Heart

Question 1

4 types of major AV blocks?

Answer 1

Sinus bradycardia
First degree AV block
Second degree AV block
Third degree AV block

Question 2

2 types of second degree AV block?

Answer 2

Second degree AV blocks
Type I - Wenchebach or Mobitz I
Type II - Mobitz II

Question 3

what is the rhyme for a second degree AV block type I?

What is the definition?

Answer 3

longer, longer, longer, DROP. Now you have a Wenchebch

the PR intervals get longer until and entire beat is dropped

Question 4

whats the definition of a second degree AV block type II?

Answer 4

When PR intervals are all equal but a random QRS complex is dropped

Question 5

What is a third degree AV block?

Answer 5

When there are no communication between the sinus and ventricles

we don’t see any QRS complex’s on the ECG

Question 6

How do you manage bradycardia?

Answer 6

If the pt is true bradycardia = less than 50 bmp

then implement ABCD
airway
breathing, check for O2 sats
Circulation - blood pressure, Heart rate, establish 12 lead ecg
Diagnose - do problem focused H&P to search for hypoxic or toxicologic causes

Question 7

what is the first line treatment of poor perfusion that is being caused by bradycardia? stable or unstable bradycardia

Answer 7

atropine

Question 8

what is a complication of atropine if too low of a dose is given?

Answer 8

if a dose of less than 1 mg is given, further slowing of the heart rate can occur

Question 9

what is second line treatment of stable bradycardia if unresponsive to atropine?

Answer 9

a Beta adrenergic infusion (dopamine or epinephrin)

Question 10

what is a second line treatment of unstable bradycardia if unresponsive to atropine?

Answer 10

TCP

transcutaneous cardia pacing

Question 11

definition of tachycardia?

above what rate does tachycardia normally become symptomatic?

Answer 11

heart rate above 100 bpm

Above 150 beats/min which then is considered unstable tachycardia

Question 12

when is tachycardia deemed unstable?

Answer 12

when signs and symptoms do not resolve after airway is managed, oxygen given, circulation support is given

Question 13

what is stable tachycardia?

Answer 13

HR above 100 beats/min with no significant signs or symptoms

if this condition persists, get and ECG to evaluate QRS complex’s (wide vs narrow/regular vs irregular)

Question 14

if while evaluating ECG for tachycardia you see QRS complexes that are less than .12 seconds, what is the treatment?

Answer 14

consider vagal maneuvers and adenosine

Question 15

what is first line treatment is unstable tachycardia?

Answer 15

cardioversion

Question 16

what causes sinus tachycardia?

Answer 16

external influences on the heart such as
fever
anemia
hypotension
blood loss 
exercise

…these are systemic causes not heart issues

Question 17

what is the upper heart rate limit for sinus tachycardia?

Answer 17

130 beats/min

Question 18

what 2 simple moves with eliminate 25% of SVT’s (supraventricular tachycardias)?

what is second line treatment if those fail>

Answer 18

valsavla maneuver
carotid sinus massage

adenosine

Question 19

what 3 drugs are used to help manage VF or PVT?

Answer 19

Epinephrin
Amiodarone- 300 mg/IV bolus
Lidocaine- 1-1.5 mg/kg IV

Question 20

what drug can be used to help manage torsades do pointes?

Answer 20

magnesium