ACLS V/F/PULSELESS VT, ASYSTOLE/PEA
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| What rhythms require unsynchronized high-energy shocks? | show 🗑
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| Which rhythms are not shockable? | show 🗑
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| An adult collapses from cardiac arrest. What do you do? | show 🗑
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| show | . Start CPR, Give oxygen, Attach monitor/defibrillator
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| show | Deliver shock
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| Give an example of how the person delivering the shock should alert team members. | show 🗑
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| One shock has been delivered. No ROSC. What’s next? | show 🗑
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| Two shocks have been delivered without return of ROSC. What’s next? | show 🗑
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| show | <10mm Hg – attempt to improve CPR quality; 35-40mm Hg – target range; > 40 mm Hg sustained indicates ROSC
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| At what rate should breaths be delivered to the patient with an advanced airway and compressions in progress? | show 🗑
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| show | Check Rhythm. Deliver shock if indicated.
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| show | Administer Amiodarone 300mg bolus followed by 20ml flush. Look for and treat reversible causes
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| show | 150mg
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| show | Hypovolemia, Hypoxia, Hydrogen Ions (Acidosis), Hypo-HyperKalemia, Hypothermia, Tension pneumothorax, Tamponade-cardiac, Toxins, Thrombosis-pulmonary or coronary
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| show | Biphasic 120-150 j, second and third doses should be equivalent or higher; Monophasic 360 j
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| show | Deliver subsequent doses at the previously successful energy level.
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| show | Give CPR for 2 minutes. Gain IV/IO access and give epinephrine 1 mg every 3-5 minutes (1st or 2nd dose may be replaced by Vasopressin 40 units) consider advanced airway and capnography
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| Patient is in Asystole or PEA. CPR has been in progress for 2 minutes, epinephrine administered, airway intact. What’s next? | show 🗑
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| show | Check for and treat reversible causes. Then check for shockable rhythm.
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| Describe the appropriate timing for pulse checks in order to avoid prolonged interruptions in compressions. | show 🗑
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| show | Proceed to post cardiac arrest care.
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| What course of action follows a questionable pulse and organized rhythm? | show 🗑
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| What is the appropriate dose of the antiarrhythmic amiordarone? | show 🗑
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| show | 1-1.5mg/kg IV/IO first dose, then 0.5-.75mg/kg IV/IO at 5-10 minute intervals to a maximum dose of 3mg/kg
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| show | only for torsades de pointes associated with a long QT interval
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| What is the appropriate dosing for magnesium sulfate? | show 🗑
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| What action is necessary if intra-arterial diastolic pressure is <20mm Hg? | show 🗑
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| If Petco2 is less than 10, what actions can be taken? | show 🗑
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| show | Improve chest compressions and vasopressor therapy
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| show | Reduce the rate of drug administration to allow for slowed metabolism and avoid toxic drug levels. Vasopressors are appropriate. Antiarrhythmics have not been proven effective for hypothermia. Re-warm the patient.
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| show | 86
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| show | Give by bolus unless otherwise indicated, Follow with 20mL normal saline bolus, Elevate extremity for 10-20 seconds to promote delivery to central circulation
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| How long does it take for drugs administered via peripheral IV during CPR to take full effect? | show 🗑
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| show | Epinephrine, Vasopressin, and Lidocaine, Dose is 2-2.5 times the IV dose, dilute the dose in 5-10 mL of sterile water or NS and inject the drug directly into the trachea
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| What are the limitations to drug administration via ET tube? | show 🗑
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| show | Vasopressors are used to optimize cardiac output and blood pressure
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| show | Epinephrine 1 mg IV/IO q 3-5 minutes, Vasopressin 1 dose of 40 units can replace the first or second dose of epinenphrine, follow each dose with 20 ml of flush and elevation of the limb for 10-20 seconds
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| show | Epinephrine acts on andrenergic receptors causing vasoconstriction resulting in increased blood pressure and heart rate and improving perfusion pressure to the heart and brain
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| show | Vasopressin causes peripheral vasoconstriction and increase in arterial blood pressure
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| When should amiordarone be used? | show 🗑
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| What kind of drugs are amiodarone, lidocaine, and magnesium sulfate? | show 🗑
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| What is the proper dosing for amiodarone? | show 🗑
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| When is it advisable to use Lidocaine in CPR? | show 🗑
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| show | 1 -1.5 mg/kg repeat if indicated at 0.5 -0.75mg/kg over 5-10 minute intervals to a maximum dose of 3mg/kg
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| show | 2-4mg/kg
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| What are the indications for magnesium sulfate? | show 🗑
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