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19 Cards in this Set

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In asymptomatic bradycardia, what steps do you initiate?
Airway Management
IV NaCl KVO
Contact Med Control
In Symptomatic Bradycardia (w/o 3rd Degree Block), what steps to you initiate?
Lie patient flat with legs elevated.
IV NaCl @ KVO.
0.5 mg Atropine IV Fast repeated every 3 minutes if symptoms persist and until 0.04 mg/kg is reached.
If refractory to Atropine, initiate Cardiac Pacing.
What is the maximum total amount of Atropine to be administered for Bradycardia?
0.04 mg/kg
For Bradycardia, how many minutes between Atropine administration?
3 minutes
In Symptomatic Bradycardia w/ a 3rd Degree Block, what steps to you initiate?
IV NaCl @ KVO.
1.0 mg Atropine IV Fast repeated once in 3 minutes.
If refractory to Atropine, initiate Cardiac Pacing.
In Bradycardia, what are the criteria for:

Giving 0.5 mg Atropine?
Giving 1.0 mg Atropine?
Giving no Atropine at all?
0.5 mg - Symptomatic Bradycardia (decreased LOC, chest pain, dyspnea, and/or hypotension) without a 3rd Degree AV Block.

1.0 mg - Symptomatic Bradycardia (decreased LOC, chest pain, dyspnea, and/or hypotension) with a 3rd Degree AV Block.

No Atropine - Asymptomatic Bradycardia.
In Bradycardia, is the Atropine administered Fast or Slow?
Fast.
In the bradycardia protocol, what do you do if the pulse increases to greater than 60 bpm but the systolic BP is less than 90 mm/Hg?
If no pulmonary edema - Administer a 250 to 500 ml fluid challenge.
What are the medication options if the Bradycardia is refractory to Atropine and Cardiac Pacing?
Dopamine.
Epinephrine.
Isuprel.
What is the dopamine mix concentration for Bradycardia?
200 mg Dopamine mixed in 250 ml D5W to yield 800 micrograms/ml.
For Bradycardia, how much Dopamine is administered and what are the flow rates?
5 to 20 micrograms/kg/min.

Flow rates:
200 mcg/min = 15 microdrops/min
400 mcg/min = 30 microdrops/min
600 mcg/min = 45 microdrops/min
800 mcg/min = 60 microdrops/min
For Bradycardia, what steps require Med Control authorization?
Cardiac Pacing.
Administration of Dopamine, Epinephrine, or Isuprel.
What is the Epinephrine mix concentration for Bradycardia?
1.0 mg Epinephrine (1:1000) mixed in 500 ml D5W to yield 2.0 micrograms/ml.
In the bradycardia protocol, how much Epinephrine is administered and what are the flow rates?
2 to 10 micrograms/kg/min.

Flow rates:
2 mcg/min = 60 microdrops/min
3 mcg/min = 90 microdrops/min
4 mcg/min = 120 microdrops/min
What is the Isuprel mix concentration for Bradycardia?
1.0 mg Isuprel mixed in 500 ml D5W to yield 2.0 micrograms/ml.
In the bradycardia protocol, how much Isuprel is administered and what are the flow rates?
2 to 10 micrograms/kg/min.

Flow rates:
2 mcg/min = 60 microdrops/min
3 mcg/min = 90 microdrops/min
4 mcg/min = 120 microdrops/min
The Bradycardia protocol states that you administer between 5 to 20 mcg/kg/min of Dopamine. How do you determine exactly how much Dopamine to administer?
Set the flow at a rate which brings the pulse up to 60 bpm or a systolic BP greater than 90 mm/Hg.
The Bradycardia protocol states that you administer between 2 and 10 mcg/kg/min of Epinephrine or Isuprel. How do you determine exactly how much to administer?
Set the flow at a rate which brings the pulse up to 60 bpm or a systolic BP greater than 90 mm/Hg.
In the Bradycardia Protocol, when should Epinephrine or Isuprel flow rates be decreased or discontinued?
Decrease flow rate if PVCs occur. Discontinue if V-Tach of V-Fib develops.