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14 Cards in this Set

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What is the criteria for utilizing the PVC protocol?
Chest pain suggestive of cardiac origin with PVCs characterized by one or more of the following:

Coupled
Multifocal
R-on-T
Greater than 6 PVCs / min
Non-sustained V-Tach (V-Tach runs)
After managing the airway and gaining IV access, what are the criteria for administering Lidocaine in the PVC protocol?
Electrical Rate > 60 bpm
Systolic BP > 90 mmHg
No 2nd Degree Type II or 3rd Degree Heart Block
What is the initial dose and route of Lidocaine in the PVC protocol?
1.0 mg/kg IV. If acute CHF, liver dysfunction, or 70 years old or older - 0.5 mg/kg IV.
What are the circumstances in which you would administer 0.5 mg/kg Lidocaine IV as the first dose in the PVC Protocol?
Acute CHF
Liver Dysfunction
At least 70 Years Old
After the first dose of Lidocaine in the PVC Protocol, how long do you wait between subsequent doses?
5 minutes
What is the maximum total amount of Lidocaine that can be administered in the PVC Protocol?
3 mg/kg. If acute CHF,
liver dysfunction, or patient is at least 70 years old, 1.5 mg/kg.
After the first dose of Lidocaine in the PVC Protocol, what are the doses of subsequent Lidocaine administrations
0.5 mg/kg. If acute CHF,
liver dysfunction, or patient is at least 70 years old, 0.25 mg/kg.
Under what circumstances would you stop administering Lidocaine in the PVC Protocol?
Maximum total dose already administered.
Ectopy is suppressed (however, will establish a Lidocaine Drip).
In the PVC Protocol, if the ectopy is suppressed by Lidocaine IV administration, what is the next step?
Establish a Lidocaine drip.
What is the Lidocaine drip mixture for the PVC Protocol?
2 grams Lidocaine in 500 ml D5W or 1 gram Lidocaine in 250 ml D5W to yield 4 mg Lidocaine per 1 ml D5W.
What size dripset is utilized for a Lidocaine drip administration in the PVC Protocol?
60 microdrips/ml
What is the Lidocaine infusion rate (mg/min and drips/min) in the PVC Protocol?
If already admininstered 1 mg/kg, administer 2 mg/min (30 drips/min).
If already admininstered between 1 and 2 mg/kg, administer 3 mg/min (45 drips/min).
If already admininstered between 2 and 3 mg/kg, administer 4 mg/min (60 drips/min).
What is the criteria for discontinuing a Lidocaine Drip in the PVC Protocol?
Patient develops:

Slurred speech
Confusion
Seizures
Coma
Paralysis
Apnea
If the patient develops slurred speech, confusion, seizures, coma, paralysis, or apnea during the administration of a Lidocaine drip in the PVC Protocol, what is the next step?
Contact Medical Control