Extras

Question 1

What are the PERC criteria (8)

Answer 1

Rule out PE without any of these: 
>50 y/o.
HR > 100
O2 sat on RA>95%
Prior history of Venous Thromboembolism
Trauma/Surgery within 4 weeks
Hemoptysis
Unilateral leg swelling
Exogenous Estrogen/hormone use

Question 2

Wells criteria

Answer 2

Clinical signs (3), alternative dx unlikely (3), hr>100 (1.5), immob prev 4d (1.5), previous dvt/PE (1.5), hemoptysis (1), malignancy (1).

PE unlikely I’d =/4

Question 3

VT or VF cardiac arrest drugs

Answer 3

Epi 1mg q3-5min
Vasopressin 40U
Amiodarone 300mg bolus then second dose is 150mg bolus (for refractory VF/VT)

These are shockable rhythms

Question 4

Reversible causes of cardiac arrest (VF/VT)

Answer 4

H’s and T’s:

Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalcemia, hypothermia, (hypoglycemia)

TPx, tamponade, toxins, thrombosis pulm (PE), thrombosis coronary (MI), (trauma)

Question 5

Rhythms that are shockable/not

Answer 5

Shockable VT/VF

Not shockable PEA/asystole

Question 6

Cardiac arrest with PEA/asystole drugs

Answer 6

Epi 1mg q3-5min

Question 7

tachycardia with pulse

Answer 7

Consider adenosine if regular and monomorphic. first does 6mg rapid IV push, follow with NS flush, second dose 12mg

Question 8

Stable wide QRS tachycardia

Answer 8

Procainamide IV 20-50mg/min until arrhythmia suppressed, or max dose 17mg/kg, 1-4mg/min maintenance infusion. Avoid it long qt or chf

Amiodarone IV: first 150mg over 10 minutes, repeat of VT recurs, maintenance 1mg/min for first 6 hours

Sotalol IV: 100mg over 5min, avoid if long qt

Question 9

Persisten bradycardia causing hypotension, acute AMS, shock signs, ischemic chest discomfort, acute heart failure

Answer 9

Give atropine: .5mg bolus q3-5min max 3mg

If atropine doesn’t work:
Dopamine IV 2-10mcg/kg per minute
Or
Epi IV 2-10mcg per min