Resuscitation stations Flashcards
What is the adrenaline dose in cardiac arrest (adult)
1mg adrenaline of 1 in 10 000
which would be 10ml
What is the IV adrenaline dose for an adult in anaphylaxis
50-100mcg IV which is 0.5ml-1ml of 1 in 1000
What is the IV paediatric dose of adrenaline in anaphylaxis
1mcg/kg
Which rhythms are shockable
VT and VF
What is the starting shock energy
150J
What would you do after 3 shocks
Give amiodarone 300mg and give adrenaline every 3-5 mins
When should adrenaline be given in cardiac arrest
As soon as non shockable rhythm confirmed or after 3rd shock in shockable rhythm
Why are the pads placed in these positions and what else is important to consider when placing pads
to allow safe defibrillation of the heart
maximise shock effectiveness
ensure skin is dry and free of hair to minimise burns
What is the parkland formula (burns)
total amount of crystalloid in 24hours= 4ml x TSBA x weight (kg)
Why might defibrillation not work in hypothermic patient
slowed electrical conduction in the heart
If VF persists after 3 shocks then no more shocks until body temp above 30 degrees
What might be seen on ECG in hypothermic patients
J waves and AF
What changes would you make to the ALS algorithm pre and post 30 degrees
PRE: withold adrenaline, delay further attempts of defibrillation after 3 shocks if still in VF
POST: increase time between adrenaline doses to 6-10 mins, further attempts at defibrillation
What are the symptoms of LA toxicity
euro: sudden alteration in mental status, severe agitation, loss of consciousness, tonic clonic seizures
CVS: Collapse, bradycardia, Conduction block, ventricular tachyarrhythmia, cardiac arrest
What is the dose of intralipid in LA toxicity
1.5ml/kg intralipid as initial bolus
15ml/kg IV infusion
do not exceed cumulative dose of 12ml/kg
how can you avoid LA toxicity
Calculate dose for patient based on ideal weight (not total body weight if obese)
Give test dose down epidural to ensure not intrathecal
Aspirate to ensure not getting CSF back or blood
What after care would you give post LA toxicity
Transfer to appropriate clinical area - may need HDU or ICU
Datix
Involve senior clinicians
Debrief with staff
Exclude pancreatitis by taking amylase and lipase levels
What dose of atropine would you use in bradycardia
500mcg IV repeat up to 3mg
In a paeds cardiac arrest what energy is used for defibrillation
4J per Kg
What is the dose of adrenaline in a paeds cardiac arrest
10mcg/kg
max single dose of 1mg
