ESO

Question 1

Asystole (3)

Answer 1

1 CPR 2 min
2 O2 15 L ambu
3 epi 1mg IVP q3-5

Question 2

Brady w sympt + H Blocks
(3)

Answer 2

1 O2 10L NRB
2 atropine 1mg Q3-5min
3 transcutaneous pacing

Question 3

Brady w sympt + H Blocks
if algorithm was ineffective + SBP<90

Answer 3

dopamine 400mg/250ml D5W

5-20mcg/kg/min until SBP>90

if ineffective, epi 2mg/250ml NS2-10mcg/min

Question 4

PEA
assess for..

Answer 4

H+T
hypovolemia
hypoxia
hypoglycemia
hypothermia
H ions
hypo/hyperkalemia

toxin
tamponade
thrombosis
trauma
tension pneumothrx

Question 5

PEA
(5)

Answer 5

1 CPR 2 min
2 O2 15L ambu
3 epi 1mg IVP Q3-5min
4 250 NS/LR if HYPOVOLEMIA
5 CXR

Question 6

stable VT (4)

Answer 6

1 call MD
2 O2 4L NC
3 EKG
4 Serum K + MG

Question 7

unstable VT (4)

Answer 7

1 O2 10L NRB
2 biphasic synchr cardioversion 200J (if HR>150)
3 Versed 0.5mg IVP if awake
4 Serum K + Mg

Question 8

versed, valium ativan (benzos) reversal agent

Answer 8

romazicon 0.2mg

Question 9

V-fib + pulseless VT (3)

Answer 9

1 CPR (give meds simult)
2 O2 15L ambu
3 defib

Question 10

Defibrillate for….

Answer 10

V fiv + pulseless VT

Question 11

BIPHASIC SYNCH CARDIOVERSION for…

Answer 11

unstable VT

Question 12

transcutaneous pacing for….

Answer 12

Brady + HB

Question 13

Defib
Steps (5)

Answer 13

1 defib>CPR>EPI
2 defib>CPR>AMIO 300
3 defib>CPR>EPI
4 defib> CPR>AMIO 150
5 defib>CPR>EPI

Question 14

CP (6)

Answer 14

1 O2 4L NC (>94%)
2NTG 0.4 SL Q3-5min x 3
3 morphinev2mg
4 ASA 325
5 if hypotensive 250ml
6 EKG

Question 15

NTG + morphine parameters for cp

Answer 15

SBP >90, MAP>60 HR>50

Question 16

contraindication for 250 ml infusion for CP

Answer 16

hypertension or pulmo congestion

Question 17

hypotension parameter

Answer 17

<90

Question 18

hypotension symptomatic (5)

Answer 18

1 O2 10L NRB
2 hypovolemic? 250ml, repeat if no change
3 dopamine 400mg.250 @ 5-20mcg/kg/min
4 H+H, T+C 2 uPRBC if blood loss
5 if suspect sepsis, follow sepsis algorithm

Question 19

hypotension post anesthesia (4)

Answer 19

1 O2 10L NRB
2 250ml + repeat if no change
3 ephedrine 10mg IVP if fluid ineffective*
4 H+H, T+C 2 uPRBC if blood loss

Question 20

hypotension. if infusion is ineffective..

Answer 20

symptomatic? dopamine 400mg/250 @5-20mcg/kg/min

post anesthesia?
ephedrine 10mg IVP

Question 21

ICP signs

Answer 21

uni/bilateral fixed + dilated pupils

decorticate or decerebrate

Question 22

ICP (3)

Answer 22

1 HOB 30 + midline
2 FiO2 100% (keep pCO2 26-30 mmHg)
3 BMP, Serume osmolality, ABG

Question 23

what happens w ICP if pCO2 is less than 25?

Answer 23

vasoconstriction> less blood in cranium + hypoxia

Question 24

resp distress <10 RR (3)

Answer 24

1 O2 10l nrb
2 Narcan naloxone if d/t narcotics
or romazicon if d/t benzo
3 RL + ETCO2 monitoring if reversal agent used

Question 25

resp distress (4)

Answer 25

1 O2 10L NRB
2 CXR
3 albuterol if bronchospasm
4 RRT for ABG + implement NIV

Question 26

status epilepticus (5)

Answer 26

1 protect airway
2 decubitus position
3 O2 10L NRB
4 lorazepam/Ativan 2mg
5 BMP + anticonvulsant levels

Question 27

severe anaphylaxis (9)

Answer 27

1 O2 10L NRB
2 epi 0.3mg x3
3 250ml infusion
4 albuterol if bronchospasm
5 diphenhydramine.Benadryl 25mg IVP
6 hydrocortison/Solucortef 100mg IVP
7 famotidine 20mg IVP
8 epi 0.1mg SLOWLY
9 RRT>for epi drip

Question 28

suspected sepsis (4)

Answer 28

1 hypovol> 250 ml
2 check for 2 SIRS criteria
3 if 2 criteria met, check for organ dysfunctn

Question 29

SIRS criteria

Answer 29

high/low WBC (>12K <4K)
RR>20
HR>90
temp >38.3<36

Question 30

ORGAN DYSFUNCTION criteria

Answer 30

SBP <90 or drop by 40
MAP<65
Lac>2
Cr>2
UOP <0.5/kg/hr
Bili>2
PLT <100k
INR >1.5
PTT>60 sec
Acute resp fail
new mental change

Question 31

if organ failure for sepsis met

Answer 31

1 lactate
2 blood cx
3 ICU/RRT only norepi 4mg/250 @2-32mcg/min
4 bolus
5 RRT/MD