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28 Cards in this Set
- Front
- Back
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Vfib/pVtach arrest |
Shock/Shock/Shock/Amio300/esmolol 500mcg |
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Fluids: Adult vs peds bolus |
Adult: 30cc/kg Peds: 20cc/kg |
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4-2-1 rule fluid maintenance |
4cc/hr x 10kg 2cc/hr x next 10 kg 1cc/hr for every 1 kg over |
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Burn fluid replacement |
4ml x %TBSA x weight (kg) 1/2 first 8hrs + 1/2 next 16 hrs |
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Normal CVP |
8-12mmHg |
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Plasma tonicity = ? 0.9NaCl = Osm/Na ? LR = Osm/Na ? 3% Na = Osm/Na ? |
Plasma tonicity = 300 0.9NaCl = 308/ 154 Na LR = 273/ 131 Na 3% Na = 1027/ 513 Na |
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Norepi drip = ? Epi drip = ? |
Norepi drip = 1-30 mcg/min (0.01mcg/kg/min) Epi drip = 1-10 mcg/min (0.01mcg/kg/min) |
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Dobutamine drip = ? Milrinone drip = ? |
Dobutamine drip = 1-40 mcg/kg/min Milrinone drip = 0.25 - 1 mcg/kg/min |
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Phenylephrine drip = ? Nitroprusside drip = ? |
Phenylephrine drip = 100mcg/min (0.1-5 mcg/kg/min) titrate by 100mcg/min. Nitroprusside drip = 0.1-4 mcg/kg/min |
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Stable bradycardia = ? Unstable bradycardia = 1. ? 2. ? 3. ? |
Stable bradycardia = supportive Unstable bradycardia = 1. Atropine 0.5mg IV q3min up to 3mg. (0.02mg/kg) 2. Transcutaneous pacing - rate of 60-70 bpm @ 50-100mAmp (max 200mAmp) 3. Epi (1-10mcg/min) (0.01mcg/kg/min) |
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SVT (stable) = 1. ? 2. ? 3. ? 4. ? 5. ? |
SVT (stable) = 1. Vagal maneuvers 2. Adenosine 6mg 3. Adenosine 12mg 4. Synchronized cardio version @ 100J (2-4J/kg) 5. Diltiazem 0.25mg/kg (max 20mg) |
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SVT Unstable = ? |
Synchronized cardioversion @ 50-100 J |
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SVT Unstable = ? |
Synchronized cardioversion @ 50-100 J |
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WPW w/ AVNRT & Afib RVR w/ WPW = ? |
Procainamide = 17mg/kg IV over 30 minutes *repeat up to 50mg/kg until complex breaks or >50% reduction in QRS |
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Multi focal atrial tach = ? 1. ? 2. ? 3. ? |
1. Treat underlying dz (Pulm dz/COPD/DigTox/Xanthine OD) 2. Diltiazem 10-20mg IV 3. Magnesium Sulf 2gram IV over 1 minute - then 1-2gram x hour |
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Frequent PVC's w/ instability = ? |
Lidocaine = 1-1.5 mg/kg IV |
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Vtach Stable = ? Vtach Unstable = ? PUlseless Vtach = ? |
Vtach Stable = Amio 150mg IV over 10 minutes * Amio drip = 1mg/min x 6 hours Vtach Unstable = DC cardiovert sync (100-200J) PUlseless Vtach = DC cardiovert sync (100-200J) + CPR |
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Torsades = 1. ? 2. ? Refractory Torsades = ? |
1. Overidepacing @ 90- 120bpm 2. MagSul @ 2 gran IV over 1 minute - drip 1-2mg/hr Refractory Torsades = * isoproterenol = 2-10 mcg/min IV |
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Afib w/ RVR Stable = **WATCH Hera Rate!!! + may cause hypotension!! 1. ? 2. ? 3. ? 4. ?
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1. Diltiazem = 0.25mg/kg IV over 2min --> 0.35mg/kg IV * drip 5-15mg/hour or 30mg PO 2. Metoprolol = 2.5-5mg IV bolus - repeat q5min * Max 15mg 3. Esmolol = 0.5mg/kg IV bolus followed by 50mcg/kg/min *if ineffective @4min: repeat 0.5mg/kg bolus + 100mcg/kg/min *refractory @4min: repeat 0.5mg/kg bolus + 150mcg/kg/min 4. Magnesium 4.5mg IV bolus over 20min |
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Afib w/RVR Unstable or poor EF? |
DC cardioversion @ 200J *Ottowa aggressive Afib protocol |
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ETT size: Adult = ? Peds = ? |
Adult = 6-8 mm @21-23cm at lip Peds = *Cuffed = 3.5 + (age/4) mm *Uncuffed = 4 + (age/4) mm |
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Intubation pretreatment for: ICP, cardiac ischemia, Ao dissection ? |
Fentanyl = 2-3 mcg/kg IV |
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Etomidate dose = ? MOA = ? |
Dose = 0.3 mg/kg ~ 20mg MOA = binds at Cl- ionopore at the GABA (a) receptor, increasing the duration of time for which the Cl- ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus. * Protein binding: 76%, primarily to serum albumin. * Metabolism: Hepatic. Metabolized rapidly by ester hydrolysis to inactive metabolites. *Route of elimination: 75% of excreted in the urine during the first day after injection. * Half life: 75 minutes. |
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Ketamine dose = ? MOA = ? |
Dose = 1-5mg/kg IV (0.5mg in Shock) MOA = N-methyl-D-aspartate (NMDA) receptors: antagonistopioid receptors: agonist/antagonist monoaminergic receptors, muscarinic receptors: antagonist voltage sensitive Ca ion channels. * Metabolism: hepatic. major metabolite is norketamine. *Elimination: 85-95% in urine. 3% bile and feces. * half life = 186 minutes ~ 3hrs |
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Indicators for respiratory assistance: 1. 2. 3. 4. 5. 6. |
1. Sat 02 < 90 2. Pa02 < 60mmHg on 40% 02 3. RR > 35 4. PaC02 > 55 mmHg 5. Vital Capacity < 15 ml/kg 6. A-a gradient > 350mmHg @ 100% 02 |
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Front (Term) |
Back (Definition) |
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Ventitalor set up: 1. Ideal Body weight ? 2. Vt ? 3. Reduce Vt by? 4. Rate? |
1. IBW = 50 + 2.3 (height (in) - 60) 2. Initial Vt = 8ml/kg of IBW 3. Tirarte 1ml/kg until SVT = 6ml/kg of IBW 4. Rate = baseline. Initial rates for normal ppl = 15 breaths/min 5. Flow rate 60 L/ min 6. PEEP 5-8cm H20 7. Plateau pressure = Alveolar pressure - < 30 cm H20 |
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Initial vent setting in COPD - Vt - Flow rate - Fi02 - RR - PEEP
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- Vt: 6-8ml/kg IBW - Flow rate: 60 L /min - Fi02: 40%, Maintain 02 > 88% - RR: 10, greater I:E ratio. Give time to expire. - PEEP: 0-5
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