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HA > ACLS/PALS Algorithms > Flashcards

ACLS/PALS Algorithms Flashcards

1
Q

Unstable bradycardia and tachycardia S/S

A

hypotension
acutely ams
shock
ischemic chest discomfort
acute hf

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2
Q

If bradycardia is unstable what do we do.

A

Atropine
if atropine is ineffective try transcutaneous pacing and or dopamine infusion or epi infusion.

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3
Q

What should we consider while doing interventions for bradycardia

A

expert consultation
transvenous pacing

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4
Q

Atropine dose for bradycardia

A

1st dose; 1mg bolus
repeat every 3-5 min
max= 3mg

<0.5 mg-> worsen brady

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5
Q

Dopamine IV infusion rate for bradycardia

A

Usual infusion rate is 5-20 mg/kg/ min titrate to patient response; taper slowly

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6
Q

Epi infusion rate for bradycardia

A

2-10 mcg/ min infusion. titrate to patient response

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7
Q

Possible causes and treatment for bradycardia

A

MI
OD/ toxicity; CCB, BB/ DIG
hypoxia
Electrolyte abnormality (hyperK; 8-12 brady -> sinewaves)

BB-> glucagon
CCB-> ca+
Dig-> Digibind

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8
Q

HR less than what is a bradyarrhythmia

A

<50bpm

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9
Q

Tachyarrhthmia is hr of what

A

> 150 bpm

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10
Q

Treatment for unstable tachycardia

A

Synchronized cardioversion
if narrow complex consider adenosine

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11
Q

treatment for refractory tachycardia

A

find underlying cause
increase energy level for next cardioversion
additional anti-arrhythmic drug
expert consultation

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12
Q

Wide QRS tachycardia tx stable

A

adenosine only if regular and monomorphic
anti-arrhythmic infusion (procainamide, amio, sotalol)
expert consultation

> 0.12

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13
Q

Narrow QRS tachycardia tx stable

A

vagal maneuvers
adenosine
BB / CCB
expert consult

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14
Q

Adenosine dose for tachycardia

A

1st dose = 6mg IV push w/ flush
2nd dose = 12 mg if required

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15
Q

Procainamide dose for tachycardia

A

20-50mg/min until arrhythmia suppressed, hypotension ensues, qrs duration increased >50% or max dose 17mg/kg given.
maint infusion 1-4mg/min. avoid if prolonged qt or chf.

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16
Q

Amiodarone dose for tachycardia

A

first dose 150 mg over 10 min. repeat as needed if VT recurs. Folllow by maintenance infusion of 1mg/min for first 6 hours

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17
Q

Sotalol IV dose for tachycardia

A

100 mg (1.5mg/kg) over 5 min. avoid if prolonged QT.

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18
Q

characteristic of high quality cpr

A

2 inch depth and 100-120 bpm, allow recoil
no interruptions
if petco2 >15

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19
Q

Shock energy for defib

A

Biphasic; 120-200 J. if unknown use max available
monophasic; 360J

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20
Q

Epi dose for cardiac arrest

A

1mg every 3-5 min

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21
Q

Amio dose for cardiac arrest

A

first dose 300 mg. second dose 150 mg

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22
Q

lidocaine dose for cardiac arrest

A

first dose= 1-1.5mg/kg
second dose= 0.5-0.75mg/kg

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23
Q

Breaths per min after advanced airway placed for cardiac arrest

A

1 breath every 6 seconds
10 breaths/ min

24
Q

ROSC s/s

A

pulse
bp
art line wave form
PETCO2 > 40 mmhg

25
Q

H’s

A

Hypovolemia
hypoxia
hydrogen ions
hypo K
hyper K
Hypothermia

26
Q

T’s

A

tension pneumothoax
tamonade
toxins
thrombosis; pulm or coronary

27
Q

Post Rosc respiratory parameters

A

start 10 breaths. min
titrate spo2 to 92-98%
titrate CO2 35-45 mmhg

28
Q

Post ROSC hemodynamic parameters

A

SBP > 90 mmhg
MAP >65

manage with cystalloids and or vasopressor or inotrope

29
Q

Post rosc interventions for comatose patient

A

TTM- 32-36 for 24 hrs
Head CT
EEG
critical care

30
Q

Maternal interventions for cardiac arrest

A

airway management (have to intubate)
admin 100% O2/ avoid excess ventilation
IV above the diaphragm
stop mag and give calcium chloride or gluconate

31
Q

Perform OB interventions for cardiac arrest

A

lateral uterine displacement
detach fetal monitors
prep for perimortem c section (5 min post arrest)

32
Q

Potential etiology of maternal cardiac arrest

A

anesthetic complications
bleeding
cardiovascular
drugs
embolic
fever
general nonOB causes (h and t)
Hypertension

33
Q

When to start chest compressions on neonate

A

HR < 60bpm

intubate if not done already

34
Q

If HR is persistently below 60 what other interventions can we do for neonate

A

epi
consider hypovolemia
consider pneumothorax

narcan?

35
Q

unstable Pediatrics s/s

A

acutely ams
s/s of shock
hypotension

36
Q

Interventions for neonate gasping/ apnea and HR <100

A

PPV
clear secretions
SPO2 monitor
ECG monitor

37
Q

Pediatric compressions are initiated when hr is at?

A

60bpm

38
Q

interventions if neonate hr <60/min

A

intubate
chest compressions
PPV
100% o2
ect monitor
consider emergency UVC (umbilical vein cannulation)

39
Q

Persistent bradycardia for peds patients interventions

A

continue cpr if hr less than 60
iv/io
epi
atropine (for inc vagal tone/ primary av block)
transthoacic/ transvenous pacing
ID cause

40
Q

Possible causes for peds bradycardia

A

hypothermia
hypoxia
medications

41
Q

Epi dose for ped bradycardia and cardiac arrest

A

0.01mg/kg (0.1ml/kg of the 0.1mg/ml concentration)
repeat every 3-5 min

42
Q

Atropine dose for peds bradycardia

A

0.02mg/kg. may repeat once
max dose 0.1mg and max single dose 0.5mg

43
Q

Infant tachycardia rate

A

> 220

44
Q

Child tachycardia rate

A

> 180

45
Q

treatment for SVT (qrs <0.09) in unstable peds

A

adenosine
sychronized cardioversion

46
Q

treatment for V tach (qrs > 0.09) in unstable peds

A

sychronized cardioversion

47
Q

treatment for SVT (qrs <0.09) in stable peds

A

Vagal maneuvers
adenosine

48
Q

treatment for V tach (qrs >0.09) in stable peds

A

regular and monomorphic qrs = adenosine

consult expert

49
Q

Synchronized cardioversion dose in peds

A

Start with 0.5-1J/kg
if not effect, increase to 2 J/kg.
sedate if needed but dont delay cardioversion

50
Q

Adenosine dose for peds tachycardia

A

first dose 0.1mg/kg rapid bolus (max; 6mg)
second dose; 0.2mg/kg rapid bolus (max 2nd dose; 12 mg)

51
Q

Amio dose for kids cardiac arrest

A

5mg/kg during arrest
may repeat up to 3 doses

52
Q

Lidocaine dose for peds cardiac arrest

A

1mg/kg loading dose

53
Q

Defibrillation dose for peds cardiac arrest

A

First shock 2J/kg
Second shock 4J/Kg
Subsequent shocks > 4 J/kg
max 10 J/kg or adult dose

54
Q

PEDS quality CPR characteristics

A

> 1/3 of anteroposterior diameter of chest
100-120bpm
allow recoil
no airway; 15;2 compression/ventilation ration

advanced airway; breath every 2-3 seconds

55
Q

Amniotic fluid embolism treatment

A

atropine
ondansetron
ketorolac

56
Q

APGAR score

A

0-10
activity
pulse
grimas
respiration

HA (15 decks)

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