Exam 1 - Algorithms Flashcards
What are the defibrillation doses for a monophasic & and biphasic defibrillators?
Monophasic: 360 joules
Biphasic: 120 - 200 joules
What dose & frequency of epinephrine is used in an adult cardiac arrest?
- 1mg every 3-5 min
What dose & frequency of amiodarone is used in an adult cardiac arrest?
When should it be administered?
- Initial dose: 300mg
- Subsequent doses: 150mg
- After shocking 3 times
What dose & frequency of lidocaine is used in an adult cardiac arrest?
- 1st dose: 1-1.5 mg/kg
- 2nd dose: 0.5-0.75 mg/kg
Name all of the reversible causes of arrest that start with H. (H’s & T’s)
- Hypovolemia
- Hypoxia
- Hydrogen ion (acidosis)
- Hypokalemia
- Hyperkalemia
- Hypothermia
Name all of the reversible causes of arrest that start with T (H’s & T’s)
- Tension pneumo
- Tamponade
- Toxins
- Thrombosis (coronary or pulmonary)
How often should you give breaths during cardiac arrest?
Every 6 seconds or 10 breaths/min
What is the first line treatment for symptomatic adult bradycardia?
What are the next treatment options?
- Atropine
- Transcutaneous pacing
- Dopamine infusion
- Epinephrine infusion
What is atropine dosing on a bradycardic patient?
- 1st dose: 1mg bolus
- Subsequent doses every 3-5min
- 3mg max
What is dopamine dosing for a bradycardic patient?
- 5 - 20 mcg/kg/min
What is epinephrine dosing for a bradycardic patient?
- 2 - 10 mcg/min
What temperature range is necessary for TTM (targeted temperature management) on post-arrest patients?
- 32 - 36°C
How should unstable, narrow-QRS adult tachycardia be treated?
- Synchronized cardioversion
- Adenosine (possibly)
When would anti-arrhythmic infusions be given for an adult tachycardia patient?
What anti-arrhythmics are a part of this algorithm?
- If the patient had a stable, wide-QRS tachyarrhythmia.
- Procainamide, Amiodarone, Sotalol
What is the adenosine dosing for an adult tachy-arrhythmia patient?
- 1st dose: 6 mg
- 2nd dose: 12 mg
What is the tachyarrhythmia dosing for Procainamide?
What three results would cause one to stop the infusion?
- 20 - 50 mg/min
1. Arrhythmia is fixed
2. QRS durations increases by 50%
3. Max dose of 17 mg/kg is reached
What is the maintenance dose of Procainamide?
- 1-4 mg/min
What is the tachyarrhythmia dosing of amiodarone?
- Bolus: 150mg over 10 mins
- Maintenance: 1 mg/min for 6 hours
What is the tachyarrhythmia dosing of sotalol?
- 100 mg (1.5 mg/kg) over 5 minutes
For a pregnant woman during cardiac arrest, how would one relieve aortocaval compression?
- Lateral uterine displacement
What are the possible etiologies of maternal arrest? ( A through H)
- Anesthetic complications
- Bleeding
- Cardiovascular
- Drugs
- Embolism
- Fever
- General H & T’s
- Hypertension
During a pregnant cardiac arrest, when should a C-section be performed?
If ROSC is not acheived in 5 minutes
When does a neonate need to be placed on PPV?
- Apnea or gasping
- HR below 100
When do you begin chest compressions on a neonate?
HR < 60/min
How often do you give breaths during pediatric cardiac arrest?
Every 2-3 seconds
What is the initial defibrillating dose for a pediatric patient?
What about subsequent defibrillations?
Initial - 2 J/kg
Second - 4 J/kg
Max 10J/kg or adult dose
What is the pediatric arrest/bradycardia dosing of epinephrine?
What if no IV is present?
- 0.01mg/kg IV
- Endotracheal dose: 0.1mg/kg
What is the pediatric arrest dosing of amiodarone?
- 5 mg/kg bolus up to 3 doses
What is the pediatric arrest dosing of lidocaine?
- 1mg/kg loading dose
What are the steps in treating symptomatic pediatric bradycardia?
- CPR if HR < 60
- Epinephrine
- Atropine
- Consider pacing
What is the dosing of atropine for a bradycardic pediatric patient?
What are the minimum/maximum doses?
- 0.02 mg/kg, can be repeated once
- 0.1mg - 0.5mg
When is cardioversion indicated for pediatric tachycardia?
What is the dose?
- If cardiopulmonary compromise is present and QRS is wide (>.09 s). Or if adensosine is ineffective.
- Begin with 0.5-1J/kg
- If ineffective, increase to 2 J/kg
What is the pediatric tachycardia adenosine dose?
- 1st dose: 0.1 mg/kg (max 6mg)
- 2nd dose: 0.2 mg/kg (max 12mg)
What H is a part of pediatric H’s/T’s that is not apart adults?
Hypoglycemia
