Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
|
Initial Rx for all Dysrhythmias
|
Monitor EKG
O2 Sat IV 250ml bolus with clear lungs - SO MR to maintain BP = or > 90 systolic - SO |
|
|
Definition of "Unstable" patient
|
BP < 90 AND chest pain OR dyspnea OR ALOC
|
|
|
Unstable Bradycardia WITH Pulse
|
Bradycardia severe (<30) AND patient unconscious:
- Begin chest compressions Atropine 0.5mg IVP for pulse < 60 - SO; MR q3-5" to max of 3mg - SO OR Atropine 1mg ET for pulse < 60 - SO; MR q3-5" to max of 6mg - SO If rhythm refractory to Atropine: ECP - BHPO If capture occurs: Sedate with Versed 1-5mg Slow IVP - BHPO After max Atropine and initiation of ECP: Dopamine (400mg/250ml) at 5-40mcg/kg/min IV Drip Titrate to BP = or > 90 - BHO |
|
|
Unstable A-Fib/Flutter (CONSCIOUS)
|
HR > 180:
- Versed 1-5mg slow IVP prn precardioversion - BHPO (If = or > 60 consider lower dose with attention to age and hydration status) - Sync cardiovert at 100J (or equivilent biphasic) - BHPO MR at 200, 300, 360J (or equivilent biphasic) - BHPO |
|
|
ECP Documentation
|
Capture of the pacing on rhythm strip
Milli-amperage employed Pulse rate before and after capture BP before and after capture Changes in symptoms (LOC, CP, SOB) |
|
|
Stable SVT
|
VSM - SO; MR - SO
*Patient with Bronchospasm or COPD Hx: ADENOSINE IS BHO* Adenosine 6mg IVP followed by 20ml NS IVP - SO Adenosine 12mg IVP followed by 20ml NS IVP - SO If NO sinus pause: MR x1 in 1-2" - SO |
|
|
Unstable SVT (with severe symptoms OR rhythm refractory to Rx) (CONSCIOUS)
|
- Versed 1-5mg slow IVP prn precardioversion - BHO
(if = or > 60 y/o consider lower dose with attention to age and hydration status) - Sync Cardiovert at 100J (or equivalent biphasic) - BHO MR at 200, 300, 360J - BHO |
|
|
Unstable A-Fib/Flutter (UNCONSCIOUS)
|
HR > 180:
- Sync cardiovert at 100J (or equivalent biphasic) - SO MR 200, 300, 360J (or equivalent biphasic) - SO MR - BHO |
|
|
Stable V-Tach
|
Witnessed Onset:
Precordial Thump - SO Lidocaine 1.5mg/kg slow IVP - SO MR 0.5mg/kg slow IVP q8-10" to max of 3mg/kg including initial bolus - SO OR Lidocaine 3mg/kg ET - SO MR 1mg/kg slow IVP q8-10" to max of 6mg/kg including initial bolus - SO |
|
|
Unstable V-Tach (CONSCIOUS)
|
- Versed 1-5mg slow IVP prn precardioversion - SO
(if = or > 60 y/o consider lower dose with attention to age and hydration status) - Sync Cardiovert at 100J (or equivalent biphasic) - SO MR at 200, 300, 360J - SO MR - BHO |
|
|
Unstable V-Tach (UNCONSCIOUS)
|
- Sync Cardiovert at 100J (or equivalent biphasic) - SO
MR at 200, 300, 360J - SO MR - BHO |
|
|
Unstable SVT (with severe symptoms OR rhythm refractory to Rx) (UNCONSCIOUS)
|
- Sync Cardiovert at 100J (or equivalent biphasic) - SO
MR at 200, 300, 360J - SO MR - BHO |
|
|
V-Fib / Pulseless V-Tach / Arrest
|
Witnessed or Cardiac Arrest with no monitor:
- Precordial thump - SO - CPR until ready to defibrillate - Defibrillate at max setting x1 - SO - CPR x 2" - 10 sec rhythm & pulse check - Repeat cycle as indicated by rhythm Once IV established and NO pulse: - Epi 1:10000 1mg IVP; MR q3-5" If still in V-Fib / V-Tach - Lidocaine 1.5mg/kg IVP; MR x1 in 3-5" - SO - Intubate (avoiding interruption of CPR- SO NG prn - SO If no IV established - Epi 1:1000 2mg ET (dilute to 10ml); MR q3-5" - SO OR - Epi 1:1000 10mg ETAD (dilute to 20ml, esophageal placement via blue port 1); MR q5"- SO - Lidocaine 3mg/kg ET; MR x1 in 3-5" - SO |
|
|
Postconversion V-Fib / V-Tach with Pulse = or > 60 (including witnessed spontaneous conversion, precordial thump, AED, AICD)
|
*IF INITIAL DOSE ALREADY GIVEN , CONTINUE WITH REPEAT DOSES*
Lidocaine 1.5mg/kg slow IVP - SO; MR 0.5mg/kg slow IVP q8-10" - SO to max of 3mg/kg including initial bolus OR Lidocaine 3mg/kg ET - SO; MR 1mg/kg ET q8-10" - SO to max of 6mg/kg including initial bolus |
