Aclspro.com V-Fib/v-Tach (Without Pulse)

Front 1

What is this algorithm for?

Back 1

Ventricular Fibrillation and Ventricular Tachycardia WITHOUT a pulse after the basic ABCDs (Primary ABCDs) have been started, and there is defibrillator on scene

Front 2

If you see a person collapse, what do you do?

Back 2

Shock Immediately?

Front 3

If you get to the scene, and you see the person go into a shockable rhythm, what do you do?

Back 3

Shock Immediately

Front 4

What is a shockable rhythm?

Back 4

V-Fib or V-Tach WITHOUT A PULSE

Front 5

What kinds of cardioversion are there?

Back 5

Electrical
Chemical

Front 6

What kinds of cardioversion are there?

Back 6

Synchronized

Unsynchronized

Front 7

What kinds of defibrillators are there?

Back 7

Automatic

or

Manual

Front 8

If a patient is in V-Tach or V-Fib, what kind of cardioversion do you use?

Back 8

Unsynchronized?

Front 9

What is the first thing you do for V-Fib/V-Tach without a pulse?

Back 9

Shock

Front 10

What are the different kinds of cardioverters are there?

Back 10

Monophasic

and

Biphasic

Front 11

What is a monophasic defibrillator?

Back 11

Electricity goes one way (Forward)?

Front 12

What is a biphasic defibrillator?

Back 12

Electricity goes both ways (Forward and back)

Front 13

If using a monophasic defibrillator, how much power do you use for the first shock?

Back 13

360 Joules

Front 14

If using a monophasic defibrillator, how much power do you use for second and following shocks?

Back 14

360 Joules

Front 15

If necessary, how often should you shock a patient with V-Fib/V-Tach without a pulse?

Back 15

Every two minutes

Front 16

What is the second step in the V-Fib/V-Tach without a pulse algorithm?

Back 16

CPR

Front 17

For V-Fib/V-Tach without a pulse, when should you do CPR?

Back 17

Immediately after shock!

Front 18

When using a basic airway how many compressions/respirations do you give?

Back 18

30 Compressions/Two Breaths

Front 19

At what speed do you give compressions?

Back 19

100 per minute

Front 20

At what speed do you give respirations?

Back 20

12-20 per minute

Front 21

If you give a breath every three seconds, how many breaths are you giving per minute?

Back 21

20

Front 22

If you give a breath every four seconds, how many breaths are you giving per minute?

Back 22

15

Front 23

If you give a breath every five seconds, how many breaths are you giving per minute?

Back 23

12

Front 24

If you are using an advanced airway, how many compressions do you give?

Back 24

100 Compressions

Front 25

If you are using an advanced airway, how many respirations do you give?

Back 25

12-20

Front 26

When giving CPR, how long should you give it?

Back 26

Two minutes

Front 27

When doing CPR, what should you do every two minutes?

Back 27

Check heart rhythm and pulse

Front 28

If a patient shows electrical activity on the ECG, then their heart is always beating...true or false?

Back 28

FALSE!...just because there is electrical activity on the ECG THAT DOESN'T MEAN THERE IS A PULSE!

Front 29

When doing CPR, you should always use an advanced airway...true or false?

Back 29

FALSE!...if the patient is getting enough oxygen using a basic airway you can keep using it?

Front 30

What is the third step in the V-Fib/V-Tach without a pulse?

Back 30

Check heart rhythm and pulse

Front 31

When doing CPR, how often should you check pulse and heart rhythm?

Back 31

Every two minutes

Front 32

When doing CPR, make sure you check the heart rhythm while CPR is in progress...true or false?

Back 32

FALSE! Never check heart rhythm while CPR is in progress

Front 33

Why shouldn't you check the heart rhythm while CPR is in progress?

Back 33

You will get an inaccurate rhythm

Front 34

When doing CPR, you should check the heart rhythm while CPR is in progress...true or false?

Back 34

FALSE!...the patient's heart should be circulating blood, not you!

Front 35

After two minutes of CPR and checking heart rhythm and pulse, what do you do?

Back 35

SHOCK AGAIN if the rhythm is not corrected!

Front 36

When should you check pulse?

Back 36

If there is an organized or unshockable rhythm

Front 37

What is the next step in the V-Fib/V-Tach without a pulse algorithm?

Back 37

Start advanced ABCs (Secondary ABCDs)
Continue this algorithm if necessary
Give drugs
Minimize interruptions in compressions
Think about differential diagnosis

Front 38

What are the advanced ABCs (Secondary ABCDs)?

Back 38

Airway
Breathing
Circulation
Differential Diagnosis

Front 39

When should you continue this algorithm?

Back 39

If V-Fib or V-Tach without a pulse continues

Front 40

If chest compressions have to be interrupted, what is the MOST amount of time it can be interrupted?

Back 40

<10 seconds

Front 41

What is the VF/PVT protocol for?

Back 41

Ventricular Fibrillation

or

Ventricular Tachycardia With No Pulse (Pulseless Ventricular Tachycardia)

Front 42

What is V-Fib?

Back 42

When the heart's electricicity becomes disorganized, and the ventricles squeeze fast and out of rhythm (AKA they "flutter" instead of beat).

Front 43

What does V-Fib look like?

Back 43

Front 44

What are the types of V-Fib??

Back 44

Course

and

Fine

Front 45

What does fine V-Fib look like?

Back 45

V-Fib with small waves?

Front 46

What does course V-Fib look like?

Back 46

V-Fib with medium to large waves?

Front 47

During V-Fib, the heart pumps twice as much blood, true or false?

Back 47

False, DURING V-FIB THE HEART PUMPS LITTLE OR NO BLOOD?

Front 48

What is "Pulseless Ventricular Tachycardia"?

Back 48

A fast heartbeat that comes from one or both? of the ventricles of the heart, and there is no pulse.

Front 49

What does "Pulseless Ventricular Tachycardia" (PVT) look like?

Back 49

Is PVT the same as VT?

Front 50

What is the acronym for the VF/PVT protocol?

Back 50

SCREAM

Front 51

What does "SCR EAM" stand for?

Back 51

Shock
CPR
Rhythm
(At this point, do secondary ABCD's, continue the protocol if necessary,and do problem search?)
Epinephrine
Antiarrhythmic
Medications
(Antiarrhythmic and Medications are together)

Front 52

When do you use the VF/PVT protocol?

Back 52

IF THERE IS V-FIB OR PVT, and;

PRIMARY ABCD's are started, and;

You have an AED or manual defibrillator.

Front 53

What is the first step in the VF/PVT protocol?

Back 53

PRIMARY ABCD's

Front 54

What is the second step in the VF/PVT protocol?

Back 54

Get AED or manual defibrillator?

Front 55

What is the third step in the VF/PVT protocol?

Back 55

Check rhythm.

Front 56

If rhythm is VF or PVT what do you do?

Back 56

Use "SCREAM".

Front 57

What is the first step in "SCREAM"?

Back 57

Shock

Front 58

For the first and following shocks, how much power should you use?

Back 58

The manufactur's recomendation, but if that is not available:

360J Monophasic

200J Biphasic (Depending on model)

Front 59

How many times do you shock and do a cycle of CPR before you give drugs in the VF/PVT protocol?

Back 59

TWO TIMES:

Shock
CPR
Shock
CPR
Drugs (During CPR?)
Shock

Front 60

If a manual defibrillator is biphasic, how much power should you use?

Back 60

Manufacturer's recomendation?, or 200J if recomendation not available.

Front 61

If manual defibrillator is biphasic, and manufactur's recomendation is unavailable, how much power should you use?

Back 61

200J for first shock, and same or more power for following shocks.

Front 62

After the first shock, how many more times should you shock?

Back 62

Until problem is solved, or given to higher care?

Front 63

After the first shock, how often should you do it?

Back 63

Every two minutes if necessary (In between cycles of CPR?)?

Front 64

After the first shock, what do you do?

Back 64

CPR

Front 65

How do you do CPR with a basic airway?

Back 65

30 compressions and 2 breaths.

Front 66

How do you do CPR with an advanced airway?

Back 66

100 compressions per minute with 8-10 breaths per minute?

Front 67

During CPR, you should check rhythm and pulse, true or false?

Back 67

False, you should check neither DURING CPR.

Front 68

After the first two minutes of CPR and every following cycle, what do you do?

Back 68

Check heart rhythm and speed?, and shock if necessary.

Front 69

You should check for a pulse after every two cycles of CPR, true or false?

Back 69

False, YOU SHOULD ONLY CHECK PULSE IF THERE IS AN ORGANIZED OR UNSHOCKABLE RHYTHM.

Front 70

After checking the rhythm, what should you do?

Back 70

Start the SECONDARY ABCD's, and continue protocol if necessary.

Front 71

When can you give drugs in the VF/PVT protocol?

Back 71

During CPR, and before or after shock.

Front 72

Twenty seconds is the longest you should stop chest compressions, true or false?

Back 72

False, TEN seconds is the absolute most you should stop chest compressions.

Front 73

In between the "R" and "E" in "SCREAM", what should you do?

Back 73

Secondary ABCD's, continue protocol if necessary, and problem search?

Front 74

After secondary ABCD's, continuing protocol if necessary, and problem search what do you do?

Back 74

"E"...Epinephrine or Vasopressin

Front 75

When should you use epinephrine for the VF/PVT protocol?

Back 75

???

Front 76

When should you use vasopressin for the VF/PVT protocol?

Back 76

???

Front 77

How much epinephrine should you give for the VF/PVT protocol?

Back 77

1mg IV or IO push

Front 78

In the VF/PVT protocol, how often should you give epinephrine?

Back 78

Every 3-5 minutes

Front 79

What is the maximum amount of epinephrine you should give in the VF/PVT protocol?

Back 79

???

Front 80

Is there any time you SHOULD NOT use epinephrine in the VF/PVT protocol?

Back 80

???

Front 81

If you choose to give vasopressin, how much should you give?

Back 81

40 Units IV or IO push

Front 82

If you choose to give vasopressin, how often should you give it?

Back 82

You must wait ten minutes after giving it to give another drug.

Front 83

When can you use vasopressin in the VF/PVT protocol?

Back 83

In place of the first or second dose of epinephrine.

Front 84

If you choose to use vasopressin, how many times can you give it?

Back 84

ONCE

Front 85

What is the most vasopressin you can give in the VF/PVT protocol?

Back 85

40 Units (Because you can only give it ONCE)

Front 86

After epinephrine or vasopressin, what is the next step in the VF/PVT protocol?

Back 86

Antiarrhythmic Medicines

Front 87

What are the antiarrhythmic medicines used in the VF/PVT protocol?

Back 87

Amiodarone

Lidocaine

Magnesium Sulfate

Front 88

What is the acronym for the anitarrhythmic medicines used in the VF/PVT protocol?

Back 88

Any Legitimate Medication

Front 89

What does "Any Legitimate Medication" stand for?

Back 89

Amiodarone

Lidocaine

Magnesium Sulfate

Front 90

What is a "Unit"?

Back 90

???

Front 91

After epinephrine, what is the first drug you should give for VF/PVT?

Back 91

"Any"...Amiodarone

Front 92

If you use amiodarone for the VF/PVT protocol, how much should your first dose be?

Back 92

300 mg IV or IO push

Front 93

What is the most amiodarone you can give a patient in the VF/PVT protocol?

Back 93

450mg in TWO DOSES.

First Dose=300mg

Second Dose=150mg

Front 94

If you give a second dose of amiodarone for the VF/PVT protocol, how much should it be?

Back 94

150 mg

Front 95

How often should you give amiodarone in the VF/PVT protocol?

Back 95

Every 3-5 minutes.

Front 96

After epinephrine, what is another drug you can give for VF/PVT protocol if amiodarone is unavailable?

Back 96

"Legitimate"...Lidocaine

Front 97

When should you give lidocaine in the VF/PVT protocol?

Back 97

ONLY IF AMIODARONE IS UNAVAILABLE?

Front 98

If you give lidocaine, how much should the first dose be for the VF/PVT protocol?

Back 98

1 - 1.5mg/kg IV or IO push

Front 99

What is the most doses of lidocaine you can give for VF/PVT?

Back 99

A total of THREE.

Front 100

If a second and third dose of lidocaine is needed for VF/PVT, how much should you give?

Back 100

0.5 - 0.75mg/kg IV or IO push

Front 101

What is the maximum lidocaine loading dose you can give in the VF/PVT protocol?

Back 101

3mg

Front 102

If you have to give a second and third dose of lidocaine for VF/PVT, how often should you give it?

Back 102

Every 5-10 minutes

Front 103

What is the maximum LOADING dose of lidocaine for the VF/PVT protocol?

Back 103

3mg/kg

Front 104

What is a loading dose?

Back 104

A large first dose of a drug, or series of doses given to build up a therapeutic amount of the drug in the body.

Front 105

After epinephrine and lidocaine, what is another drug you can give in the VF/PVT protocol?

Back 105

"Medication"...Magnesium Sulfate

Front 106

What are the only things you can give magnesium sulfate for in the VF/PVT protocol?

Back 106

Tordades de Pointes

Hypomannesemia

Front 107

What is torsades de pointes?

Back 107

A kind of V-Tach that changes more than once?, and in which the QRS waves are different from beat to beat.

Front 108

What does torsades de pointes look like?

Back 108

(Is this from lead II?)

Front 109

How do you tell the difference between V-Fib/PVT and Torsades?

Back 109

???

Front 110

What is hypomagnesemia?

Back 110

Not enough magnesium.

Front 111

What are the signs and/or symptoms of hypomagnesemia?

Back 111

Muscle Cramps
Weakness
Tremors
Irregular Heartbeats

Front 112

If a patient has torsades de pointes or hypomagnesemia, how much magnesium sulfate should you give for the VF/PVT protocol?

Back 112

1-2g IV or IO push diluted in 10 ml D5W

Front 113

What is D5W?

Back 113

5% sugar (Dextrose) in water?

Front 114

If you give magnesium sulfate in the VF/PVT protocol, how long should you take inject it into an IV or IO port?

Back 114

5-20 minutes

Front 115

If you give magnesium sulfate in the VF/PVT protocol, how many times should you give it?

Back 115

???

Front 116

According to Doogie, if you witness the VF/PVT after you get there, what should you do?

Back 116

Shock immediately.

Front 117

According to Doogie, if you don't witness the VF/PVT after you get there, what should you do?

Back 117

Two minutes of CPR, and then shock?