Random Flashcards
Treatment for V. fib or pulseless V. tach
defib (360 J) -> CPR defib (360 J) -> CPR Epi or vasopressin defib (360 J) Epi every 3-5 minutes, no mac Consider amiodarone / lidocaine
Treatment for stable asymptomatic V. tach
PAL: procainamide / amiodarone / lidocaine
Treatment for SVT
- carotid massage / valsalva / eyeball pressure / ice water -> adenosine -> rate control with AV node blocker (verapamil / digoxin) -> procainamide
- Unstable: DC cardioverison
Treatment for new A. fib with RVR of unknown duration
Stable: B or C blocker / digoxin
Anticoagulate
Unstable and new: cardioversion
Treatment for pulseless electrical activity
ABC -> Epi and atropine -> evaluate and treat cause
Causes of pulseless electrical activity
H’s and T’s:
Hypovolemia, hypoxia, H+ (acidosis), HypoK, HyperK, Hypoglycemia, Hypothermia
Toxins / tablets, Tamponade, Tension pneumo, Thombosis, Trauma
Treatment for B blocker overdose
IVF, atropine, GI decontamination, Glucagon, CaCl, Insulin, Vasopressor (norepi), pacing / balloon / bypass
Treatment for asystole
Epi -> Atropine
x3 then just epi
Pacemaker
Tet spell
Squatting increases SVR, decreasing R to L shunt
Hypertrophic CM murmur
- Valsalva and standing decrease preload, which increases murmur (decreases AS murmur)
- Squatting increases preload, decreasing murmur (removing outflow obstruction)
Tamponade signs
Beck’s triad: hypotension, JVD, distant heart sounds
Pulsus paradoxus (>10 drop in BP on inspiration)
Low voltage ECG
Tension pneumothorax signs
Hypotension, JVD, absent breath sounds, hyperresonance, shifted trachea and mediastinum
Hemothorax signs
Hypotension, flat neck veins, tachycardia, decreased breath sounds, dull to percussion
RV infarct signs
Hypotension, JVD, clear lung fields, inferior wall MI known
Myocardial contusion signs
Trauma, Increased CVP or PCWP (no hypovolemia), bruising over chest. Get cardiac enzymes and ECG (possible new LBBB or arrhythmia)
