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19 Cards in this Set
- Front
- Back
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Normal Sinus Rhythm |
Assess patient and continue to monitor |
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Sinus Bradycardia |
-Treat only if symptomatic -Atropine .5-1mg; repeat every 3-5 minutes for max of 3mg -denervated transplanted heart is not responsive to atropine (use epi and pacing) -pacemaker -vasopressors to support BP |
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Sinus Tachycardia |
-treat underlying cause -hemodynamic/perfusion considerations |
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Premature Atrial Complex (PAC) |
-assess/determine underlying rhythm -count frequency of PACs -withhold causative agent -assess consistency and shape of abnormal P waves |
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Atrial Flutter |
Same as afib -how long as the patient been under this rhythm (48hr guidelines) -if ventricular rate > 100, slow rate with bblockers and calcium-channel blockers -rhythm conversion may be considered -anticoagulants -ablation procedure |
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Junctional Rhythm |
-treat if symptomatic -atropine .5mg IV, repeat every 3-5min for max of 3mg -pacemaker |
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Premature Junctional Complex (PJCs) |
-count number per minute -usually none indicated |
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Supraventricular Tachycardia |
-slow ventricular rate: vagal maneuvers, carotid massage, adenosine, digoxin -determine site of origin -address specific rhythm -synchornized cardioversion, if unstable |
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Atrial Tachycardia |
-vagal stimulation/valsalva maneuvers -adenosine 6mg IVP -amiodarone (150mg bolus, followed by drip) -synchronized cardioversion, if unresponsive to meds |
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First Degree AV Block |
-evaluate for possible underlying cause |
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Second Degree AV Block - Type I, Mobitz I, Wenckebach |
-if asymptomatic, treatment may not be needed -if symptomatic, atropine and pacemaker |
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Second Degree AV Block - Type II, Mobitz II |
-Pacemaker -Vasopressors for BP support -atropine will WORSEN this block |
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Third Degree Heart Block |
-Pacemaker |
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Premature Ventricular Complex (PVCs) |
-count number of PVCs/min -consider impact of treatment on hemodynamics -bolus of ventricular meds: lidocaine, amiodarone, magnesium, followed by drip if effective |
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Ventricular Tachycardia |
Stable: lidocaine or amiodarone, followed by drip Unstable: ventricular meds PLUS synchronized cardioversion Pulseless: full code, CPR, oxygen, defribillation, epi/vasopressin, ventricular meds |
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Torsades de Pointes |
-Prevention! -magnesium sulfate -dilantin may be indicated in some cases to override effects of other meds -defribillation in some cases |
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Ventricular Fibrillation |
Full code |
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Idioventricular Rhythm |
-NEVER suppress this rhythm -increase rate -support hemodynamics |
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Asystole |
-Full code (except for defribillation, not a shockable rhythm) |
