Terms in this set (45)
What's the DOC during an MI?
How many joules are used for unstable SVT?
If you see a patient collapse and that patient has VF or VT, what is the sequence of care?
- shock (if you saw them go down)
- CPR for 2 min (get IV ax)
- ax rhythm/pulse, if shockable...
- CPR for 2 min (admin epinepherine)
- CPR 2 min (admin amiodarone)
What two drugs are used in the CPR/shock cycle w/ VF/VT? What doses?
- epinepherine 1 mg q 3-5 minutes
- amiodarone 300 mg bolus, 150 mg second dose
Vasopressin can replace which doses of epinepherine?
40 units - the 1st or 2nd dose of epi.
What effect does amiodarone have? What is amiodarone's dosing schedule?
300 mg w/ 450 mg max dose
- calms irritability of cardiac cells
- half-life is 40 days
What effect does epi have?
- peripehral constriction (alpha 1)
- regulates rate/force (beta 1)
- dilates bronchioles (beta 2)
What is the effect of
Shuts down conduction temporarily
- half-life of 6-10 seconds
- first dose - 6 mg
- second dose - 12 mg
- no third dose
If adenosine doesn't convert the rhythm, what is used?
Cardizem - CCB
- hydrogen ions (acidosis)
- thrombis (pulmonary)
- thrombis (cardiac)
- tamponade, cardiac
- tension pneumothorax
How do you help maintain a BP of (how do you keep it up?)
- start w/ 1 L, use 2 L if necessary
How high do you want to bring the BP in ROSC?
If fluids don't work to maintain BP, what do you use?
Dopamine 2-10 or 20 mcg/kg/min
If the patient remains unresponsive and comatose, what is done?
Initiate hypothermic protocol at
32-34 degrees for 12-24 hours
What does it mean, if during CPR the ETCO2 is at 9?
CPR is inadequate
- it should be at least 10 and ideally
After heartbeat and BP is restored, what is ideal ETCO2?
What is normal oxygen saturation?
What should you do if the AED isn't functional?
When an advanced airway is in place, how often is the patient ventilated?
1 breath q 6-8 seconds
For what reason would you stop a resuscitation effort in a hospital?
- the patient recovers
- the patient is declared dead
When suctioning, when is suction applied and for how long?
Suction while pulling out, less than 10 seconds.
In respiratory arrest, when administering rescue breaths, what is the rate in adults? Children?
- q5-6 seconds
- children - q3-5 seconds
Why should you avoid securing anything around the face?
Impairs venous return
What is constructive intervention?
Addressing issues during a code with tact and respect.
What medication is typically used for V-fib if the patient is stable?
Amioderone 300 mg bolus, 150 mg second dose
When is V-tach shockable?
without a pulse
For a-fib, synch cardioversion is done at how many joules?
What is done for sinus tach?
Tx underlying cause - pain, etc.
What strip is represented by a P wave that's regular and a ventricular rhythm that's regular, but the two aren't related?
3rd degree heart block
What's the DOC for a complete, third degree heart block?
If the monitor shows a rhythm, but there is not pulse, what is done?
Treat as PEA
A patient is in cardiac arrest (no pulse), what do you do?
1. should for help/activate response
2. start CPR
3. attach monitor/defib pads
4. determine if rhythm is shockable
Which rhythms aren't shockable?
PEA and Asystole
- CPR for 2 min
- est. IV ax
- admin epi
- scan pt to determine new rhythm
What is the drug cycle for VF/VT?
- Epi 1 mg during second CPR cycle
- Amiodarone 300 mg during third CPR cycle
Biphasic is how many joules, normally? Monophasic?
Biphasic - start at 120-200 J
Monophasic - 360 J
List the 3 cardiac arrest drugs:
A patient has stable bradycardia, what is done? 1/6
Treat underlying cause:
- maintain airway
- oxygen if hypoxemia
- cardiac monitoring, BP, oximetry
- IV access
- 12 lead if readily available
What is done when the patient with bradycardia becomes symptomatic? What's the max dose?
First administer Atropine 0.5 mg q 3-5 min
- max dose of 3 mg
If Atropine is ineffective in tx symptomatic bradycardia, what are the options?
- Dopamine 2-10 mcg/kg/min
- Epinepherine 2-10 mcg/min
Pacing for symptomatic bradycardia begins at what rate and what force?
- rate of 60/min - increase until symptoms cease
- ~70 joules
- increase joules until capture, then 5 over
How is stable SVT treated?
1. valsalva maneuver
2. Adenosine - 6 mg, then 12 mg
How is unstable SVT treated?
- 50 - 100 joules depending on size
VF/VT is managed w/ cycles of CPR and what else?
- shock if rhythm stays in VF/VT
- Epinepherine 1 mg q 3-5 minutes
- Amioderone 300 mg, then 150 mg
PEA and Asystole is managed with rounds of what?
CPR 2 minutes
- Epi 1 mg q 3-5 minutes
- cycle through until rhythm is shockable