Als

Front 1

What are the shockable rhythms?

Back 1

Vientricular fibrilation and puseless ventricular tachycardia

Front 2

What are the 4 Hs and Ts of reversible causes of cardiac arrest?

Back 2

Hypoxia

Hypovolaemia

Hypo/hyperkalaemia or other metabolic

Hypothermia

Tamponade

Toxins

Thombus

Tension pneumothorax

Front 3

During shockable rhythms, what drugs should be given and when?

Back 3

1mg adrenaline after 3rd shock

300mg amiodarone after 3rd shock

150mg amiodarone after 5th shock

1mg adrenaline every 3-5 minutes

Front 4

What drug should be given in non-shockable rhythms? How often should it bbe gven?

Back 4

1mg Adrenaline ASAP then every 3-5 minutes (alternating rhythm checks)

Front 5

What positional change in obstetric cardiac arrest?

Back 5

Left lateral tilt

Front 6

What are the 4 life-threatening signs in arrhythmias?

Back 6

Shock

Syncope

Heart failure

MI

Front 7

What are the 4 risks of asystole in bradycardia?

Back 7

Recent asystole

Mobitz Type II

Complete heart block with broad QRS

Ventricular pause >3s

Front 8

What drugs should be given in life threatening bradycardia?

Back 8

Atropine 500mg repeated up to 6 times (3g)

Bonus; if pacing unavailable, adrenaline, isoprenaline or dopamine

Front 9

When should atropine not be given to bradycardic patients?

Back 9

When they have had a heart transplant

Front 10

What drug should be given for bradycardia 2ndry to beta blockers or CCBs?

Back 10

Glucagon

2-10mg IV in glucose 5%, then 50mcg per kg per hour IV infusion

Front 11

When should drug tratment be used in compromised tachycardia?And what drug should be used?

Back 11

After 3 unsucessful synchronised shocks

300mg Amiodarone IV over 10-20 mins

Then 4th shock

Then amiodarone infusion 900mg IV over 24h

Front 12

What shock strength should be given in broad complex tachycardia?

Back 12

120-150J then increased incrementally

Front 13

What shock strength should be given for narrow complex tachycardia or atrial flutter?

Back 13

70-120 J then increasing incrementally

Front 14

What shock strength should be given for AF?

Back 14

Maximum strength

Front 15

When should naloxone be used and how much?

Back 15

Opoid overdose +/- reduced consiousness

400mcg IV naloxone

OR 800mcg IM/scut naloxone

OR 2mg naloxone intranasal

Front 16

What is flumezanil used for and how should it be given?

Back 16

For benzo overdose

200mcg IV then 100mcg every minute until patient is conscious

Front 17

What are the 3 main features of anaphylaxis?

Back 17

Hypotension and tachycardia

Airway obstruction

Skin changes

Front 18

Which drugs, how much and when should be given in refractory anaphylaxis?

Back 18

0.5mg IM immediately and every 5 minutes

Rapid bolus of IV crystalloid (eg NaCl)

Front 19

When should refractory anaphylaxis pathway be followed?

Back 19

If no improvement after 2 doses of adrenaline

Front 20

What are the drugs and dosages for an asthma attack?

Back 20

O SH I T MI

Oxygen - 15L via resevoir mask

Salbutamol - 5mg nebulised, 250mcg IV

Hydrocortisone - 100mg IV (or 40mg prednisolone PO)

Ipratropium bromide - 500mcg neb

(Theophylline/)Aminophylline - 5mg per kg

Magnesium sulphate - 2g IV

(Intubation)

Hint 20

O SHI*T ME

Front 21

What are the features of severe asthma?

Back 21

PEF 33-50% predicted

RR 25

BPM >110

Cannot complete sentences

Front 22

What are features of life-threatening asthma?

Back 22

PEF <33%

Sats <92% or PaO2 <8Pa

CO2 >4.6 (can be "normal")

Silent chest, cyanosis or poor resp effort

Arrhythmia

Hypotension

Altered concious level

Front 23

What drugs should be given in severe hyperkalaemia?

Back 23

Calcium - 10mmL chloride or 30mL gluconate

Insulin/dextrose - 10U insulin in 50mL 50% dextrose

Salbutamol - 10-20mg nebulised

(Sodium bicarbonate 50mmol IV in cardiac arrest)

Front 24

What drug should be given in arrest with severe hyperkalaemia?

Back 24

Sodium bicarbonate 50mmol IV

Front 25

What level of potassium is considered severe hyperkalaemia?

Back 25

>6.5mmol per L

Front 26

How should tranexamic acid be given?

Back 26

1g IV over 10 minutes

then

1g IV over 8h

Front 27

What electrolyte imbalance can occur in major heamorrhage? And how would you treat it?

Back 27

Hypocalcaeima

10% Clacium chloride 10ml IV

10% calcium gluconate 30ml IV

Front 28

What blood products should be used in major haemorrhage?

Back 28

1:1 ratio red cells and FFP

Cryoprecipitate if fibronigen low

Front 29

What treatment should be used for PE with an eGFR of <30?

Back 29

Unfractionated heparin - 5000 - 10 000 U bolus, then 18U per kg IV infusion

Front 30

What treatment should be used in massive PE with haemodynamic instability?

Back 30

Unfractionated heparin (5000 U - 10 000 U then 18U per kg infusion)

Fibrinolysis

- tenecteplase 500-600mg per kg IV

- Alteplase 50mg IV bolus then again after 30 mins if still arresting

Front 31

What PE treatment should be given if haemondynamically stable AND eGFR >30?

Back 31

Fondaparinux

- <50kg: 5mg SC

- 50-100 kg: 7.5mg SC

- >100kg: 10mg SC

or

LMW Heparin

- Dalteparin 200U per kg SC

- Enoxaparin 1.5 mg per kg SC if uncomplicated (else 1mg per kg)

Front 32

What is the mainstay treatment of tachy arrhythmias?

Back 32

Syncornised DC shock (up to 3 times, then give meds)

Front 33

What drug should be given if 3 synchronised shocks in tachy arrhythmias has not worked?

Back 33

Amiodarone 300mg IV

Then repeat shock

Than amiodarone infusion 900mg over 24h

Front 34

What are the likely rhythms in an irregular broad complex QRS tachyarrhythmia? How should they be treated?

Back 34

AF with bundle branch block - treat as narrow complex

Polymorphic VT (e.g. torsades) - magnesium 2g IV

Front 35

What are the likely rhythms in an regular broad complex QRS tachyarrhythmia? How should they be treated?

Back 35

VT - amiodarone 300mg IV

SVT with bundle branch block - treat at narrow

Front 36

What are the likely rhythms in a regular narrow complex QRS tachyarrhythmia? How should they be treated?

Back 36

SVT

Vagal manoeuvres

Adenosine - 6mg, then 12mg, then 18mg

if ineffective

Verapamil or beta-blocker

Front 37

What are the likely rhythms in an irregular narrow complex QRS tachyarrhythmia? How should they be treated?

Back 37

AF

beta-blocker

Digoxin or amiodarone if heart failure

Anticoagulate if >48h

Front 38

Venturi mask - what flow does each colour represent?

Back 38

BLUE = 2-4L/min = 24% O2WHITE = 4-6L/min = 28% O2YELLOW = 8-10L/min = 35% O2RED = 10-12L/min = 40% O2GREEN = 12-15L/min = 60% O2

Hint 38

By the Way You R Great

Front 39

What is a normal PR interval

Back 39

0.12-2s (3-5 small squares)

Front 40

What shock strength should be given in VF?

Back 40

At least 120J

Front 41

How should defib pads be placeD in those with an ICD?

Back 41

At least 10-15cm from the ICD