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ekg > ekg > Flashcards

ekg Flashcards

1
Q

Normal Sinus Rhythm

A

Assess, O2, IV

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2
Q

Sinus Tachycardia

A

Assess, O2, IV

Identify and treat possible causes

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3
Q

Sinus Bradycardia

A

Assess, O2, IV

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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4
Q

Sinus Arrhythmia

A

Assess, O2, IV
(same as sinus brady)

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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5
Q

Sinus Pause/ Sinus Arrest/ Sinus Block

A

Assess, O2, IV
(same as sinus brady)

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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6
Q

Wandering Atrial Pacemaker

A

Assess, O2, IV
(same as sinus brady)

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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7
Q

Premature Atrial Contraction (PAC)

A

Assess, O2, IV

INFREQUENT:
No treatment

Frequent:

  • Identify and treat possible causes
  • May need beta blockers, calcium channel blockers or *Amiodarone
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8
Q

Wandering Atrial Pacemaker (WAP)

A

Assess, O2, IV
(same as sinus brady)

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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9
Q

Atrial Tachycardia/Paroxysmal Tachycardia/Supraventricular Tachycardia
(AT/PAT/SVT)

A

Assess, O2, IV

IF STABLE:
-Vagal Maneuvers
-ADENOSINE 6 MG IVP over 1-2 sec., followed by rapid 10 mL NS IVP
-If ineffective, repeat ADENOSINE 12 MG in 2 mins in same manner
-FOR RATE CONTROL:
BETA or CALCIUM CHANNEL BLOCKERS

IF UNSTABLE:

  • SYNC CARDIOVERSION (consider presedation)
  • BECAUSE PT IS NOT ABLE TO CIRCULATE HIS MEDS ANYMORE!
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10
Q

Ventricular Fibrillation (VFIB)

A

Assess, O2, IV
-Defib 120 J- 200 J
(1st 120 joules - 2nd 150 joules - 3rd 200 joules)
-CPR (5 cycles over 2 minutes; at least 100 compressions/minute)
-EPI 1 mg IVP every 3-5 minutes (NO MAX!)
- VASOPRESSIN 40 UNITs to replace 1st or 2nd dose of EPI
-CPR - SHOCK - CPR - DRUG SEQUENCE
-ANTIARRHYTHMICS:
-AMIO 300 MG IVP (consider mixing with 20 ml D5W)
- after 3-5 minutes, AMIO 150 mg IVP
- Follow with IVP drip (see VT TX)
-LIDOCAINE 1-1.5 mg/kg IVP
-second dose in 5-10 min: 0.5-0.75 mg/ kg every 5-10 min, max 3 mg/kg
-Follow with IV Drip at 1-4 mg/min

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11
Q

ASYSTOLE

A

ASSESS, O2, IV

  • CHECK in 2 leads; increase gain on cardiac monitor
  • CPR
  • EPINEPHRINE 1 mg IVP every 3-5 minutes
    - VASOPRESSIN 40 units IVP x 1 dose to replace 1st or 2nd dose of EPI
  • CONSIDER H’s & T’s
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12
Q

Idioventricular Rhythm (IVR)

A

ASSESS, O2, IV

ASYMPTOMATIC:
-NO TREATMENT!

SYMPTOMATIC:

  • PACING (TCP until TVP)
  • VASOPRESSORS:
    • DOPAMINE 2-10 mcg/kg/min IV
    • EPI 2-10 mcg/ min IV

accelertated ivr- no tx 60-100, no antiarrythmics

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13
Q

VTACH

A

ASSESS, O2, IV

STABLE WITH PULSE!:

  • AMIO 150 MG/100 ml D5W IVPB x 20 mins
  • –may repeat x 1
  • –if successful, amio 900 mg/500 ml D5W, 1 mg/min x 6 hrs
  • –then decrease to 0.5 mg/min x 18 hours
  • -total dose less than OR equal 2.2 g/24 hours
  • -follow with oral amio
  • -sync cardio version 100 joules (consider presedation)

UNSTABLE WITH PULSE!:

  • sync cardioversion 100 joules (consider presedation) ((hit sync to get marker!))
  • followed by amio drip, then oral (see above)

WITHOUT PULSE!:
-treat like vfib! … 120 joules!

*ICD or reentry circuit ablation

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14
Q

NSR with FIRST DEGREE AV BLOCK

A

ASSESS, O2, IV
-check meds and d/c as needed.
(first degree have to say underlying rhythm !)

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15
Q

SECOND DEGREE AV BLOCK TYPE 1/ MOBITZ 1/ WENCHEBACH

A

ASSESS, O2, IV

  • check meds and d/c as needed
  • treat like symptomatic brady, see below…(TX COMPLAINTS IF SYMPTOMATIC)

IF SYMPTOMATIC:

  • identify and treat possible causes
  • *ATROPINE 0.5 mg q 5 minutes. MAX of 3 MG.
  • TCP (Transcutaneous Pacemaker)
  • PPM (Permanent Pacemaker)
  • *DOPAMINE 2-10 mcg/kg/min
  • *EPINEPHRINE 2-10 mcg/min
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16
Q

SECOND DEGREE AV BLOCK TYPE 2/ MOBITZ 2

A

ASSES, O2, IV

  • TCP UNTIL, TVP (TRANSVENOUS PACEMAKER); MAY REQUIRE PPM
  • DOPAMINE 2-10 MCG/KG/MIN
  • EPI 2-10 MCG/MIN
17
Q

THIRD DEGREE AVB/COMPLETE HEART BLOCK

A

ASSES, O2, IV

  • TCP UNTIL, TVP (TRANSVENOUS PACEMAKER); MAY REQUIRE PPM
  • DOPAMINE 2-10 MCG/KG/MIN
  • EPI 2-10 MCG/MIN

SAME AS TYPE 2!

18
Q

ATRIAL FLUTTER

A

ASSESS, O2, IV
IDENTIFY AND TREAT REVERSIBLE CAUSES

RATE CONTROL:
BETA OR CALCIUM CHANNEL BLOCKERS

RHYTHM CONTROL:

  • ->ONSET < 48 HOURS:
  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION)
  • AMIO 150 MG IVP X 10 MINS
  • ->ONSET >48 HOURS:
  • ANTICOAG FOR SEVERAL WEEKS. (BC THEY MIGHT HAVE A CLOT)
  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION)

IF UNSTABLE:

  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION) ((NEVER MOVE JOULES UP))
  • ANTIARRHYTHMIC POST SHYTHM CONVERSION.

RADIOFREQUENCY CATHETER ABLATION

19
Q

AFIB (CONTROLLED OR UNCONTROLLED)

A

((SAME AS A FLUTTER))
ASSESS, O2, IV
IDENTIFY AND TREAT REVERSIBLE CAUSES

RATE CONTROL:
BETA OR CALCIUM CHANNEL BLOCKERS

RHYTHM CONTROL:

  • ->ONSET < 48 HOURS:
  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION)
  • AMIO 150 MG IVP X 10 MINS
  • ->ONSET >48 HOURS:
  • ANTICOAG FOR SEVERAL WEEKS. (BC THEY MIGHT HAVE A CLOT)
  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION)

IF UNSTABLE:

  • SYNC CARDIOVERSION 50-100 JOULES. (CONSIDER PRESEDATION) ((NEVER MOVE JOULES UP))
  • ANTIARRHYTHMIC POST SHYTHM CONVERSION.

RADIOFREQUENCY CATHETER ABLATION

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