dysrhythmias Flashcards
what electrolytes are used for muscle contraction
Na and K
which drugs block fast Na channels?
Amiodarone
Lidocaine
what do you give if a pt is dead
epi and O2
if pt has PEA from hyperkalemia, give…
NaHCO3
how to reverse a beta blocker
glucagon
hypothyroid can be indicated via
-inverted T waves
-QT >.4
bradycardia
VT vs
SVT
- > 3 big boxes (.12)
- <3 big boxes
tight complex, irregularly irregular
a-fib
when to convert a-fib?
within 24 hours of occurrence
how to control afib?
- use negative chronotropes (slow rate)
- dig, dilitiazem, verapamil, esmolol
2 options to definitively treat a-fib
-ablation
-maze procedure
pacemaker will be needed
pts that have a-fib must be on
- coumadin/zarelto/eliquis
- andexxa is a reversal now available
temp solution for afib
- cardioversion
- overdrive
Paroxysmal Supraventricular Tachycardia
- > 150, narrow complex
- reentry phenomenom, WPW
- commonly seen in young pts
how to treat SVT?
- carotid massage, valsalva
- adenosine 6, 12, 12 (stops misbehaving atrial cells)
- cardizem
- lopressor
preexcitation syndrome
- WPW (delta wave, short PR)
- Accelerated transmission of impulses from atrium to ventricle via an accessory, bypass tract (bypassing the AV node)
how to treat WPW
- CCB/B-blockers/dig, makes problem worse
- Adenosine works well but it is short acting, amiodarone is best
- catheter ablation
we are concerned if there are more than ( ) PVCs/min
6, and there is structural damage, poor EF (<45), or ischemia.
when to treat non-sustained Vtach
if structural defect or significant ischemia and EF <40%.
how to treat non sustained Vtach
Lidocaine, procainamide and Amiodarone(live dose)
these block fast Na channels
causes of sustained Vtach
ischemia (previous MI, pre-excitatory)
HOCM
how to treat sustained Vtach?
if pt is stable think pharm first
***Amiodarone (2A) live dose
Cardioversion first if not hemodynamically stable= ACLS,
what causes torsades
Mg deficiency, give IV Mg
can also try overdrive pacing
how to treat bradyarythmias
all PAs eat dessert atropine pacing epi dopamine
how to treat 3rd degree HB?
try atropine and set up the pacer…..you would pace which squeezes the heart
