Cardiac Arrest VF/Pulseless VT

Question 1

Cardiac arrest algorithm step 1-4:

Answer 1

Step 1:
- Start CPR
- Give O2
- Attach monitor/defibrillator
Step 2: If rhythm shockable: VF, pVT
Step 3: Give shock
Step 4: CPR 2 minutes
- IV/IO access

If not shockable: Aystole/PEA go to step 10

Question 2

Cardiac arrest algorithm step 5-6:

2nd shock forward

Answer 2

Step 5:
- Rhythm shockable: yes shock
- No go to step 10
Step 6: 
- CPR 2 min
- Epinephrine every 3-5 mintues
- Consider advanced airway, capnography

Question 3

Cardiac arrest algorithm step 7:

3rd shock forward

Answer 3

Step 7:
- Rhythm shockable: yes shock
- No go to step 10
Step 8: 
- CPR 2 min
- Amiodarone 300 mg IV once, consider additional 150 mg
- Treat reversible causes

Return to step 5: 2nd shock and Epi

Question 4

Cardiac arrest algorithm step 9-11:

Rhythm not shockable

Answer 4

Step 9: Asystole/PEA
Step 10:
- CPR 2 min
- IV/IO access
- Epi every 3-5 minutes
- Consider advanced airway, capnography
Is rhythm shockable? Yes=> go to step 5
No: Step 11:
- CPR 2 min
- Treat reversible causes
Is rhythm shockable? Yes=> go to step 5
No: go to step 10

Question 5

First steps in asystole

Answer 5

Rule out technical problems:

• Loose leads, leads not connected to patient
• No power
• Signal gain too low

Question 6

Most common causes of PEA

Answer 6

Most common hypovolemia and hypoxia

Question 7

Reversible causes of PEA

Answer 7

Hypovolemia
hypoxia
hydrogen atom
Hypo/hyperkalemia
Hypothermia
Tension pneumothorax
Tamponade, cardiac
Toxins
Thrombosis, pulmonary
Thrombosis, coronary

Question 8

PEA definition

Answer 8

Any organized rhythm w/o a pulse

Excluding: VF, pVT and asystole

Question 9

Dose and admin of epinephrine in cardiac arrest

Answer 9

1 mg IV/IO every 3 to 5 minutes

Follow each peripheral injection w/ 20-mL flush of fluid, elevate extremity above heart for 10-20 seconds.

Question 10

Intraosseous route

Answer 10

• IO can be used in all age groups
• IO access acheived in 40-60 seconds
• IO preferred over ET route
• Any ACLS drug can be done IO

Question 11

What is the indication for Mag Sulf in cardiac arrest?

Answer 11

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