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134 Cards in this Set
- Front
- Back
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Epinephrine
What is the IV/IO push dose in Pulseless VF/VT (cardiac arrest)? |
1 mg Q3-5 min
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Epinephrine
What is the endotracheal dose in Pulseless VF/VT (cardiac arrest)? |
2-2.5 mg Q3-5 min diluted in 10mL NS
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For any rhythm.
Epinephrine What is the maximum total dose? |
No Maximum
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Epinephrine
What is the IV/IO push dose in Asystole/PEA? |
1 mg Q3-5 min
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Epinephrine
What is the infusion dose in Symptomatic Bradycardia? |
2-10 ug/min
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Epinephrine
Epinephrine is commonly available in tow concentrations. Which dose is most concentrated (10 times more concentrated)? 1:1000 1:10,000 |
1:1000
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Epinephrine
Which container holds the 1:10,000 dose? Ready syringe or multi-use bottle |
Ready syringe
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Atropine
What is the IV/IO dose in Symptomatic Bradycardia? |
0.5 mg Q 3-5 min
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Atropine
What is the maximum total dose for any rhythm? |
0.04 mg/kg (3mg)
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Atropine
What is the endotracheal dose for any rhythm? |
2-3 mg in 10cc water or NS
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Amiodarone
What is the first IV/IO dose in Cardiac Arrest? (Pulseless VF/VT) |
300 mg
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Amiodarone
What is the second IV/IO dose in Cardiac Arrest? (Pulseless VF/VT) |
150 mg
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Amiodarone
What maximum total dose for 24 hours? |
2.2 gm per 24 hours
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Amiodarone
What is the Rapid Infusion dose for Recurrent Life-Threatening Ventricular Arrhythmias? |
150 mg over 10 min. May repeat Q 10 min as necessary.
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Amiodarone
What is the Slow Infusion dose for Recurrent Life-Threatening Ventricular Arrhythmias? |
360 mg over 6 hours
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Lidocaine
What is the initial IV/IO Dose for Cardiac Arrect from VF/VT? |
1.0-1.5 mg/kg
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Lidocaine
What is the additional IV/IO dose for Cardiac Arrest from VF/VT |
0.5-0.75 mg/kg Q 5-10 min
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Lidocaine
How often can Lidocaine be repeated? |
Every 5-10 minutes
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Lidocaine
What is the maximum total dose |
3 mg/kg
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Lidocaine
What is the maintenance infusion dose? |
1-4 mg/min
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Lidocaine
What is the Endotracheal Dose? |
2-4 mg/kg
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Vasopressin
What is the dose in cardiac arrest? (VF, VT, asystole, PEA) |
40u IV/IO
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Vasopressin
What is the Endotracheal Dose for Cardiac Arrest (VF, VT, Asystole, PEA) |
May be given through the ET tube but there is insufficient evidence to recommend a specific dose.
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Vasopressin
How often can Vasopressin be given? |
Once, may replace 1st or 2nd dose of epinephrine
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Magnesium
What is the IV/IO dose in VF/VT cardiac arrest associated with hypomagnesemia or Torsades? |
1-2 gms in 10cc D5W
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Procainamide
What is the dose for recurrent VF/VT with a pulse? |
20 mg/min IV/IO
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Procainamide
What is the maximum dose |
17 mg/kg
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Procainamide
What is the dose in urgent situations, no pulse? |
50 mg/min IV/IO
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Procainamide
Which is NOT an indication to stop the infusion? |
hypertension
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Procainamide
What are the indications to stop the infusion |
QRS Widens by 50% or more
Hypotension Arrhythmia supression |
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Dopamine
What is the infusion dose in Symptomatic Bradycardia? |
2-10 ug/kg/min
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Adenosine
What is the first dose and how is it given? |
6 mg given rapidly over 1-3 secs followed by a 20cc NS bolus
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Adenosine
What is the second dose and how is it given? |
12mg given rapidly over 1-3 secs followed by a 20cc NS bolus
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Adenosine
When can a second dose be given? |
1-2 minutes after the first dose
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Sodium Bicarbonate
When is sodium bicarbonate administration appropriate? |
Known preexisting hyperkalemia
Know preexisting bicarbonate-responsive acidosis. |
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Sodium Bicarbonate
What is the IV bolus dose of sodium bicarbonate |
1 mEq/kg
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What is the most important therapy to perform immediately after defibrillation?
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CPR
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When a rhythm check by a manual defibrillator reveals VF/VT, one provider charges the defibrillator. What function does the other provider perform?
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Continues CPR
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After two minutes of CPR which action is immediately performed?
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Rhythm check
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Which energy level should providers use with biphasic defibrillators?
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Manufacturer's recommended energy dose
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When a shockable rhythm is discovered after a rhythm check, how many times should the victim be defibrillated before resuming CPR?
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1 time
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If a monophasic defibrillator is used, which energy level is delivered for Pulseless VF-VT?
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Always 360 joules
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What is the most important issue in predicting Return Of Spontaneous Circulation (ROSC) after defibrillation?
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Short time interval between compressions and defibrillation
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Which is true about ventricular tachycardia?
a. VT therapy should always be guided by the Pulseless Arrest Algorithm b. Victims in VT are unresponsive c. VT victims are treated with the Pulseless Arrest Algorithm if they are pulseless. d. VT victims are treated with the Tachycardia Algorithm if they have a pulse. e. Answers c and d. |
e.
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In the Pulseless Arrest Algorithm, what is the first type of medication administered for Pulseless VF-VT?
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Vasopressor
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What is a theoretical benefit of a vasopressor drug in cardiac arrest?
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To increase myocardial coronary blood flow
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If given as a bolus during CPR, when is the peak effect of an IV/IO vasopressor?
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1-2 minutes after administration
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Which vasopressors are suggested to be given in VF/VT Pulseless Arrest?
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Epinephrine and Vasopressin
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What drug is the first-line Antiarrhythmic used in VF-VT Pulseless Arrest
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Amiodarone
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If Amiodarone is unavailable, which drug may be considered for VF-VT Pulseless Arrest?
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Lidocaine
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Which drug may be considered for torsades de pointes associated with a long QT interval?
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Magnesium
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What is fundamental to the management of all cardiac arrest rhythms?
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Diagnosis and treatment of the cause
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What should be considered as a potential etiology in the case of refractory VF/Pulseless VT?
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Coronary ischemia
Myocardial infarction |
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What describes Pulseless Electrical Activity (PEA).
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a. PEA may appear as a somewhat normal appearing organized rhythm
b. PEA may be the result of no ventricular mechanical activity c. PEA may be the result of ventricular activity that is too weak to generate a detectable pulse. |
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Which of the following should be done after a monitor/defibrillator/AED reveals Asystole?
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CPR resumed immediately
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What should be done after a monitor-defibrillator reveals an organized rhythm?
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A pulse check is performed
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Which should be done after a monitor-defibrillator reveals an organized rhythm and a pulse is detected?
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Post-cardiac care should be initiated immediately
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Which of the following drug classes is given first for Asystole/PEA?
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Vasopressor
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What vasopressor(s) are appropriate for the first medication in Asystole/PEA?
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Epinephrine and Vasopressin
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What do the rhythms on the Asystole/PEA side of the Pulseless Arrest Algorithm have in common?
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The rhythms are not shockable
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What are the benefit(s) of a vasopressor cardiac arrest?
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Increased myocardial blood flow
Increased cerebral blood flow |
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Which drug has been removed from the Asystole/PEA AHA 2010 Guidelines?
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Atropine
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What is/are unique concerning PEA?
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PEA is often caused by reversible conditions
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Which of the following is/are true for PEA?
a. A slow rhythm with a weak pulse b. Any rhythm with a weak pulse c. Any organized rhythm without a pulse d. Answers a and c |
c. Any organized rhythm without a pulse
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Which of these rhythms are excluded by definition from the PEA category?
a. Sinus Rhythm without a pulse b. Ventricular fibrillation c. Ventricular tachycardia, pulseless d. Asystole e. All of the above f. Answers b, c and d. |
f. answers b, c and d.
b. Ventricular fibrillation c. Ventricular tachcardia, pulseless d. Asystole |
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Which is/are necessary to achieve good resuscitation outcomes in Asystole/PEA?
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High quality CPR
Identify and correct the cause |
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Which of these rhythms should be defibrillated?
a. Sinus rhythm with a pulse b. Sinus rhythm without a pulse c. Asystole d. Ventricular tachycardia without a pulse |
d. Ventricular tachycardia without a pulse
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Which is/are true regarding PEA?
a. A patient in PEA has no pulse b. A patient in PEA has no palpable pulse c. A Doppler can often detect blood flow when there is no palpable pulse d. Answers b. and c. |
d. Answers b. and c.
b. A patient in PEA has no palpable pulse c. A Doppler can often detect blood flow when there is no palpable pulse |
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What is/are true regarding Asystole
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Survival rates from Asystole are poor
Asystole may represent an agonal end-stage rhythm |
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When Asystole is displayed on the monitor, what are important considerations?
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a. Fine ventricular fibrillation may appear as asystole in some leads
b. The monitor is operating properly c. All ECG leads are connected d. Monitor signal gain is adjusted properly |
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What are some reasons to stop or withhold resuscitation is Asystole?
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a. Rigor mortis
b. Indicators of DNAR status (bracelet, written documentation) c. Living Will d. Threat to safety of rescuers |
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What drugs are used in Asystole/PEA?
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Epinephrine
Vasopressin |
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What is the proper dose for epinephrine in Asystole/PEA?
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1 mg IV/IO Q3-5 min
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What is the proper dose for Vasopressin in Asystole/PEA?
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40u IV/IO
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What is correct regarding vasopressin in Asystole/PEA?
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Vasopressin can be given once to replace the first or second dose of epinephrine
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What is true regarding pacing in Asystole?
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Pacing is not recommended in Asystole
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What is true regarding drug/doses given in aystole and PEA?
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There is no difference is drugs/doses for asystole and PEA
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According to the AHA, what is/are true for Unstable Bradycardia
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a. Cardiac arrest is ongoing or imminent
b. The heart rate is less than 50 beats per minute. |
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According to the AHA, what is/are true for Stable Bradycardia
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The heart rate is less than 50 beats per minute
The arrhythmia is causing symptoms but the pateint is not in imminent danger. |
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Which of the following is the initial treatment for bradycardia with signs and symptoms of instabiltiy?
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Atropine 0.5 mg IV
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What heart rate parameter(s) does the AHA use to define bradycardia?
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<50 beats per minute
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Which of the statements below are true for bradycardia?
a. All patients with a heart rate <50 will be symptomatic b. Patients should be treated based on their clinical condition c. Patients should be treated based on their heart rate d. Answers a. and b. |
b. Patients should be treated based on their clinical condition
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What statements are ture for athletic patients regarding bradycardia?
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a. Many athletic patients do well with bradycardic rates
b. Athletic patients at rest often have heart rates <50 |
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Which of the conditions below should be treated even with mild or asymptomatic bradycardic symptoms
a. First Degree AV Block b. Mobitz type I AV block in the setting of acute myocardial infarction c. Mobitz type II AV block in the setting of acute myocardial infarction d. Answers a. and b. |
c. Mobitz type II AV block in the setting of acute myocardial infarction
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What is a concern when a patient presents with Mobitz type II AV block?
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Third degree heart block may develop
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What is/are the first-line drug(s) for acute symptomatic bradycardia?
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Atropine
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What is/are true for atropine administration in symptomatic bradycardia?
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Atropine is a temporary solution for symptomatic bradycardia
Atropine is used while awaiting a transcutaneous or transvenous pacemaker |
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What is the IV/IO dose of atropine in symptomatic bradycardia?
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0.5 mg Q 3-5 min
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How often can atropine be given in symptomatic bradycardia?
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Q 3-5 min
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What is the maximum total dose of atropine for any rhythm?
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0.04 mg/kg (3mg)
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What is the endotracheal dose of atropine for any rhythm?
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2-3mg in 10cc water or NS
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How might a bradycardic rhythm be affected with an atropine dose less than 0.5 mg?
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Paradoxical slowing of the heart
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Why should atropine be used cautiously in the presence of acute coronary ischemia?
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Increased heart rate may worsen ischemia
Increased heart rate may increase infarction site |
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Which of the following are true regarding cardiac transplant patients and atropine?
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Atropine will likely be ineffective due to lack of vagal tone
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What is/are ture concerning transcutaneous pacing (TCP)?
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TCP is a temporary measure
TCP is painful in conscious patients |
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TCP should be used before atropine
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False
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It is reasonable for healthcare providers to initiate TCP in unstable patients who do not respond to atropine
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True
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What rhythm(s) is/are commonly responsive to atropine?
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Sinus bradycardia
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What drug(s) can be considered for symptomatic bradycardia unresponsive to atropine?
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Dopamine
Epinephrine Isoproterenol |
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What is/are true concerning Dopamine infusion at lower doses?
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Increased strength of heart contractions
Increased heart rate |
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What is/are true concerning Dopamine infusion at higher doses?
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>10mcg/kg/min
Increased vasoconstriction |
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Which of the following is the recommended dose for dopamine infusion
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Begin 2-10 mcg/kg/min, titrate to patient response
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What drug(s) is/are important to consider in symptomatic bradycardia with hypotension.
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Dopamine
Epinephrine |
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What describes wide complex tachycardias?
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Most wide complex tachycardias are ventricular in origin
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What is the correct QRS width parameter used to define wide-complex tachycardia?
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QRS > or = 0.12 seconds
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What is/are important consideration(s) with an unstable patient in tachycardia?
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Determine if the tachycardia is causing an unstable condition
Determine if the tachycardia is a symptom of an underlying issue |
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What describes a tachycardic pateint who is now pulseless?
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Cardiac Arrest
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What is a relatively common cause of tachycardia?
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Hypoxia
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What is/are appropriate treatment(s) for a tachycardic patient with shock symptoms?
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Immediate synchronized cardioversion
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What is the most probable cause if a tachycardia is <150/min?
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The tachycardia is in response to an underlying condition such as hypoxia
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What is true for stable tachycardia patients regarding treatment?
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Because treatment has the potential for harm, Providers may wait for expert consultation
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What QRS width parameter describes narrow-QRS-complex tachycardia?
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QRS <= 0.12 seconds
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What rate parameter is used to define sinus tachycardia?
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HR >100/min
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What defines the upper limit for sinus tachycardia?
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220/min minus patient age in years.
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What therapy is/are appropriate for sinus tachycardia?
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Treatment of underlying cause
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What is true for synchronized cardioversion?
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Synchronized cardioversion is timed with the QRS to avoid shocking during the relative refractory period.
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What is true for unsynchronized cardioversion?
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Unsynchronized cardioversion is not timed with the QRS
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Why is the timing of shocks with synchronized cardioversion important?
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A timed shock prevents shocking during the relative refractory period
A timed shock can prevent converting a coordinated rhythm into ventricular fibrillation |
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Which of the following generally require less defibrillation energy to cardiovert?
a. Atrial Fibrillation b. Atrial Flutter c. Both require the same defibrillation level |
Atrial Flutter
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What defines the upper limit for sinus tachycardia?
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220/min minus patient age in years.
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What is the recommended initial energy dose for biphasic synchronized cardioversion in atrial flutter and other SVTs?
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It depends on the manufacture recommendations for the device being used
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What therapy is/are appropriate for sinus tachycardia?
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Treatment of underlying cause
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Synchronized cardioversion is recommended for which of these unstable rhythms
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Atrial Fibrillation
Atrial Flutter Monomorphic VT (with pulse) |
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What is true for synchronized cardioversion?
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Synchronized cardioversion is timed with the QRS to avoid shocking during the relative refractory period.
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Synchronized cardioversion is recommended for which of these unstable rhythms?
a. Atrial Fibrillation b. Atrial Flutter c. Monomorphich VT (without a pulse) d. All the abofve |
Atrial Fibrillation
Atrial Flutter |
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What is true for unsynchronized cardioversion?
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Unsynchronized cardioversion is not timed with the QRS
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Which of the following best describe Paroxysmal Supraventricular Tachycardia (PSVT).
a. PSVT has a slow beginning and end b. PSVT has a suddent beginning and end. |
b. PSVT has a sudden beginning and end
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Why is the timing of shocks with synchronized cardioversion important?
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A timed shock prevents shocking during the relative refractory period
A timed shock can prevent converting a coordinated rhythm into ventricular fibrillation |
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Which of the following generally require less defibrillation energy to cardiovert?
a. Atrial Fibrillation b. Atrial Flutter c. Both require the same defibrillation level |
Atrial Flutter
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What is the recommended initial energy dose for biphasic synchronized cardioversion in atrial flutter and other SVTs?
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It depends on the manufacture recommendations for the device being used
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Synchronized cardioversion is recommended for which of these unstable rhythms
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Atrial Fibrillation
Atrial Flutter Monomorphic VT (with pulse) |
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Synchronized cardioversion is recommended for which of these unstable rhythms?
a. Atrial Fibrillation b. Atrial Flutter c. Monomorphich VT (without a pulse) d. All the abofve |
Atrial Fibrillation
Atrial Flutter |
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Which of the following best describe Paroxysmal Supraventricular Tachycardia (PSVT).
a. PSVT has a slow beginning and end b. PSVT has a suddent beginning and end. |
b. PSVT has a sudden beginning and end
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What is/are possible diagnostic benefit(s) of vagal maneuvers and adenosine?
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Differentiate between supraventricular and ventricular rhythms
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