ACLS 1

Question 1

drugs for narrow QRS tachycardia

Answer 1

1. verapamil
2. Esmolol
3. Labetalol

Question 2

remarks on verapamil

Answer 2

blocks slows calcium channel receptors
indication:
-alternative for adenosine in stabe SVT
-rate controller for stable AF and atrial flutter

2.5-5.0 mg SIVP over 2 mins every 15-30 mins
max dose 20 mg

Question 3

remarks on esmolol

Answer 3

indication:
-widely used for supraventricular and ventriculararrhythmia

0.5 mg/kg LD over 1min
MD: 0.05-0.20 mg/kg/min

Question 4

remarks on labetalol

Answer 4

ind:
- widely used for SVT and ventricular arrhythmias

10 mg IV push over 1-2 mins every 10 mins
max 150 mg

Question 5

drugs for wide QRS tachycardia

Answer 5

1. Amiodarone
2. Lidocaine
3. Magnesiumf

Question 6

remarks on amiodarone

Answer 6

prolongs action potential duration
decreases AV node conduction
ind:
-supraventricuar and ventricular tachyarrhthmias

150 mg SIVP over 10 mins
1 mg/min infusion over 6 hours
0.5 mg/min infusion for 18 hour

Question 7

remarks on lidocaine

Answer 7

blocks Na channels in the AV node
ind:
-alternative to amiodarone if amiodarone is not available

1st dose: 1.0-1.5 mg/kg IV bolus
2nd dose: 0.5-0.75 mg/kg IV bolus

Question 8

remarks on magnesium

Answer 8

indication:
termination. of. Torsades de Pointes
1-2 g in 100 mL D5W
infuse over 1-2 mins

Question 9

energy level for synchronized cardioversion

Answer 9

narrow regular: 50-100 J
narrow irregular:
150-200 J (biphasic)
200 J (monophasic)

wide regular: 100 J
Wide irregular:
debribillation

Question 10

management for unstable bradycardia

Answer 10

1. atropine
2. dopamine infusion
3. epineprhine infusion
4. transcutaneou pacing

Question 11

remarks on atropine

Answer 11

1 mg IV bolus every 3-5 mins
max dose 3 mg

Question 12

remarks on dopamine infusion

Answer 12

5-20 mcg/kg/min iV infusion

Question 13

remarks on epinephrine infusion

Answer 13

2-10 mcg/min IV infusion

Question 14

indication for pacing

Answer 14

persistent hemodynamically unstable
- sinus node dysfunction
- 2nd and 3rd degree AV block

refractory to medical therapy

Question 15

pacing is not recommended for

Answer 15

patients with minimal symptoms without hemodynamic compromise
asystolic cardiac arrest

Question 16

steps in transcutaneous pacemaker placement

Answer 16

1. apply the pacing pads
2. consider sedaton
3. turn on the monitor and set it to pacing mode
4. set the pacing rate using the rate button
5. increase current output (mA) from minimal until capture is achieved
6. confirm mechanical capture with femoral pulse

Question 17

electrical capture is confirmed by

Answer 17

1. pacemaker spikes
2. widened QRS complex
3. tall and broad T wave opposite QRS