Arrhythmia Treatment

Front 1

Pulseless arrest
VF/VT

Back 1

Tx: Shock 200 J
CPR x 5 cycles
Recheck
Shock
CPR x 5, Recheck
(Intubate), (H&Ts) IV/IO access
Epi 1 mg IV/IO (Repeat q 3-5 min) OR Vasopressin 40 U IV/IO (may replace 1st or 2nd dose epi)
shock
CPR x 5
Amiodarone 300 mg IV/IO (may repeat 150 mg once) OR Lidocaine 1-1.5 mg/kg (may repeat .5-.75 mg/kg up to 3 mg/kg)
shock
CPR x 5
(Drip: .2-2 mg/min amiodarone, 2-4 mg/min lidocaine)

Front 2

Asystole/PEA

Back 2

IV-IO Access
Epi 1 mg IV/IO (repeat q 3-5 min) OR Vasopressin 40 U IV/IO for 1st or 2nd dose Epi
CPR x 5
(Intubate) (H&Ts)
Recheck
Atropine 1 mg IV/IO (repeat 3-5 min up to 3 doses)

Front 3

Hs and Ts

Back 3

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo/hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Tamponade, cardiac
Tension pneumothorax
Thrombosis, heart/lung
Trauma (volume, ICP)

Front 4

Bradycardia, severely symptomatic/ Mobitz II or 3rd blocks

Back 4

Hs&Ts
Transcutaneous pacing

Front 5

Bradycardia, not severely symptomatic/ Mobitz II or 3rd degree block

Back 5

Hs&Ts, Atropine .5mg IV q 3-5 min, max 3 mg in 24 h
Dopamine 2-10 ug/kg/min
OR
Epinephrine drip 2-10 ug/min

Front 6

Tachycardia, with pulse, unstable

Back 6

May sedate
Synchronized cardioversion 200 J

Front 7

Tachy, with pulse, stable, Narrow Regular

Back 7

SVT
Tx: vagal stim
adenosine 6 mg
Adenosine 12 mg (may repeat once)

Control rate: Diltiazem, Beta blockers

Front 8

Tachy, with pulse, stable, Narrow Irregular

Back 8

A-Fib/flutter
Tx: Consultation
Control rate: Diltiazem, Beta Blockers

Front 9

Tachy, with pulse, stable, Wide Regular

Back 9

V-tach
Tx: Amiodarone 150 mg over 10 min, may repeat to 2.2g/24h
Elective cardioversion

Can give amiodorone for burst of V tach or multifocal PVCs

Front 10

Tachy, with pulse, stable, Wide Irregular

Back 10

Torsades de points
Tx: Magnesium 1-2 g/5-50 min, possible cardiovert

Front 11

Narrow or wide, regular or irregular, delta wave

Back 11

WPW
Tx: Consultation
Amiodorone 150 IV/10 min

Front 12

Just tachy (jxn tach, sinus tach, atrial tach, a fib if tach, a flutter if tach)

Back 12

Tx cause/rate
Examples: stimulants, dehydrated, viral, H&Ts

Front 13

MI

Back 13

MONA:
Morphene
Oxygen
Nitroglycerin
Asprin

Front 14

Slow down drugs

Back 14

Beta blocker
Diltiazem
Adenosine
Amiodarone
Lidocaine

Front 15

Speed up/listen up drugs

Back 15

Epinephrine
Vasopressin
Atropine
Dopamine