Peri-arrest rhythms Flashcards

1
Q

Describe how you would manage a broad complex tachycardia.

A

determine if irregular or regular

if regular - assume VT
= IV amiodarone followed by 24 hour infusion

if irregular
- AF: <48hrs DC cardioversion or if > 48hrs then rate control + anticoagulation

  • polymorphic VT (torsades de pointes)
    = IV magnesium sulphate
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2
Q

describe how you would manage a narrow complex tachycardia.

A

determine if irregular or regular

if regular - assume SVNRT

  • vagal manœuvres followed by adenosine
  • if fails then assume atrial flutter and treat with beta blockers

if irregular
- AF: if < 48hrs then DC cardioversion but if > 48 hours treat with beta blockers and anticoagulation

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3
Q

when would give DC cardioversion in a patient with a tachycarrythmia?

A

if patients was unstable (showed one of the following signs);

  • shock: systolic < 90, cold clammy skin, confusion
  • syncope
  • heart failure
  • myocardial ischaemia
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4
Q

1st line management of bradycardia with haemodynamic compromise ?

A

IV atropine 500mcg

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5
Q

if bradycardia still persists after atropine, what are the other treatment options ?

A

IV atropine, up to 3mg can be given
transcutaneous pacing
isoprenaline/adrenaline infusion titrated to response

transvenous pacing (specialist advise required)

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6
Q

what are risk factors for systole in a patient with bradycardia ?

A

previous asystole
complete heart block with broad QRS complex
mobitz type II AV block
ventricular pause > 3 seconds

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