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105 Cards in this Set
- Front
- Back
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Adrenaline actions |
Naturally occurring catecholamine Alpha and beta effects Peripheral vasoconstriction via alpha-adrenergic action Directs cardiac output to brain and myocardium May facilitate defib by improving myocardial blood flow during CPR |
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Adrenaline indications |
VF or pulseless VT - after 2nd shock and every 2nd cycle Asystole or PEA - immediately then every 2nd cycle |
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Adrenaline dosage |
1 mg (1 in 10,000 or 1 in 1000) IV push Via ETT tube x3 times the dose diluted with 10-20mls sterile water |
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Adrenaline adverse affects |
Tachyarrhythmias HTN post resus Tissue necrosis at site of extravasation |
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Amiodarone actions |
Class III antiarrhythnic agent Affects Potassium sodium and calcium channels Prolongs the refractory period of atrial, nodal and ventricular tissue by prolonging action potential duration Reduces rate of impulse conduction through the AV node Decreases sinus node automaticity |
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Amiodarone indications |
VF or pulseless VT (after 3rd shock) Consider for prophylaxis of recurrent VF/VT AF |
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Amiodarone dosage and administration |
300mg slow IV push 20mls 5% Dex pre and post Additional 150mg slow IV push may be considered 3-5 mins after first dose For uncompromised tachyarrhymias infuse 300mg over 20-30 mins. Followed by infusion of 10-50mcg/kg over 24 hours |
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Amiodarone adverse effects |
AV blocks Prolonged QT interval Hypotension Bradycardia |
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Adenosine actions |
Transiently blocks conduction through the AV node interrupting re-entry pathways through the node Half life 0.6-10 seconds |
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Adenosine indications |
Indications: SVT (haemodynamically stable) Paroxysmal SVT To differentiate between SVT and VT (reveal underlying rhythm eg A flutter, AF) No effect on VT Will terminate AVNRT |
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Adenosine indications |
Indications: SVT (haemodynamically stable) Paroxysmal SVT To differentiate between SVT and VT (reveal underlying rhythm eg A flutter, AF) No effect on VT Will terminate AVNRT |
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Adenosine contraindications |
2nd or 3rd degree AV blocks Sick sinus syndrome Acute asthma (can precipitate bronchospasam) Long QT Decompensated HF |
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Adenosine indications |
Indications: SVT (haemodynamically stable) Paroxysmal SVT To differentiate between SVT and VT (reveal underlying rhythm eg A flutter, AF) No effect on VT Will terminate AVNRT |
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Adenosine contraindications |
2nd or 3rd degree AV blocks Sick sinus syndrome Acute asthma (can precipitate bronchospasam) Long QT Decompensated HF |
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Adenosine dosage and administration |
6mg IV push followed by rapid 20ml flush Wide bore IV or central line if possible Can be followed by a further 12mg (which can be repeated) |
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Adenosine indications |
Indications: SVT (haemodynamically stable) Paroxysmal SVT To differentiate between SVT and VT (reveal underlying rhythm eg A flutter, AF) No effect on VT Will terminate AVNRT |
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Adenosine contraindications |
2nd or 3rd degree AV blocks Sick sinus syndrome Acute asthma (can precipitate bronchospasam) Long QT Decompensated HF |
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Adenosine dosage and administration |
6mg IV push followed by rapid 20ml flush Wide bore IV or central line if possible Can be followed by a further 12mg (which can be repeated) |
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Adenosine side effects |
Sinus arrest 2-10 sec AV blocks Bradycardia Hypotension Dyspnoea Facial flushing Headache Chest pressure Feeling of impending doom |
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Atropine actions |
Anticholenergic agent Suppresses parasympathetic innervation allowing the sympathetic nervous system to take over |
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Atropine actions |
Anticholenergic agent Suppresses parasympathetic innervation allowing the sympathetic nervous system to take over |
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Atropine indication |
Severe symptomatic bradycardia 2nd degree AV block type 2/movies type 2 (regular or sporadic non conduction of a QRS) Complete heart block |
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Atropine actions |
Anticholenergic agent Suppresses parasympathetic innervation allowing the sympathetic nervous system to take over |
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Atropine indication |
Severe symptomatic bradycardia 2nd degree AV block type 2/movies type 2 (regular or sporadic non conduction of a QRS) Complete heart block |
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Atropine dosage |
500-600mcg IV push, repeated every 3-5 mins up to a total of 3mg |
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Atropine actions |
Anticholenergic agent Suppresses parasympathetic innervation allowing the sympathetic nervous system to take over There will be no response in a heart transplant patient due to inervation |
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Atropine indication |
Severe symptomatic bradycardia 2nd degree AV block type 2/movies type 2 (regular or sporadic non conduction of a QRS) Complete heart block |
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Atropine dosage |
500-600mcg IV push, repeated every 3-5 mins up to a total of 3mg |
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Atropine side effects |
Tachyarrthmias Pupillary dilation Delirium Urinary retention Increased ICP Excitement |
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Isoprenaline actions |
Sympathomimetic amine Acts on beta 1 adrenergic receptors with inotropic, dromotropic and chronotropic effects (Increased contraction force, velocity and speed) |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline side effects |
Tachyarrthmias/palpitations Ischaemic chest pain Headache |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline side effects |
Tachyarrthmias/palpitations Ischaemic chest pain Headache |
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Isoprenaline dose |
3mg in 50 mls NaCl Comence at 2mcg/min Increase by 1-2 mcg/min every 3-5 mins guided by ventricular response and MAP |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline side effects |
Tachyarrthmias/palpitations Ischaemic chest pain Headache |
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Isoprenaline dose |
3mg in 50 mls NaCl Comence at 2mcg/min Increase by 1-2 mcg/min every 3-5 mins guided by ventricular response and MAP |
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Calcium actions |
Required for normal nerve and muscle activity Transiently increases myocardial contractility and excitability and SVR |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline side effects |
Tachyarrthmias/palpitations Ischaemic chest pain Headache |
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Isoprenaline dose |
3mg in 50 mls NaCl Comence at 2mcg/min Increase by 1-2 mcg/min every 3-5 mins guided by ventricular response and MAP |
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Calcium actions |
Required for normal nerve and muscle activity Transiently increases myocardial contractility and excitability and SVR |
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Calcium dosage and admin |
5-10mls 10% calcium chloride Or 10mls 10% calcium glauconate IV |
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Calcium adverse effects |
Possible increase in myocardial and cerebral tissue injury mediating cell death Tissue necrosis at site Routine admin is not recommended |
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Isoprenaline indications and precautions |
Bradycardia with poor perfusion Caution: acute or recent MI IHD Hypotension due to intravascular volume depletion HTN Contraindicated: HR >120 AV block due to dig toxicity |
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Isoprenaline side effects |
Tachyarrthmias/palpitations Ischaemic chest pain Headache |
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Isoprenaline dose |
3mg in 50 mls NaCl Comence at 2mcg/min Increase by 1-2 mcg/min every 3-5 mins guided by ventricular response and MAP |
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Calcium actions |
Required for normal nerve and muscle activity Transiently increases myocardial contractility and excitability and SVR |
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Calcium dosage and admin |
5-10mls 10% calcium chloride Or 10mls 10% calcium glauconate IV |
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Calcium adverse effects |
Possible increase in myocardial and cerebral tissue injury mediating cell death Tissue necrosis at site Routine admin is not recommended |
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Calcium indications |
Not given routinely Hyperkalaemia Hypocalciemia Calcium channel blocker therapy or overdose |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Magnesium actions |
Electrolyte essential for membrane stability Hypomag can cause myocardial hyper excitability especially in the setting of hypokalaemia and dig toxicity |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Magnesium actions |
Electrolyte essential for membrane stability Hypomag can cause myocardial hyper excitability especially in the setting of hypokalaemia and dig toxicity |
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Magnesium indication |
Torsades de pointes Cardiac arrest associated with dig toxicity VF/pulseless VT (when refractory to defib and adrenaline) Hypokalaemia Not routinely give in an arrest |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Magnesium actions |
Electrolyte essential for membrane stability Hypomag can cause myocardial hyper excitability especially in the setting of hypokalaemia and dig toxicity |
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Magnesium indication |
Torsades de pointes Cardiac arrest associated with dig toxicity VF/pulseless VT (when refractory to defib and adrenaline) Hypokalaemia Not routinely give in an arrest |
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Magnesium dose/admin |
5 mmol SLOW IV push May be repeated once Followed by an infusion of 20mmol over 4 hours |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Magnesium actions |
Electrolyte essential for membrane stability Hypomag can cause myocardial hyper excitability especially in the setting of hypokalaemia and dig toxicity |
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Magnesium indication |
Torsades de pointes Cardiac arrest associated with dig toxicity VF/pulseless VT (when refractory to defib and adrenaline) Hypokalaemia Not routinely give in an arrest |
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Magnesium dose/admin |
5 mmol SLOW IV push May be repeated once Followed by an infusion of 20mmol over 4 hours |
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Magnesium adverse effects |
Rapid administration can cause: Asystole Significant clinical hypotension Excessive use can cause: Respiratory failure Respiratory muscle weakness |
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Lignocaine actoin |
Class 1b sodium channel blocker Shortened action potentials Suppresses automaticity of ventricular ectopic foci Action is restricted to ischaemic ventricular myocardial cells Local anaesthetic |
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Lignocaine indications |
Used when amiodarone cannot be used When ventricular ischaemic tissue is thought to be the cause of the arrest VF/pulseless VT refractory to defib May be used as prophylaxis for recurrent VF/VT |
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Potassium actions |
Electrolyte essential for maintaining membrane stability Low K can lead to life threatening ventricular arrhythmias especially in the setting of dog toxicity and low mag |
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Lignocaine adverse effects |
Coma Seizure Decreases effectiveness of defibrillation Hypotension |
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Potassium indications |
Persistent VF due to suspected or documented hypokalaemia |
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Potassium dosage/admin and side effect |
5mmol SLOW IV push Bradycardia Hypotension Asystole Extravasation at the site |
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Magnesium actions |
Electrolyte essential for membrane stability Hypomag can cause myocardial hyper excitability especially in the setting of hypokalaemia and dig toxicity |
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Magnesium indication |
Torsades de pointes Cardiac arrest associated with dig toxicity VF/pulseless VT (when refractory to defib and adrenaline) Hypokalaemia Not routinely give in an arrest |
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Magnesium dose/admin |
5 mmol SLOW IV push May be repeated once Followed by an infusion of 20mmol over 4 hours |
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Magnesium adverse effects |
Rapid administration can cause: Asystole Significant clinical hypotension Excessive use can cause: Respiratory failure Respiratory muscle weakness |
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Lignocaine actoin |
Class 1b sodium channel blocker Shortened action potentials Suppresses automaticity of ventricular ectopic foci Action is restricted to ischaemic ventricular myocardial cells Local anaesthetic |
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Lignocaine indications |
Used when amiodarone cannot be used When ventricular ischaemic tissue is thought to be the cause of the arrest VF/pulseless VT refractory to defib May be used as prophylaxis for recurrent VF/VT |
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Lignocaine dosage/admin |
1-1.5 mg/kg IV slow push A further 0.5-0.75mg/kg May be considered Diluted dose via ETT Not recommended until ROSC |
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Metaraminol actions |
Sympathomimetic amine Vasopressor to increase BP in emergency situations Positive inotropic effect on the heart and peripheral vasoconstriction Onset of action 1-2 min post IV injection Duration of action 20mins - 1 hour |
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Metaraminol actions |
Sympathomimetic amine Vasopressor to increase BP in emergency situations Positive inotropic effect on the heart and peripheral vasoconstriction Onset of action 1-2 min post IV injection Duration of action 20mins - 1 hour |
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Metaraminol dosage |
0.5mg = 1ml (prediluted vial) IV push Repeat every 5mins as required Can consider an infusion 1-5mh/hr |
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Metaraminol actions |
Sympathomimetic amine Vasopressor to increase BP in emergency situations Positive inotropic effect on the heart and peripheral vasoconstriction Onset of action 1-2 min post IV injection Duration of action 20mins - 1 hour |
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Metaraminol dosage |
0.5mg = 1ml (prediluted vial) IV push Repeat every 5mins as required Can consider an infusion 1-5mh/hr |
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Metaraminol side effects |
Tachyarrthmias Bradycardia Necrosis at site |
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Sodium bicarbonate (NaHCO3) actions |
Alkalising solution used for severe metabolic acidosis Not routinely used in cardiac arrest |
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Sodium bicarbonate (NaHCO3) actions |
Alkalising solution used for severe metabolic acidosis Not routinely used in cardiac arrest |
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Sodium bicarbonate indications |
documented metabolic acidosis Hyperkalemia Tricyclic overdose Prolonged arrest >15mins |
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Sodium bicarbonate (NaHCO3) actions |
Alkalising solution used for severe metabolic acidosis Not routinely used in cardiac arrest |
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Sodium bicarbonate indications |
documented metabolic acidosis Hyperkalemia Tricyclic overdose Prolonged arrest >15mins |
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Sodium bicarbonate dosage |
1mmol/kg over 2-3 mins Then guided by ABG |
