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11 Cards in this Set

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Ventricular Fibrillation (VFib) or Pulseless Ventricular Tachycardia (VTach)
1. CPR immediately only until defibrillator is available
2. Defibrillate...continue CPR 2 minutes
3. Epinephrine....continue CPR 2 mins
4. Defibrillate....continue CPR 2 mins
5. Amiodarone...continue alternating defibrillation and epinephrine with continued CPR in between
Pulseless Electrical Activity:
any pulseless rhythm other than VFib/VTach and Asystole
CPR and Epi while trying to identify and treat the cause (H's & T's). (Don't shock)
Asystole
CPR and Epi while trying to identify and treat the cause (H's & T's). (Don't shock)
Reversible causes of PEA and Asystole (H's & T's)
Hypovolemia
Hypoxia
Hydrogen Ion (Acidosis)
Hypo/Hyperkalemia
Hypothermia

Tension pneumo
Tamponade, cardiac
Toxins (like drug OD)
Thrombosis, pulmonary or coronary
VTach with a pulse
1 - Amiodarone
2 - Procainamide
3 - Synchronized Cardioversion
Sinus bradycardia or heart block, asymptomatic
Monitor for development of symptoms (AMS, chest pain, low BP, dizziness)
Rapid AFib/AFlutter
If asymptomatic - we send them home on Cardizem, a beta-blocker, or digoxin for rate control and Coumadin for clot prevention. (teaching about coumadin - avoid leafy greens)

If symptomatic - synchronized cardioversion if drugs fail, but first perform a Transesophogeal echocardiogram (TEE) to look for clots. (You don't want to shock a clot up into their brain or lungs if one has developed)
Supraventricular Tachycardia (SVT)
1 - Valsalva (bear down)
2 - Adenosine rapid IV push (stops and reboots heart)
3 - Try Adenosine again
4 - Synchronized cardioversion
Premature Ventricular Contractions (PVCs) - symptomatic
Amiodarone or Procainamide IV
Look for cause to correct
First degree heart block
Monitor pt for adequate CO
Sinus bradycardia / 2nd Degree Block Types I and II / 3rd Degree Block - symptomatic
1 - Atropine 0.5 mg IVP, repeating to a total dose of 3 mg
2 - Pace (2nd Degree Type II Block and 3rd degree blocks only)