V-Fib Algorithm

Question 1

How long are CPR windows?

Answer 1

2 minutes

Question 2

How many joules for biphasic?

Answer 2

200 J

Question 3

What is a joule?

Answer 3

Watts/sec

Question 4

How many joules for monophasic?

Answer 4

360 joules

Question 5

What do you need for an IV?

Answer 5

1000 mL NS
Maxi drip set
Largest catheter possible
Proximal vein

Question 6

9 ways to confirm endotracheal tube placement?

Answer 6

1. Visualize tube placement in cords
2. End tidal CO2 colorimetric (yellow is good)
3. End tidal CO2 waveform (On monitor)
4. Listen to lung sounds. Epigastric first, then upper left, right, lower right, lower left.
5. Bilateral chest excursion (rise)
6. Condensation in tube
7. 22 cm depth for male, 21 cm for female. On average
8. EDD Esophageal detector device
9. Chest x-rayl

Question 7

What are first line cardiac drugs? First option and second option.

Answer 7

Epinephrine and vasopressin

Question 8

What are second line cardiac drugs? First and second option.

Answer 8

Lidocaine and amiodarone

Question 9

Epinephrine cardiac dose?

Answer 9

1 mg. 1:10000.

Question 10

Vasopressin dose?

Answer 10

40 units. One time dose

Question 11

How long does epinephrine last?

Answer 11

Loses effect after 3 to 5 minutes.

Question 12

Lidocaine dose?

Answer 12

1-1.5 mg/kg. max dose is 3 mg/kg

Question 13

Amiodarone dose?

Answer 13

300 mg. max dose of 450 mg.

Question 14

What is ROSC?

Answer 14

Return of spontaneous circulation

Question 15

What do you fix when you get ROSC?

Answer 15

1. Rate
2. BP
3. Ectopic

Question 16

What do you do for a dialysis patient with V-fib/V-tach?

Answer 16

Give them calcium gluconate at 1g.

Give sodium bicarbonate at 1mEg/kg.

Question 17

How much pressure do you put on the defib pads? And how do you know it’s enough?

Answer 17

25 lbs.

You’ll go down 1/8-1/4 inch.

Question 18

What is the general order of the v-fib algorithm?

Answer 18

CAB
CPR
Defibrillate ASAP
CPR - 2 minute window
IV/IO
ETT
Defib
CPR
1st line drugs
Defib
CPR
2nd line drugs
Defib
CPR
1st line drugs....continue for 15 minutes or so or ROSC