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EB Assessment > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

V fib steps ACLS

A
  1. CPR
  2. Shock
  3. CPR
  4. Shock
  5. Epi Q3-5 min
  6. Shock
  7. Amio or Lido
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2
Q

Initial dose amio and lido

A

amio 300 mg
lidocaine 1-1.5 mg/kg

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3
Q

Initial defibrillator joules monophasic

A

360 J

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4
Q

Initial defibrillator joules biphasic

A

120-200 J

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5
Q

H’s (5)

A

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo/hyperkalemia
Hypothermia

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6
Q

T’s (5)

A

Tension
Tamponade
Thrombosis, pulmonary
Thrombosis, coronary
Toxins

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7
Q

SVT, stable

A

Adenosine, 6 and then 12 mg

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8
Q

SVT unstable intervention

A

cardioversion

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9
Q

Meds that can be given via ETT

A

Lidocaine
Epinephrine
Atropine
Narcan
(LEAN)

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10
Q

2 most common causes of cardiac arrest:

A

hypoxia and hypovolemia

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11
Q

Hyperkalemia interventions

A

-Calcium
-Insulin / D50
-Albuterol
-Volume
-Bicarb

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12
Q

Beck’s triad

A

Hypotension (narrow pulse pressure too), JVD and muffled heart sounds.

Indicates cardiac tamponade

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13
Q

Beta blocker OD interventions

A

Glucagon - 3-5 mg
If unstable, may need to pace as a bridge to get glucagon working

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14
Q

Adult bradycardia atropine doses

A

1 mg bolus Q3-5 min to a max of 3 mg

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15
Q

Adult bradycardia epi dose, drip

A

2-10 mcg/min

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16
Q

Adult bradycardia dopamine dose, drip

A

5-20 mcg/kg/min

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17
Q

Adult bradycardia steps:

A
  1. Identify and treat underlying cause
  2. Atropine
  3. If atropine ineffective:
    Pacing and/or dopamine or epinephrine infusion
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18
Q

Stable wide QRS tachycardia Procainamide IV dose

A

20-50 mg/min max dose 17 mg/kg
Maintenance infusion 1-4 mg/min

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19
Q

Stable wide QRS tachycardia amiodarone IV dose

A

150 mg over 10 min
Maintenance dose: 1mg/min x 6 hours

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20
Q

Stable wide QRS tachycardia sotalol IV dose

A

100 mg (1.5 mg/kg) over 5 min. Avoid in prolonged QT

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21
Q

Unstable tachyarrhythmia cardioversion joules dose

A

1-2 J/kg

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22
Q

Peds compression to ventilation ratio and how often to deliver a breath

A

15:2
Q 2-3 seconds

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23
Q

Pediatric ACLS shock energy for defibrillator

A

First shock: 2J/kg
Second shock: 4j/kg
Subsequent shocks: >4J/kg up to a max of 10J/kg or adult dose

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24
Q

PALS epinephrine dose IV

A

0.01 mg/kg max dose of 1 mg

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25
Q

PALS epi dose down ETT

A

0.1 mg/kg

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26
Q

PALS amiodarone IV dose for VF/VT

A

5mg/kg bolus. May repeat up to 3 doses for refractory VF/pulseless VT

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27
Q

PALS lidocaine dose

A

1mg/kg

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28
Q

PALS atropine dose for bradycardia

A

0.02 mg/kg
May repeat once.
Max single dose 0.5 mg

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29
Q

PALS bradycardia steps

A

CPR if HR <60 BPM despite oxygen and ventilation
Epi
Atropine

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30
Q

Why to have atropine ready when giving succ to kids?

A

Sucd byproduct can cause bradycardia in kids

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31
Q

Peds tachycardia adenosine IV dose

A

0.1 mg/kg rapid bolus (max 6mg)
Second dose:
0.2 mg/kg (max 12 mg)

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32
Q

Biggest causes of tachycardia in kids:

A

volume depletion and elevated temp

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33
Q

Pediatric tachycardia HR in 2-8 year olds

A

> 180

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34
Q

Pediatric tachycardia HR in child less than 2 years

A

> 220

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35
Q

In neonates, HR less than ___, we ventilate

A

100

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36
Q

In peds and neonates; if HR less than ___, start compressions

A

60

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37
Q

Potential cause of cardiac arrest in pregnancy

A

Anesthesia complications
Bleeding
Cardiovascular
Drugs
Embolic
Fever
General (H and Ts)
HTN

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38
Q

The heart has the ability to generate its own spontaneous action potentials, a phenomenon known as ___

A

automaticity.

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39
Q

the SA node can produce spontaneous action potentials at a rate of ____ beats per minute intrinsically without any external stimuli.

A

60-100 beats

40
Q

SA node is represented by _ wave

41
Q

Pathway of electrical signal in heart

A

SA –> internodal –> AV –> bundle of His –> R and L bundle branches –> purkinje fibers

42
Q

The rate at which the AV node produces spontaneous action potentials is approximately ______ beats per minute.

43
Q

The bundle of His has pacemaker cells that can generate action potentials at ___ beats per minute.

44
Q

The bundle branches consist of pacemaker cells that can generate spontaneous action potentials at a rate of ___ beats per minute.

45
Q

The pacemaker cells within the Purkinje fibers have the ability to generate spontaneous action potentials at a rate of ___ beats per minute.

A

20-40

but often lower

46
Q

How many seconds is a big box on EKG? Little box?

A

Big box = 0.2 seconds
Little box = 0.04 seconds

47
Q

P wave length

A

0.12 seconds

48
Q

What does the PR interval represent? Why is the end flat?

A

Represents AV conduction
PR interval later part flat is due to delay as it travels through AV node

49
Q

QRS normal duration

A

0.12 seconds

50
Q

What does the QRS represent?

A

Ventricular depolarization

51
Q

What does the ST segment represent?

A

Early stages of ventricular repolarization

52
Q

If confirming MI, need ST segment greater than ____ elevation/depression in contiguous leads

53
Q

What does T wave represent?

A

Ventricular repolarization

54
Q

This a physiological response that causes a decrease in heart rate (bradycardia) when pressure is applied to the eyeball or traction is exerted on the extraocular muscles.

What can we give to block this?

A

Oculocardiac reflex

Can give atropine or glycopyrrolate to block reflex

55
Q

Volatile that prolongs QT interval

A

Desflurane

56
Q

Volatile with high potential for bradycardia, especially in kids

57
Q

Why does giving a bunch of blood impact calcium?

A

Citrate lowers calcium levels because it readily binds to calcium ions, forming a complex that effectively removes free calcium from the bloodstream, essentially “chelation” of calcium; this is why citrate is often used as an anticoagulant, as calcium is a crucial factor in blood clotting mechanisms.

76
Q

Normal junctional rate is ___ BPM
Junctional bradycardia is

A

40-60
Brady: <40

77
Q

How long to be NPO after a full meal / enteral tube feeds

78
Q

Your patient had toast, liquids, formula and coffee with milk as well as non human milk. How long should they be NPO

79
Q

How long to be NPO after breast milk

80
Q

How long to stay NPO after clear liquids (coffee, tea, juice no pulp, carbonated beverages)

81
Q

ASA I

A

Healthy non smoking no/minimal alcohol use

82
Q

What asa score is a current smoker

83
Q

What asa score is a social drinker or pregnany patient

84
Q

What ASA score is a patient with a BMI between thirty and 40 or someone with well controlled DM/HTN

85
Q

A patient with severe systemic disease is an ASA

86
Q

Poorly controlled DM / HTN COPD and morbid obesity will all fall into ASA

87
Q

Hepatitis, alcohol abuse, implanted PM moderately reduced EF are all ASA

88
Q

ESRD undergoing regular HD and >3 month history of: MI, CVA, TIA or CAD/stents are ASA

89
Q

ESRD non compliant with HD, recent <3 months CVA, MI, TIA or CAD/stents are ASA

90
Q

DIC, ARDS or severely reduced EF and most ICU patients are ASA

91
Q

ASA VI

A

STA patients

92
Q

What ASA class is the only one who mentions surgery

93
Q

A moribund patient who is not expected to survive without the operaiton is an ASA

94
Q

Examples of ASA V patients

A
  • Ruptured abdominal or thoracic aneurysm
  • Massive trauma
  • Intracranial bleed with mass effect
  • MODS
  • Ischmic bowel in the face of significant cardiac pathology

EB Assessment (1 decks)

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