MegaCode Flashcards
What is the acronym for ACLS and meaning
VOMIT
V: visualize, verbalize, vital signs O: administer oxygen M: monitoring pads I: intravenous access/intraosseous T: treatment
What questions do we ask for Vs?
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?”
What questions do we ask for verbalize?
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?
When do you administer oxygen?
If the O2 saturation is below 95% then administer oxygen.
oxygen via Nasa cannula
. 2-4 liters
. 6-10 liters
. 11-15 liters
Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters
oxygen via face mask
. 2-4 liters
. 6-10 liters
. 11-15 liters
Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters
oxygen via non-rebrather mask
. 2-4 liters
. 6-10 liters
. 11-15 liters
Nasa cannula at 2-4 liters
Face mask at 6-10 liters
Non-rebreather mask at 11-15 liters
placement of 3 lead ECG
White at 2nd ICS RMCL
Black at 2nd ICS LMCL
Red at 5th ICS LMCL
placement of 5 lead ECG
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
after how many failed attempts is intraosseous route used and where
After 2 failed attempts, use the INTRAOSSEOUS route via promixal humerus or tibia
slow rhythm
. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse
. Sinus Bradycardia
fast and narrow
. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse
. Supraventricular Tachycardia
fast and wide
. Sinus Bradycardia
. Supraventricular Tachycardia
. Ventricular Tachycardia with Pulse
. Ventricular Tachycardia with Pulse
Slow rhythm acronym
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.
How is atropine administered with slow rhythm
Atrophine – 0.5 mg IV every 3-5 mins., maximum of 6 doses or 3 mg
sinus bradycardia
How is dopamine administered with slow rhythm
. renal dose of 2 mcg/kg/min.
. cardiac dose of 5 mcg/kg/min.
. vasopressor dose of 10 mcg/kg/min.
renal dose of dopamine in sinus bradycardia
. renal dose of 2 mcg/kg/min.
cardiac dose of dopamine in sinus bradcardia
. cardiac dose of 5 mcg/kg/min.
vasopressor dose of dopamine in sinus bradycardia
. vasopressor dose of 10 mcg/kg/min.
how is epinephrine administered in sinus bradycardia
2-10 mcg/min.
what is target BP for tachycardia
90 mmHg
treatment for unstable fast and narrow rhythm
(supraventricular tachycardia)
Sedate – Midazolam or Diazepam at 5 mg Syncronized Cardioversion – 50 Joules
treatment for unstable fast and wide rhythm
(Ventricular Tachycardia with Pulse)
Sedate – Midazolam or Diazepam at 5 mg Syncronized Cardioversion – 120 Joules
what is used for sedation in unstable tachycardias
Midazolam or Diazepam at 5 mg
Syncronized Cardioversion for Superventricular Tachycardia
. 20 joules
. 50 joules
. 100 joules
. 120 joules
. 50 joules
Syncronized Cardioversion for Ventricular Tachycardia with Pulse
. 20 joules
. 50 joules
. 100 joules
. 120 joules
. 120 joules
treatment for stable Superventricular Tachycardia
. Physiologic – Vagal Maneuver: carotid massage or cough
. Pharmacologic – Adenosine 6 mg rapid IV push q 3-5 mins.
then 12mg rapid IV push
treatment for stable Ventricular Tachycardia with Pulse
Pharmacologic – Amiodarone 150 mg
after cpr tachycardia becomes non-shockable rhythm (asystole or pulseless electrical activity) and last medication was Amiodarone continue by
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.
after cpr tachycardia becomes non-shockable rhythm (asystole or pulseless electrical activity) and last medication was Epinephrine continue by
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”
5 H’s
hypovolemia hypoxia hydrogen (acidosis) hypo/hyper kalemia hypothermia
5 T’s
tension pneumothorax tamponade toxins thrombosis - pulmo thrombosis - cardiac
steps after ROSC
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
what is given for congestion after ROSC
DEN
Dopamine – 10 mcg/kg/min. Epinephrine – 2-10 mcg/min. Norepinephrine – 2-10 mcg/min.
