ACLS Scenarios Flashcards
When is Narcan used in ACLS?
When respiratory distress or cardiac arrest from opioid overdose is suspected
What are 2 ways Narcan can be administered?
What are the doses of each?
intramuscular: 0.4 mg
intranasal: 2 mg
* doses can be repeated after 4 minutes
3 drugs used for bradycardia
- epi
- atropine
- dopamine
What is the disadvantage of transcutaneous pacing?
does not produce as effective capture as trans venous pacing
What is the preferred method of pacing for emergent, unstable bradycardia?
transcutaneous pacing
What is the better pacing option for stable bradycardia?
transvenous pacing
What is the 3 step protocol for stable bradycardia?
- atropine
- monitor and observe
- SAMPLE
What is the 5 step protocol for unstable bradycardia?
- Monitors, IV, Oxygen
- Atropine
- consider transcutaneous pacing, epi, dopamine
* if atropine is ineffective - SAMPLE
- consult or transvenous pacing
Clinically, a HR is considered SVT when:
- the HR is ____
- the QRS complex is _____
- difficult to differentiate between _____ and _____
- > 150 bpm
- normal width
- sinus tach and junctional tach (p waves may or may not be present)
is SVT an emergency?
yes,
ventricular filling time is greatly reduced and this reduces cardiac output
What is paroxysmal SVT?
SVT that begins and ends abruptly (occurs in spasms)
-need to witness the stopping/starting on ECG
What is the BIG difference between SVT and afib/flutter?
AV node is part of the SVT re-entrant circuit, but NOT part of afib/flutter pathway
most types of SVT occur within the _____
AV node
For SVT, recommended therapies will ______ conduction through the _____
slow, AV node
What are 5 treatment options for SVT
- Vagal maneuvers
- carotid massage
- cold stimulus to the face
- valsalva maneuver - Adenosine
- Beta blockers (sotalol)
- Ca2+ channel blockers (cardizem)
- synchronized cardioversion
What is the treatment for afib/flutter?
synchronized cardioversion
What are 2 other drugs that can treat SVT that are not part of the ACLS protocol?
- amiodarone
2. Procainamide
What type of patients should a carotid massage be avoided?
geriatric patients or patients with hx of stroke or high cholesterol
SVT usually refers to a (narrow/wide) tachycardia with a more (regular/irregular) rhythm
narrow
regular
Afib usually manifests as a (narrow/wide) tachycardia with a more (regular/irregular) rhythm
narrow
irregular
atrial flutter can be (regular, irregular, both) rhythm
both
What is the only reason to use AV nodal blockers in Afib/flutter?
to slow down the HR in SVT to better diagnose the arrhythmia (SVT, Afib, Aflutter)
What is the only difference in treatment for stable vs unstable SVT?
in unstable SVT you perform immediate synchronized cardioversion before administration of adenosine
In stable SVT you will try vagal maneuvers first
What is the first thing you should do when you encounter a patient in SVT? (stable or unstable)
monitors, IV, oxygen