MegaCode

Question 1

What is the acronym for ACLS and meaning

Answer 1

VOMIT

V: visualize, verbalize, vital signs
O: administer oxygen
M: monitoring pads
I: intravenous access/intraosseous
T: treatment

Question 2

What questions do we ask for Vs?

Answer 2

Visualize - the patient is conscious, in pain, canotic, and diaphoretic

Verbalize - “I am Dr. — how are you feeling today? What were you doing when the pain started? What does it feel like? Where is the pain located? Does the pain radiate? How severe is the pain? When did it start and how long does it last?”

Vital Signs -“Ma’am/ Sir what are the vital signs?”

Question 3

What questions do we ask for verbalize?

Answer 3

Introduce yourself and make a quick history of chest pain (PQRST)
“I am Dr. — how are you feeling today? What were you doing when the pain started? What does it feel like? Where is the pain located? Does the pain radiate? How severe is the pain? When did it start and how long does it last?

Question 4

When do you administer oxygen?

Answer 4

If the O2 saturation is below 95% then administer oxygen.

Question 5

oxygen via Nasa cannula

. 2-4 liters
. 6-10 liters
. 11-15 liters

Answer 5

Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters

Question 6

oxygen via face mask

. 2-4 liters
. 6-10 liters
. 11-15 liters

Answer 6

Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters

Question 7

oxygen via non-rebrather mask

. 2-4 liters
. 6-10 liters
. 11-15 liters

Answer 7

Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters

Question 8

placement of 3 lead ECG

Answer 8

White at 2nd ICS RMCL
Black at 2nd ICS LMCL
Red at 5th ICS LMCL

Question 9

placement of 5 lead ECG

Answer 9

White at 2nd ICS RMCL 
Black at 2nd ICS LMCL
Red at 5th ICS LMCL
Green at 5th ICS RMCL
Brown is between black and red

Question 10

after how many failed attempts is intraosseous route used and where

Answer 10

After 2 failed attempts, use the INTRAOSSEOUS route via promixal humerus or tibia

Question 11

slow rhythm

. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse

Answer 11

. Sinus Bradycardia

Question 12

fast and narrow

. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse

Answer 12

. Supraventricular Tachycardia

Question 13

fast and wide

. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse

Answer 13

. Ventricular Tachycardia with Pulse

Question 14

Slow rhythm acronym

Answer 14

ATDE

. Atrophine – 0.5 mg IV every 3-5 mins., maximum of 6 doses or 3 mg
. Transcutaneous Pacing
. Dopamine –
. Epinephrine – 2-10 mcg/min.

Question 15

How is atropine administered with slow rhythm

Answer 15

Atrophine – 0.5 mg IV every 3-5 mins., maximum of 6 doses or 3 mg

sinus bradycardia

Question 16

How is dopamine administered with slow rhythm

Answer 16

. renal dose of 2 mcg/kg/min.
. cardiac dose of 5 mcg/kg/min.
. vasopressor dose of 10 mcg/kg/min.

Question 17

renal dose of dopamine in sinus bradycardia

Answer 17

. renal dose of 2 mcg/kg/min.

Question 18

cardiac dose of dopamine in sinus bradcardia

Answer 18

. cardiac dose of 5 mcg/kg/min.

Question 19

vasopressor dose of dopamine in sinus bradycardia

Answer 19

. vasopressor dose of 10 mcg/kg/min.

Question 20

how is epinephrine administered in sinus bradycardia

Answer 20

2-10 mcg/min.

Question 21

what is target BP for tachycardia

Answer 21

90 mmHg

Question 22

treatment for unstable fast and narrow rhythm

Answer 22

(supraventricular tachycardia)

Sedate – Midazolam or Diazepam at 5 mg Syncronized Cardioversion – 50 Joules

Question 23

treatment for unstable fast and wide rhythm

Answer 23

(Ventricular Tachycardia with Pulse)

Sedate – Midazolam or Diazepam at 5 mg Syncronized Cardioversion – 120 Joules

Question 24

what is used for sedation in unstable tachycardias

Answer 24

Midazolam or Diazepam at 5 mg

Question 25

Syncronized Cardioversion for Superventricular Tachycardia

. 20 joules
. 50 joules
. 100 joules
. 120 joules

Answer 25

. 50 joules

Question 26

Syncronized Cardioversion for Ventricular Tachycardia with Pulse

. 20 joules
. 50 joules
. 100 joules
. 120 joules

Answer 26

. 120 joules

Question 27

treatment for stable Superventricular Tachycardia

Answer 27

. Physiologic – Vagal Maneuver: carotid massage or cough

. Pharmacologic – Adenosine 6 mg rapid IV push q 3-5 mins.
then 12mg rapid IV push

Question 28

treatment for stable Ventricular Tachycardia with Pulse

Answer 28

Pharmacologic – Amiodarone 150 mg

Question 29

after cpr tachycardia becomes non-shockable rhythm (asystole or pulseless electrical activity) and last medication was Amiodarone continue by

Answer 29

giving high-quality CPR and administer Epinephrine every 3-5 minutes

“The monitor reveals a nonshockable rhythm. Please check for pulse. Still without a pulse. Please continue giving high quality CPR and administer Epinephrine 1mg at 1:10,000 dilution and 20cc NSS.

Question 30

after cpr tachycardia becomes non-shockable rhythm (asystole or pulseless electrical activity) and last medication was Epinephrine continue by

Answer 30

giving high quality CPR and administer Epinephrine after 3 minutes.

“The monitor reveals a nonshockable rhythm. Please check for pulse. Still without a pulse. Please continue giving high quality CPR”

Question 31

5 H’s

Answer 31

hypovolemia
hypoxia
hydrogen (acidosis)
hypo/hyper kalemia
hypothermia

Question 32

5 T’s

Answer 32

tension pneumothorax
tamponade
toxins
thrombosis - pulmo
thrombosis - cardiac

Question 33

steps after ROSC

Answer 33

Check for blood pressure. If it is low, give 1L to 2L of NSS or PLR fast drip but check first for presence of congestion

Question 34

what is given for congestion after ROSC

Answer 34

DEN

Dopamine – 10 mcg/kg/min. Epinephrine – 2-10 mcg/min. Norepinephrine – 2-10 mcg/min.