Meds Flashcards
What is the treatment for SVT?
Vagal maneuvers
Adenosine
What does adenosine treat?
SVT
Adenosine dosing
First dose 0.1mg/kg MAX 6mg
Second dose 0.2 mg/kg MAX 12mg
What if adenosine is ineffective for SVT
Synchronized cardio version
0.5-1 J/kg
Increase to 2 J/kg if needed
Sedate if possible
What is amiodorone used for?
Tachyarrhythmia
How should adenosine be given?
Rapid IV bolus
What should not be given with amiodorone?
Procainamide
What should not be given with procainamide?
Amiodorone
Which antiarrhythmics should be considered in VT (with expert consultation)
Amiodorone
Procainamide
Adenosine
Cardioversion
Amiodarone dosing
5mg/kg over 20-60 minutes
MAX 300mg
How should adenosine be given?
Rapid IV/IO bolus
No ET tube
Flush with saline
What is atropine used for?
Bradycardia
What is first line med for bradycardia?
Epinephrine IV/IO
How is epinephrine dosed for bradycardia?
IV/IO
0.01 mg/kg every 3-5 minutes
ET tube
0.1mg/kg
Atropine dosing
0.02 mg/kg
MIN 0.1mg MAX 0.5mg
May repeat once
How do you treat continued bradycardia?
Epinephrine
Atropine
Transcutaneous pacing
Identify and treat underlying cause
Which rhythms are shockable?
Pulseless V tachycardia
Ventricular fibrillation
How is epinephrine dosed in cardiac arrest?
0.01 mg/kg
Repeat every 3-5 minutes
ET tube 0.1 mg/kg
How to dose epinephrine for fluid-refractory shock?
0.03-0.05 mcg/kg/min
Epinephrine dosing for anaphylactic shock
1:1000
0.01 mg/kg IM
MAX 0.5mg
Repeat every 5-15 minutes
How is glucose dosed?
0.5-1 gram/kg
Which solutions to use for glucose infusion?
Newborn 5-10 ml/kg D10W
Infant/child 2-4 ml/kg D25W
Teen 1-2ml/kg D50W
What is lidocaine used for?
Tachyarrhythmia
CPR defibrillation max doses
10 J/kg or the maximum adult dose of 360J
How to dose lidocaine for CPR
Initial bolus dose 1mg/kg
Maintenance infusion 20-50 mcg/kg/min
What is magnesium used for?
Torsades de pointes
Asthma
How to dose magnesium for torsades de pointes?
25-50 mg/kg over 10-20 minutes
MAX 2 grams
How to dose magnesium for asthma?
20-50 mg/kg over 15-30 minutes
Monitor HR and BP
Formula for minimum systolic BP
(Age x 2) + 70
How to size ET tube?
4 + (age in years / 4) uncuffed
3.5 + (age in years / 4) cuffed
What is milrinone used for?
Cardiogenic shock
How is milrinone dosed?
50 mcg/kg over 10-60 minutes
Maintenance 0.5-0.75 mcg/kg/min
What are signs of cardiogenic shock?
Tachycardia
Dyspnea
JVD
Hepatomegaly
What is the primary assessment model?
A - airway B - breathing C - circulation D- disability E - exposure
Cardiogenic shock medications
Improve contractility and reduce SVR:
Dobutamine, milrinone, dopamine, epinephrine
How do you dose naloxone?
0.1 mg/kg if <5 yo or <20 kg
2 mg IV if >5 yo or >20kg
Repeat every 2-3 minutes
What is procainamide used for?
Ventricular tachycardia after expert consultation
Procainamide dosing
15 mg/kg IV over 30-60 minutes
What is sodium bicarbonate used for?
Metabolic acidosis
How to dose sodium bicarbonate
1 mEq/kg slow bolus
MAX 50 mEq
What is SAMPLE?
Secondary assessment:
Signs and symptoms, allergies, meds, PMH, last meal, events
