lecture. Flashcards
Tell me about Ventricular tachycardia.
Ventricular Tachycardia
•Irritable ventricle site fires at a rapid rate and over rides the SA and AV nodes
•Rate between 150 –250
•Usually regular but can be slightly irregular
•No P wave preceding the QRS •Saw tooth appearance •May have a pulse or be pulseless
Define torsades.
Torsades De Pointes
•Polymorphic V- Tach
causes of Torsades
•Can be caused my alcoholism, malnutrition, hypomagnesaemia, hypokalemia and medication interactions causing QT prolongation.
treatment of torsades
2mg of magnesium
Tell me about Ventricular Fibrillation.
Ventricular Fibrillation
•Chaotic with multiple foci •Irregularly irregular •No discernible or measurable complexes •VF does not have a pulse •The ventricles are fibrillating not
contracting
Idioventricular rhythms talk about it.
Idioventricular
•Ventricles take over as the final pacemaker after all the upper pacers have failed
•Rate 20-40 •Wide QRS •Regular but unreliable and may become irregular as it
degreased to agonal-dying •No P waves •May or may not have a pulse
Tell me about PEA
Pulseless Electrical Activity (PEA)
•An organized narrow complex rhythm with no pulse
•Occurs when the electrical conduction system of the heart is functioning but there is no mechanical pumping
•Rate, rhythm, P waves, QRS and PRI may vary
Cardiac arrest management
Cardiac Arrest Management •BSI •Check for responsiveness •Breathing and pulse check •Start CPR •Hook up to the monitor •Assess rhythm
Define ROSC
- Pulse and BP
* Abrupt sustained increase in EtCO2 (typically 40 mmHg or more)
Vtach with a pulse treatment….
Stable
•Amniodarone 150 mg over 10 min
•Supportive care
Unstable
•Synchronized Cardioversion •100 joules •Sedate if possible
How to synchronize cardiovert
Hit the “Sync” button and wait for the machine to find the R waves
Press and Hold the “Shock” button until the
machine delivers the shock
H causes of asystole
Hypovolemia, hypoxia, hydrogen ions, hypothermia, hyperkalemia, hypoglycemia
T causes of asystole
tablets (drug OD), tamponade, tension pneumo, thrombosis (MI, PE), Trauma (blood loss)
Hypovolemia symptoms
rapid heart rate; narrow qrs
hypovolemia treatment
Saline or LR bolus
hypoxia symptom
slow HR; cyanosis
hypoxia treatment
airway and vent with 02
H+ ion excess symptoms
Low amplitude QRS
H+ ion excess treatment
Hyperventilate; sodium bicarb
hypoglycemia symptoms
ALOC, arrythmias
hypoglycemia treatment
Dextrose
Hypokalemia symptoms
Flat T waves and appearance of U wave
Hypokalemia treatment
magnesium infusion
hyperkalemia symptoms
Peaked T waves, wide QRS
hypekalemia treatment
calcium chloride; sodium bicarb; glucose with insulin
hypothermia symptoms
shivering; previous exposure to cold
hypothermia treatment
rewarming
tension pneumothorax symptoms
slow heart rate with narrow QRS
tension pneumo treatment
needle decompression
cardiac tamponade symptoms
rapid hr with narrow QRS
cardiac tamponade treatment
pericardiocentesis
toxins symptoms
prolonged QT interval
toxins treatment
antidote based on overdose agent
pulmonary thrombosis symptoms
Rapid rate with narrow QRS
pulmonary thrombosis treatments
fibrolyntics or embolectomy
thrombosis (acute MI) symptoms
abnormal EKG
thrombosis (acute MI) treatments
See STEMI checklist
