ECG

Question 1

Ventricular tachycardia treatment if patient has a pulse would be?

Answer 1

• Amiodarone (150 mg in 100 ml D5W) IV piggyback over 10 minutes.
• Then, amiodarone maintenance infusion 900 mg in 500 ml D5W at 1mg/min for 6 hrs, then decrease to 0.5 mg per minute for 18 hours.

Question 2

Ventricular tachycardia pulseless, treatment?

Answer 2

Treat like ventricular fibrillation with debrillation at 200 Joules.

Question 3

What causes ventricular tachycardia?

Answer 3

• Stimulants such as coffee, methamphetamines.
• Medication toxicity such as DIGITALIS toxicity
• Electrolyte imbalances such as low magnesium, low calcium and low potassium.

Question 4

Torsades de pointes treatment?

Answer 4

• Magnesium 1 gram over 10 ml over 5 minutes followed by 0.5 to 1.0 gram IV drip.
• Transvenous pacemaker- set greater than HR and you slow it down.
• Unsynchronized shock at 200 J biphasic energy dose

Question 5

Ventricular fibrillation treatment?

Answer 5

• DEFIBRILLATION
• if defibrillation not available start CPR 5 cycles for 2 minutes.
• Administer epinephrine 1 mg IV push and repeat for 3 to 5 minutes.

Question 6

What causes ventricular fibrillation?

Answer 6

• Cardiac injury such as CAD, MI, valvular disease.
• Medication toxicity such as digitalis AKA digoxin
• Electrical imbalance
• Stimulants such as coffee, methamphetamines, etc.
• Cardiac trauma.
• Occlusion in the artery.

Question 7

Second degree AV block type 2 treatment?

Answer 7

• STOP or DECREASE drugs that decrease HR such as beta blockers, calcium channel blockers, and Digoxin.
• If hypotensive: epinephrine infusion!
• Will need pacemaker therapy (pacing).

Question 8

What causes Second Degree AV block type 2?

Answer 8

• Anterior MI
• Does occur after cardiac surgery, open heart, manipulating the heart.
• They are also manipulating the electrical system.

Question 9

What causes third degree AV block?

Answer 9

• Medication toxicity such as Digoxin, Beta blockers, and Calcium channel blockers
• History of MI” heart attack”

Question 10

What is the treatment for third degree AV block?

Answer 10

• Pacemaker
  -STOP medications that decrease HR such as Beta blockers, Calcium channel blockers, and Digoxin.
  -

Question 11

High potassium means what on ECG?

Answer 11

peaked T waves

Question 12

Low potassium means what on ECG?

Answer 12

might reflect purkije fiber depolarization

Question 13

Treatment for Sinus Bradycardia would be?

Answer 13

• First assess patient and shake them to increase HR.
• Coughing increase vagal tone
• if they have acute alteration of mental status, chest discomfort, or hypotension then give atropine 0.5mg IV bolus repeated every 3 to 5 minutes with maximum dose of 3 mg.
• Transcutanoues pacemaker

Question 14

Treatment for Sinus Tachycardia would be?

Answer 14

V: Vagal maneuvers
      -Bare down
      -Corotid massage
B: Beta Blockers
C: Calcium Channel Blockers
     -Diltiazem

Question 15

What is the most common cause of Sinus Tachycardia?

Answer 15

Fever, then it would be hypervolemia- infuse normal saline