Treatments

Question 1

What are the 3 drugs to consider when confronted with a bradycardic patient? What is the dose?

Answer 1

Atropine, Epinephrine, Calcium (Hyper K Patient).

Atropine: 0.6mg IVP to max of 0.04mg/kg (3mg in most patients)
Epinephrine: 10mcg/mL push dose, or infusion started at 4mcg/min (1 drop per second)
Calcium: 10mg/kg IV over 15 mins, max single dose of 1g. Q10 x1 more if symptoms persist.

Question 2

What are the goals of care in a ROSC patient?

Answer 2

Intubate early if not already done
Spo2 92-98%
ETCO2 35-45
BP: Map >65, Systolic >90 –> Vasopressors
Correct dysrhythmias
12 Lead after 10 mins of ROSC

Question 3

Where might we use permissive hypotension and why?

Answer 3

In the setting of a shock patient mainly having to with a penetrating injury but can be used in any case of hypovolemic shock. Studies have shown rapid increases in fluid have caused decreases in vascular constriction which would help with blood loss, further increased fluids leads to a coagulopathy that disrupts the clotting cascade which can harm your patient. Targets are MAPs below normal physiologic levels, as long as mentation can be maintained.