SYMPTOMATIC bradycardia, epinephrine infusion is infused at a dose range of 2-10 mcg/min

In post-cardiac arrest care, epinephrine is infused at a rate of 0.1 - 0.5 mcg/kg/min

114
Q

What is called when three or more ventricular beats occur in a row at a rate of 20-40 bpm?

A

A ventricular escape or idioventricular rhythm

115
Q

Can you use lidocaine when treating a ventricular escape rhythm?

A

No! lidocaine should be avoided because it can abolish ventricular activity possible causing asystole in a patient with a ventricular escape rhythm

116
Q

What is it called when a patient with a ventricular escape rhythm is not breathing and has no pulse despite the appearance of organized electrical activity on the EKG?

A

pulseless electrical activity

117
Q

What is seen in a first-degree AV block?

A

PR is prolonged more than 0.2 seconds but it’s constant

Note that 1st degree AV block is not a dysrhythmia itself, it’s a condition that describes the consistent prolonged PR interval seen on EKG - the impulses from the SA node to the ventricles is DELAYED not blocked

118
Q

Give a run down of what you see with the P waves in the different AV blocks?

A

1st degree AV block –> All P waves are conducted but delayed

2nd degree AV block –> Some P waves are conducted, and others are blocked

3rd degree AV block –> No P waves are conducted

119
Q

Where is the site of block in second degree AV block type 1?

A

AV node

120
Q

where is the site of block in second degree AV block type 2?

A

the bundle of His or more commonly at the bundle branches

121
Q

What is second degree AV block type 1 also known as?

A

Mobitz type 1 or Wenckebach

122
Q

What is seen with second degree AV block type 1?

A

progressive lengthening of the PR interval with each cycle until a p wave appears without a QRS complex.

note that the atrial rhythm (P’s) are regular, it’s the ventricular rhythm that is irregular

123
Q

what causes second degree AV block type 1?

A

The RCA supplies the AV node so RCA occlusions can lead to AV block at the AV node

124
Q

what causes second degree AV block type 2?

A

Bundle branches receive their primary blood supply from the LCA so disease of the LCA or an anterior MI can be seen. AV block type II can also be seen with acute myocarditis or other organic heart diseases

Note that 2nd degree AV block type 2 is more serious than 1st degree and it can progress to 3rd degree AV block

125
Q

T or F - second degree AV block type II is usually an indication for a permanent pacemaker

A

True

126
Q

What AV block has compete block in conduction of impulses between the atria and the ventricles?

A

3rd degree AV block

127
Q

If monomorphic or polymorphic ventricular tachycardia present without a pulse, how do you treat them?

A

You should treat them as ventricular fibrillation

128
Q

what is seen with ventricular fibrillation?

A

The ventricular muscle quivers, therefore there is no effective myocardial contraction and no pulse

129
Q

what are the priorities of care in cardiac arrest due to pulseless VT or VF?

A

High quality CPR and defibrillation

130
Q

why is epinephrine given in cardiac arrest?

A

Primarily for its vasoconstricting (alpha-adrenergic) properties

Vasoconstriction helps increase coronary and cerebral perfusion pressures

131
Q

What are the adverse effects of epinephrine?

A

myocardial oxygen consumption and necrosis, post-resuscitation myocardial dysfunction and ventricular dysfunction

132
Q

What medications are absorbed via the trachea?

A

Naloxone, atropine, vasopressin, epinephrine, and lidocaine

tracheal route is NOT preferred but recommended dose would be 2 - 2.5 times the IV dose

133
Q

If pulseless VT/VF continues despite CPR, defibrillation and administration of a vasopressor what antiarrhythmic should you give?

A

Amiodarone - improves the rate of return of spontaneous circulation

lidocaine may be considered if amiodarone is not available

134
Q

what is the rhythm called when you have a total absence of ventricular electrical activity?

A

asystole or ventricular asystole

135
Q

what are the possible treatable causes of cardiac arrest?

A

PATCH-4-MD, 5Hs, 5Ts

136
Q

what should you do before you start CPR in a patient with asystole?

A

see asystole on a cardiac monitor, confirm that the patient is unresponsive and has no pulse then begin CPR

Additional care includes establishing vascular access, considering the possible causes of the arrest, administering epinephrine and possibly inserting an advanced airway

137
Q

what is called when organized electrical activity (other than VT) is observed on the cardiac monitor, but the patient is unresponsive and not breathing and a pulse can’t be felt?

A

Pulseless electrical activity

138
Q

how do you treat PEA?

A

High-quality CPR, establishing vascular access, the administration of epinephrine and an aggressive search for possible causes of the situation and the possible insertion of an advanced airway

139
Q

A resuscitation effort requires coordination of what four critical tasks?

A
  1. chest compressions
  2. airway management
  3. ECG monitoring and defibrillation
  4. vascular access and drug administration
140
Q

how are IV bolus medications given?

A

IV bolus medications are followed with a 20 mL fluid flush and the brief elevation of the affected extremity

141
Q

What are the seven phases of the phase response of code organization?

A 
phase 1 - anticipation
phase 2 - entry
phase 3 - resuscitation
phase 4 - maintenance
phase 5 - family notification
phase 6 - transfer
phase 7 - critique
142
Q

What can be helpful in letting you know that there has been a return of spontaneous circulation?

A

existence of a waveform on the pulse oximeter

143
Q

If no IV is in place at the time of cardiac arrest, what do you do?

A

start a peripheral IV with a large gauge catheter (without interrupting CPR)
the antecubital or external jugular veins are preferred.

144
Q

What are the preferred IV solutions to use in cardiac arrest?

A

Normal saline or lactated ringer’s

glucose containing solutions should be avoided unless theres documented hypoglycemia

145
Q

If peripheral IV attempts are unsuccessful during cardiac arrest what should you do?

A

Intraosseous access should be attempted before trying a central line

146
Q

When should drugs be given during cardiac arrest?

A

During brief pauses for rhythm checks and then followed with a 20 ml flush of IV fluid and brief elevation of the affected extremity.
the drug is then circulated when CPR is continued

147
Q

how do you know you’re in the maintenance phase (phase 4) of the phase response of code organization?

A

a spontaneous pulse has returned or the patients vital signs have stabilized

148
Q

what does post-cardiac arrest care focus on?

A

cardioprotective and neuroprotective interventions

149
Q

why should you avoid hyperventilation?

A

hyperventilation increases the intrathoracic pressure and lowers cardiac output

150
Q

why should you avoid hypoventilation?

A

hypoventilation can contribute to hypoxia and hypercarbia

151
Q

why is it important to maintain temperature regulation after a cardiac arrest?

A

for each degree Celsius higher than 37C the risk of an unfavorable neurologic recovery increases

152
Q

portion of the ECG tracing between the QRS complex and the T wave

A

PR interval

153
Q

portion of the ECG tracing between the end of the T wave and the beginning of the following P wave

A

TP segment

154
Q

represents atrial depolarization and the spread of an electrical impulse through the left and right atria

A

P wave

155
Q

represents the spread of an electrical impulse through the ventricles (ventricular depolarization)

A

QRS complex

156
Q

first positive deflection in the QRS complex

A

R wave

157
Q

Represents total ventricular activity - the time from ventricular depolarization (stimulation) to repolarization (recovery)

A

QT interval

158
Q

normally measures 0.12 to 0.2 s in adults

A

PR interval

159
Q

This is ALWAYS negative

A

S wave

160
Q

horizontal line between the end of the p wave and the beginning of the QRS complex

A

PR segment

161
Q

ventricular rhythm may be regular or irregular, waveforms resembling teeth of a saw or picket fence before QRS

A

Atrial flutter

162
Q

Regular ventricular rate between 150 - 250 bpm; narrow QRS

A

AV nodal reentrant tachycardia

163
Q

More P waves than QRSs, P waves occur regularly, irregular ventricular rhythm, lengthening PR intervals, QRS usually narrow

A

Second-degree AV block type 1

164
Q

absent P waves, wide QRS, ventricular rate 40 bpm or less

A

ventricular escape rhythm

165
Q

Rapid rhythm in which the QRS complex is wide and usually regular; QRS complexes are of same shape and amplitude

A

monomorphic ventricular tachycardia

166
Q

irregularly irregular ventricular rhythm, no identifiable P waves

A

atrial fibrillation

167
Q

more P waves than QRSs, P waves occur regularly, regular ventricular rhythm, no pattern to PR intervals, QRS narrow or wide

A

third-degree AV block

168
Q

irregularly irregular rhythm with no normal looking waveforms; chaotic deflections vary in shape and amplitude

A

ventricular fibrillation

169
Q

one upright P wave before each QRS, ventricular rate 101 - 180 bpm

A

sinus tachycardia

170
Q

more P waves than QRSs, P waves occur regularly, irregular ventricular rhythm, constant PR intervals, QRS usually wide

A

second degree AV block Type 2

171
Q

rapid rhythm in which the QRS complexes are wide and appear to twist from upright to negative or negative to upright and back

A

polymorphic ventricular tachycardia

172
Q

Initial dosage of adenosine IV

A

6 mg rapid IV push

173
Q

initial dosage of verapamil IV

A

2.5 to 5 mg slow IV push

174
Q

atropine dose IV

A

0.5 mg every 3 to 5 minutes, total dose 3 mg

175
Q

dosage of vasopressin IV in cardiac arrest

A

40 units

176
Q

loading dose of IV amiodarone for indications other than cardiac arrest

A

150 mg over 10 min

177
Q

Dopamine IV infusion dosage

A

2 to 10 mcg/kg/min

178
Q

Initial IV/IO dosage of amiodarone in cardiac arrest

A

300 mg

179
Q

Dosage of IV magnesium sulfate for torsades de pointes

A

1 to 2 g

180
Q

Epinephrine IV dosage in cardiac arrest

A

1 mg every 3 to 5 min

181
Q

Initial dose of diltiazem IV

A

0.25 mg/kg IV bolus over 2 min

182
Q

dosage of procainamide

A

20 to 50 mg/min; total dose 17 mg/kg

183
Q

epinephrine IV infusion dosage

A

2 to 10 mcg/min

184
Q

initial IV/IO dosage of lidocaine

A

1 to 1.5 mg/kg

185
Q

what’s the intrinsic rate of the AV junction?

A

40 - 60 bpm

186
Q

atrial fibrillation, atrial flutter and polymorphic ventricular tachycardia are examples of what?

A

irregular tachycardias

187
Q

What is the R wave?

A

The first positive defection after the P wave

188
Q

what’s the most common type of paroxysmal supraventriular tachycardia?

A

AV nodal reentrant tachycardia

189
Q

What are the main branches of the LCA?

A

circumflex and anterior descending arteries

190
Q

What are three or more PVS occurring in a row at a rate of more than 100/min called?

A

A run of ventricular tachycardia

191
Q

What medication can you give as an IV bolus in pulseless electrical activity, pulseless ventricular tachycardia and asystole?

A

Epinephrine

192
Q

What’s the recommended treatment in a patient with monomorphic ventricular tachycardia?

A

ABCs, O2, IV, and procainamide 20-50 mg/min IV

193
Q

A rapid wide WRS rhythm associated with pulselessness, shock or heart failure should be assumed to be what?

A

Ventricular tachycardia

194
Q

What’s the correct IV dose of atropine in the management of symptomatic bradycardia?

A

0.5 mg every 3 to 5 min with a maximum dose of 3 mg

195
Q

what’s the lidocaine dosing in pulseless VT/VF ?

A

initial dose is 1 to 1..5 mg/kg IV push; repeat doses of 0.5 to0.75 mg/kg IV push may be given at 5 to 10 minute intervals to a maximum dose of 3 mg/kg

196
Q

when administering procainamide, what is the maximum dose and what is the maintenance dose?

A

the maximum dose is 17 mg/kg and the maintenance infusion is 1 to 4 mg/min

197
Q

When do you give an IV bolus of epinephrine?

A

An IV bolus of epinephrine is indicated in cardiac arrest (PEA, asystole, pulseless VT and VF)
Epinephrine is not given IV bolus to patients who have a pulse

although epinephrine may be given to patients for symptomatic bradycardia, it is given as an IV infusion, not an IV bolus

198
Q

what is the preferred antiarrhythmic in patients with cardiac arrest due to pulseless VT/VF?

A

amiodarone

lidocaine when amiodarone is not available

ACLS (5 decks)

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