EKGs

Question 1

What rhythm?

Interventions?

Answer 1

1st Degree AV Block

None neededed

Question 2

What rhythm?

What intervention?

Answer 2

2nd Degree AV Block Type I (Wenckebach)

-IV, Monitor, Vitals, Oxygen if saturation < 94%.
*unstable
-Atropine 0.5mg IV —> Dopamine IV 2-20
mcg/kg/min
-prepare for transcutaneous pacing.
-Evac
*Stable but symptomatic
-Monitor observe
-MEDADVICE
*Stable Asymptomatic
-Get back to work nerd,
-MEDADVICE

Question 3

What rhythm?

What intervention?

Answer 3

2nd Degree AV Block Type II (Morbitz II)

ABCs, IV, Monitor, Vitals, Oxygen if saturation < 94%.
*unstable
-Atropine 0.5mg IV —–> Dopamine IV 2-20
mcg/kg/min
-Regardless of treatment you need to transcutaneous pace the patient.

Question 4

What rhythm?

What intervention?

Answer 4

3rd Degree AV Block

ABCs, IV, Monitor, Vitals, Oxygen if saturation < 94%.

• unstable
  
  • Atropine 0.5 mg IV —–>Dopamine IV 2-10 mcg/kg/min
  • Regardless of treatment you need to transcutaneously pace the patient
  • MEDEVAC to a higher level of care to a cardiologist and permanent pacemaker

Question 5

What rhythm?

What intervention?

Answer 5

Torsades de Pointes

IF stable

• Vitals every 5 minutes
• 2 grams of Magnesium Sulfate IV
• MEDEVAC to higher level of care

IF unstable

• synchronized cardioversion at 100 J
• 2 grams of Magnesium Sulfate IV

IF PULSELESS then initiate ACLS Protocol

Question 6

What rhythm?
What intervention?
(PULSELESS)

Answer 6

V-Tach

Start CPR immediately 
Repeat cycles of 2 minutes of CPR, rhythm check, shock and medications as appropriate until the rhythm check reveals a nonshockable rhythm, Return of Spontaneous Circulation (ROSC) is achieved or resuscitation is terminated.
-Meds
  1. Epinephrine 1mg IV push
  2. Amiodarone 300 mg IV push OR 
      Lidocaine 1-1.5 mg/kg IV push

Question 7

What rhythm?
What intervention?
(PULSELESS)

Answer 7

V-Fib

Start CPR immediately 
Repeat cycles of 2 minutes of CPR, rhythm check, shock and medications as appropriate until the rhythm check reveals a nonshockable rhythm, Return of Spontaneous Circulation (ROSC) is achieved or resuscitation is terminated.
-Meds
  1. Epinephrine 1mg IV push
  2. Amiodarone 300 mg IV push OR 
      Lidocaine 1-1.5 mg/kg IV push