Adult Cardiac Protocols

Question 1

According to the Chest Pain protocol what 6 serious causes should you consider?

Answer 1

1. Acute pericarditis/ myocarditis
2. Aortic dissection
3. Pulmonary embolism
4. Esophageal rupture
5. Angina/ MI
6. Spontaneous pneumothorax

Question 2

According to the Chest Pain protocol what should you obtain on the chest pain pt?

Answer 2

IV access
O2 to keep sats >94% (COPD>92%)
Cardiac Monitoring
12 Lead EKG

Question 3

According to the Chest Pain protocol how many IV access should you get if the Chest Pain pt is a STEMI?

Answer 3

2 large bore

Question 4

According to the Chest Pain protocol what are angina equivalents you should be aware of?

Answer 4

Nausea
Indigestion
Back pain
Diaphoresis
Dyspnea

Question 5

According to the Chest Pain protocol if your 12 lead reveals a STEMI what should you do immediately?

Answer 5

Notify accepting cardiac facility to activate the cath lab

Question 6

According to the Chest Pain protocol if your 12 lead reveals ST elevation or depression what should you obtain next?

Answer 6

15 Lead

Question 7

According to the Chest Pain protocol what is your first treatment option for a pt experiencing Chest Pain?

Answer 7

Aspirin

Question 8

According to the Chest Pain protocol by what route is Aspirin given?

Answer 8

PO

Question 9

According to the Chest Pain protocol what is the PO adult dose of Aspirin?

Answer 9

324/325mg

Question 10

According to the Chest Pain protocol for what reason should Aspirin be withheld from the Chest Pain pt?

Answer 10

History of GI bleed in the past 24 hours

Question 11

According to the Chest Pain protocol if a right ventricular infarct is suspected on 15 lead what should be withheld from the Chest Pain pt?

Answer 11

Nitroglycerin

Morphine

Question 12

According to the Chest Pain protocol instead of administering Nitroglycerin and/or Morphine in the Chest pain pt with a suspected right ventricular artifact what should instead be administered?

Answer 12

NS fluid bolus to maintain SBP>100

Question 13

According to the Chest Pain protocol after Aspirin what is your next treatment option for suspected Cardiac Chest Pain?

Answer 13

Nitroglycerin or Nitrospray

Question 14

According to the Chest Pain protocol by what route is Nitroglycerin or Nitrospray given?

Answer 14

Sublingual

Question 15

According to the Chest Pain protocol what is the sublingual adult dose of Nitroglycerin or Nitrospray?

Answer 15

0.4mg

May repeat every 5 minutes if improving

Question 16

According to the Chest Pain protocol what are the conditions for giving Nitroglycerin?

Answer 16

SBP >100

Not suspected right ventricular infarct

Question 17

According to the Chest Pain protocol what is the condition for giving Nitroglycerin prior to IV access and/or 12 lead?

Answer 17

1 dose

SBP>110

Question 18

According to the Chest Pain protocol after Nitroglycerin what are the treatment options for residual Chest Pain?

Answer 18

Morphine Sulfate
Hydromorphone
Fentanyl

Question 19

According to the Chest Pain protocol by what routes can Morphine Sulfate be given for residual Chest Pain?

Answer 19

IV

Question 20

According to the Chest Pain protocol what is the IV adult dose of Morphine Sulfate given for residual Chest Pain

Answer 20

2-4mg
May repeat every 5 minutes as needed for pain
Max 3 doses

Question 21

According to the Chest Pain protocol what is the adult dose of Hydromorphone given for residual Chest Pain?

Answer 21

1mg

Every 5 minutes as needed for pain

Question 22

According to the Chest Pain protocol what is the adult dose of Fentanyl given for residual Chest Pain?

Answer 22

50-100mcg

Every 5 minutes as needed for pain

Question 23

According to the Chest Pain protocol what medication used in pain management should be avoided in the Chest Pain pt?

Answer 23

Ketamine

Question 24

According to the Chest Pain protocol for blood pressure not responding to fluid bolus what treatment option should be considered?

Answer 24

Epinephrine Push Dose Presser

Question 25

According to the Chest Pain protocol by what route is the Epinephrine Push Dose Presser given?

Answer 25

IV

Question 26

According to the Chest Pain protocol what is the IV adult dose of the Epinephrine Push Dose Presser?

Answer 26

0.5-2ml every 2-5 minutes for SBP<90

Question 27

According to the Chest Pain protocol if the Chest Pain is caused by Cocaine ingestion what treatment option should be considered?

Answer 27

Versed

Question 28

According to the Chest Pain protocol by what route is Versed given in the Chest Pain pt caused by Cocaine ingestion?

Answer 28

IV/IO IN IM

Question 29

According to the Chest Pain protocol what is the IV/IO adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

Answer 29

1-2.5mg May repeat every 2-3 minutes Max 3 doses

Question 30

According to the Chest Pain protocol what is the IN adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

Answer 30

1-2.5mg May repeat every 2-3 minutes Max 3 doses

Question 31

According to the Chest Pain protocol what is the IM adult dose of Versed given in the Chest Pain pt caused by Cocaine ingestion?

Answer 31

2.5mg May repeat every 10-15 minutes Max 2 doses

Question 32

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what should be obtained?

Answer 32

``` IV access 12 Lead EKG Capnography Cardiac Monitoring If STEMI notify accepting cardiac facility ```

Question 33

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol how should the pt be placed?

Answer 33

In seated position

Question 34

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what treatment should be considered early?

Answer 34

CPAP

Question 35

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what treatment options should be considered?

Answer 35

Aspirin Nitroglycerin or Nitrospray Lasix

Question 36

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the goal blood pressure to reach by administering Nitroglycerin or Nitrospray?

Answer 36

SBP<140mmHg

Question 37

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what are the conditions for giving Lasix?

Answer 37

SBP<140 | SBP>100

Question 38

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol by what routes can Lasix be given?

Answer 38

IV

Question 39

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the IV adult dose of Lasix?

Answer 39

40-80mg

Question 40

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol if SBP<90 what treatment option should first be considered?

Answer 40

NS Fluid bolus

Question 41

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol what is the adult dose for a NS Fluid Bolus given for SBP<90?

Answer 41

250-500 mg

Question 42

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol after treatment with a NS Fluid Bolus what is the next treatment option for SBP still <90?

Answer 42

Epinephrine Push Dose Presser

Question 43

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol in Acute CHF pts what treatment has studies shown may lead to higher rates of intubation?

Answer 43

Neb treatments

Question 44

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol can Neb treatments be used in the Acute CHF pt?

Answer 44

Yes but with caution | May lead to higher rate of intubation

Question 45

According to the Congestive Heart Failure (CHF): Pulmonary Edema protocol in what pts should a Neb treatment be considered?

Answer 45

Pt with wheezing and a history of asthma or COPD

Question 46

According to the Cardiogenic Shock protocol what should be obtained?

Answer 46

``` IV 12 Lead EKG Capnography Cardiac Monitoring If STEMI notify accepting cardiac facility ```

Question 47

According to the Cardiogenic Shock protocol what 3 causes should be considered in the Cardiogenic Shock pt?

Answer 47

1. Volume problem 2. Rate problem 3. Pump problem

Question 48

According to the Cardiogenic Shock protocol if the problem is believed to be volume related what treatment should be considered first?

Answer 48

NS fluid bolus to maintain SBP>100

Question 49

According to the Cardiogenic Shock protocol if the problem is believed to be rate what treatment should be considered first?

Answer 49

Tachycardia protocol or Bradycardia protocol

Question 50

According to the Cardiogenic Shock protocol if the problem is believed to be with the pump what treatment option should be considered?

Answer 50

Epinephrine Push Dose Presser

Question 51

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol what should be obtained?

Answer 51

``` IV access 12 Lead EKG Consider capnography Cardiac monitoring If STEMI notify accepting cardiac facility ```

Question 52

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if pt is unstable what is the first treatment option?

Answer 52

Cardioversion

Question 53

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if the pt is stable what should be verified?

Answer 53

Narrow Complex Irregular Rhythm Rate >110

Question 54

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol if the pt is stable and the EKG reveals a Narrow Complex Irregular Rhythm with Rate >110 what is the treatment option?

Answer 54

Cardizem

Question 55

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol by what route is Cardizem given for the stable pt with an EKG revealing a Narrow Complex Irregular Rhythm with a Rate >110?

Answer 55

IV

Question 56

According to the Atrial Fibrillation/ Atrial Flutter with Rapid Ventricular Response protocol what is the IV adult dose for Cadizem given for the stable pt with an EKG revealing a Narrow Complex Irregular Rhythm with a Rate >110?

Answer 56

10-20mg SLOW May repeat dose if rate >110 after 5 minutes

Question 57

According to the Adult Bradycardia protocol what is the definition of Adult Bradycardia?

Answer 57

HR <50

Question 58

According to the Adult Bradycardia protocol what should be considered prior to any treatment?

Answer 58

Treatable Causes

Question 59

According to the Adult Bradycardia protocol what should your first course of action be?

Answer 59

``` Support ABC's Give Oxygen Attach monitor/defibrillator Consider Capnography Obtain 12 lead ```

Question 60

According to the Adult Bradycardia protocol what question should you ask yourself about the pts Bradycardia prior to any further treatments?

Answer 60

Is the Bradycardia causing Cardiorespiratory Compromise?

Question 61

According to the Adult Bradycardia protocol what is meant by Cardiorespiratory Compromise?

Answer 61

``` Hypotension AMS Shock Ischemia CHF ```

Question 62

According to the Adult Bradycardia protocol if the Bradycardia is NOT causing Cardiorespiratory Compromise what is the course of action?

Answer 62

Continue to support ABC's Given Oxygen as needed Observe cardiac activity Transport

Question 63

According to the Adult Bradycardia protocol if the Bradycardia IS causing Cardiorespiratory Compromise what is the first treatment option?

Answer 63

Atropine

Question 64

According to the Adult Bradycardia protocol what by what route is Atropine given for the Bradycardia pt with Cardiorespiratory Compromise?

Answer 64

IV/IO/ET

Question 65

According to the Adult Bradycardia protocol what is the IV/IO/ET adult dose of Atropine given for the Bradycardia pt with Cardiorespiratory Compromise?

Answer 65

0.5-1mg May repeat every 3-5 minutes Max 3mg

Question 66

According to the Adult Bradycardia protocol what should be considered concerning the EKG and the use of Atropine?

Answer 66

Some blocks may be resistant to Atropine especially if Wide Complex

Question 67

According to the Adult Bradycardia protocol if the Bradycardia appears to be resistant to Atropine and the pt continues to experience Cardiorespiratory Compromise what should the next treatment be?

Answer 67

Transcutaneous Pacing

Question 68

According to the Adult Bradycardia protocol what treatment options should be considered if after treatment pt blood pressure remains <90?

Answer 68

Epinephrine Push Dose Presser

Question 69

According to the Adult Bradycardia protocol if the pt improves what should the next course of action be?

Answer 69

Continue to support and transport

Question 70

According to the Adult Bradycardia protocol if the pt develops pulseless cardiac arrest what should the next course of action be?

Answer 70

Adult Cardiac Arrest Protocol

Question 71

According to the Adult Tachycardia protocol what is the definition of Adult Tachycardia?

Answer 71

HR >150

Question 72

According to the Adult Tachycardia protocol prior to treatment what should you consider?

Answer 72

Treatable Causes

Question 73

According to the Adult Tachycardia protocol what should your first course of action be?

Answer 73

``` Support ABC's Give oxygen Attach monitor/defibrillator Consider capnography Obtain 12 Lead EKG ```

Question 74

According to the Adult Tachycardia protocol what should you ask yourself about the Tachycardia?

Answer 74

Is tachycardia causing Cardiorespiratory Compromise?

Question 75

According to the Adult Tachycardia protocol what is meant by Cardiorespiratory Compromise?

Answer 75

Hypotension AMS Ischemia with sever chest pain SOB

Question 76

According to the Adult Tachycardia protocol if the Tachycardia IS causing Cardiorespiratory Compromise what should your next course of action be?

Answer 76

Synchronized Cardioversion

Question 77

According to the Adult Tachycardia protocol if you are going to Synch Cardiovert the pt due to Cardiorespiratory Compromise what should you first consider as a treatment?

Answer 77

Sedation

Question 78

According to the Adult Tachycardia protocol what is your treatment option to sedate a pt you are about to Synch Cardiovert due to Cardiorespiratory Compromise?

Answer 78

Etomidate

Question 79

According to the Adult Tachycardia protocol by what route is Etomidate given to sedate a pt who is about to be Sync Cardioverted due to Cardiorespiratory Compromise?

Answer 79

IV/IO

Question 80

According to the Adult Tachycardia protocol what is the IV/IO adult dose for Etomidate given to sedate a pt who is about to be Synch Cardioverted due to Cardiorespiratory Compromise?

Answer 80

0.1mg/kg

Question 81

According to the Adult Tachycardia protocol what should you assess about the pt EKG when choosing your dosage for Synchronize Cardioversion?

Answer 81

QRS duration

Question 82

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Narrow and Regular?

Answer 82

50-100J

Question 83

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Narrow and Irregular?

Answer 83

120-200J Biphasic

Question 84

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Wide Regular?

Answer 84

100J

Question 85

According to the Adult Tachycardia protocol what is the adult dose for Synchronized Cardioversion when the QRS is found to be Wide Irregular?

Answer 85

Defibrillate (Not Synchronized)

Question 86

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise what should you next assess?

Answer 86

The QRS duration

Question 87

According to the Adult Tachycardia protocol what is considered a Wide QRS?

Answer 87

>= 0.12 seconds

Question 88

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide what is your first treatment option?

Answer 88

Amiodarone

Question 89

According to the Adult Tachycardia protocol by what route is Amiodarone given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide?

Answer 89

IV/IO

Question 90

According to the Adult Tachycardia protocol what is the IV/IO adult dose of Amiodarone if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide

Answer 90

150mg Over 10 minutes May mix in 100ml NS over 10 minutes

Question 91

According to the Adult Tachycardia protocol if the pt converts with Amiodarone what is your next course of action?

Answer 91

Observe and Transport | Contact ER to notify to have Amiodarone drip prepared

Question 92

According to the Adult Tachycardia protocol if the pt returns to initial tachycardic rhythm after having converted with first dose of Amiodarone what is your next course of action?

Answer 92

May repeat Amiodarone dose

Question 93

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone what is your next treatment option?

Answer 93

Adenosine

Question 94

According to the Adult Tachycardia protocol by what route is Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone?

Answer 94

IV

Question 95

According to the Adult Tachycardia protocol what is the IV adult dose of Adenosine if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Wide and it is resistant to Amiodarone?

Answer 95

6mg with 20cc NS bolus RAPID May repeat with 12 mg with 20cc NS bolus RAPID

Question 96

According to the Adult Tachycardia protocol if the rhythm converts with Adenosine what is your next course of action?

Answer 96

Observe and Transport

Question 97

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow what is your first course of action?

Answer 97

Consider Vagal Maneuvers

Question 98

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow after Vagal Maneuvers what is your next treatment option?

Answer 98

Adenosine

Question 99

According to the Adult Tachycardia protocol by what route is Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow?

Answer 99

IV

Question 100

According to the Adult Tachycardia protocol by what is the IV adult dose of Adenosine given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow?

Answer 100

6mg with 20cc NS bolus RAPID May repeat with 12 mg with 20cc NS bolus RAPID

Question 101

According to the Adult Tachycardia protocol if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and at any time appears irregular what is your treatment option?

Answer 101

Cardizem

Question 102

According to the Adult Tachycardia protocol by what route is Cardizem given if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and appears at any time irregular?

Answer 102

IV

Question 103

According to the Adult Tachycardia protocol what is the IV adult dose of Cardizem if the tachycardia is NOT causing Cardiorespiratory Compromise and the QRS is assessed as being Narrow but resistant and at any time appears irregular?

Answer 103

10-20mg | SLOW

Question 104

According to the Adult Tachycardia protocol if the pt develops pulseless arrest what is your next course of action?

Answer 104

Adult Cardiac Arrest Protocol

Question 105

According to the Adult Cardiac Arrest protocol what is your first course of action when presented to an adult pt in cardiac arrest?

Answer 105

Perform CPR for 2 minutes

Question 106

According to the Adult Cardiac Arrest protocol what are the expectation concerning compression when performing CPR

Answer 106

Rate = 100-120 compressions/minute Hard and Fast Allow for full recoil

Question 107

According to the Adult Cardiac Arrest protocol other than compressions what other things should occur during the first 600 compressions?

Answer 107

Ventilate via BVM with oxygen Attach monitor/defibrillator Establish IV/IO

Question 108

According to the Adult Cardiac Arrest protocol when should an advanced airway be established?

Answer 108

After 600 compressions

Question 109

According to the Adult Cardiac Arrest protocol is there a benefit to IV fluids during cardiac arrest?

Answer 109

There are no trials showing a clear benefit of IV fluids during cardiac arrest unless hypovolemia is suspected

Question 110

According to the Adult Cardiac Arrest protocol if hypovolemia is suspect during Cardiac Arrest what is the treatment option during CPR?

Answer 110

1-2L NS

Question 111

According to the Adult Cardiac Arrest protocol what should you consider during CPR concerning why the pt is in Cardiac Arrest?

Answer 111

Treatable Causes

Question 112

According to the Adult Cardiac Arrest protocol if it is an unwitnessed arrest, prolonged downtime, dialysis pt, or persistent PEA what treatment option should you first consider during your CPR?

Answer 112

Sodium Bicarbonate

Question 113

According to the Adult Cardiac Arrest protocol by what routes is Sodium Bicarbonate given during CPR?

Answer 113

IV/IO

Question 114

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Sodium Bicarbonate given during CPR?

Answer 114

1meq/kg

Question 115

According to the Adult Cardiac Arrest protocol during CPR what should you ask yourself concerning the pts rhythm when assessing the EKG?

Answer 115

Is the rhythm Shockable?

Question 116

According to the Adult Cardiac Arrest protocol what are considered Shockable Rhythms?

Answer 116

Ventricular Fibrillation | Pulseless Ventricular Tachycardia

Question 117

According to the Adult Cardiac Arrest protocol if the pt IS in what is considered a Shockable rhythm what is your first course of action after your 2 minutes of CPR?

Answer 117

Give 1 Shock

Question 118

According to the Adult Cardiac Arrest protocol what is the adult dose of defibrillation for a pt with a shockable rhythm?

Answer 118

200-360J Biphasic or AED

Question 119

According to the Adult Cardiac Arrest protocol when choosing your dosage for defibrillation what should you consider?

Answer 119

The highest defibrillation amount available

Question 120

According to the Adult Cardiac Arrest protocol immediately following your first shock during CPR what should you do?

Answer 120

Resume CPR

Question 121

According to the Adult Cardiac Arrest protocol when resuming CPR throughout the course of a cardiac arrest how long should it be performed?

Answer 121

5 cycles/ 2 minutes

Question 122

According to the Adult Cardiac Arrest protocol after each 5 cycles/ 2 minutes of CPR what should occur?

Answer 122

Rhythm Check

Question 123

According to the Adult Cardiac Arrest protocol during each rhythm check what are you asking yourself concerning the rhythm?

Answer 123

Is the Rhythm Shockable or NOT shockable

Question 124

According to the Adult Cardiac Arrest protocol what are your treatment options during your 3rd round (minutes 4-6) of CPR?

Answer 124

Epinephrine 1:10,000 | Vasopressin

Question 125

According to the Adult Cardiac Arrest protocol by what routes can Epinephrine 1:10,000 be given?

Answer 125

IV/IO | ET

Question 126

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Epinephrine 1:10,000?

Answer 126

1mg | Repeat every 3-5 minutes

Question 127

According to the Adult Cardiac Arrest protocol what is the ET adult dose of Epinephrine 1:10,000?

Answer 127

2x IV/IO dose | Repeat every 3-5 minutes

Question 128

According to the Adult Cardiac Arrest protocol by what routes can Vasopressin be given?

Answer 128

IV/IO/ET

Question 129

According to the Adult Cardiac Arrest protocol what is the IV/IO/ET adult dose of Vasopressin?

Answer 129

40 Unites | Can replace 1st or 2nd dose of Epinephrine 1:10,000 the continue with Epinephrine after 5 minutes

Question 130

According to the Adult Cardiac Arrest protocol if you replace your first or 2nd dose of Epinephrine 1:10,000 with Vasopressin with what medication will you follow it with and after how long?

Answer 130

Epinephrine 1:10,000 | After 5 minutes

Question 131

According to the Adult Cardiac Arrest protocol other than Defibrillation and Epinephrine 1:10,000/ Vasopressin what other treatment options should you consider for the pt in a shockable rhythm?

Answer 131

Amiodarone

Question 132

According to the Adult Cardiac Arrest protocol by what routes can Amiodarone be given for the shockable rhythm?

Answer 132

IV/IO

Question 133

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Amiodarone for the shockable rhythm?

Answer 133

300mg | May repeat with 150mg ONCE

Question 134

According to the Adult Cardiac Arrest protocol if the pt is in a shockable rhythm and the rhythm is interpreted as Torsades de Pointes what is the treatment option?

Answer 134

Magnesium

Question 135

According to the Adult Cardiac Arrest protocol by what routes can Magnesium be given for the pt in a shockable rhythm interpreted as Torsades de Pointes?

Answer 135

IV/IO

Question 136

According to the Adult Cardiac Arrest protocol what is the IV/IO adult dose of Magnesium given for the pt in a shockable rhythm interpreted as Torsades de Pointes?

Answer 136

2 grams

Question 137

According to the Adult Cardiac Arrest protocol if the pt is in a shockable rhythm but hypothermic how does this affect your treatment options?

Answer 137

Withhold Amiodarone until pt is warmed above 92 degrees F

Question 138

According to the Adult Cardiac Arrest protocol if the pt converts with Amiodarone what is your next course of action?

Answer 138

Observe and Transport | Contact ER and notify to have Amiodarone drip prepared

Question 139

According to the Adult Cardiac Arrest protocol if the pt has a Return of Spontaneous Circulation (ROSC) what is your course of action?

Answer 139

Continue supportive care | Refer to Hypothermic Protocol after ROSC

Question 140

According to the Adult Cardiac Arrest protocol what is your treatment option for a pt with ROSC but BP <90?

Answer 140

Epinephrine Push Dose Presser

Question 141

According to the Adult Cardiac Arrest protocol what Unshockable Rhythms?

Answer 141

Asystole | PEA

Question 142

According to the Adult Cardiac Arrest protocol when does a rhythm check take place?

Answer 142

After 5 cycles/2 minutes of CPR

Question 143

According to the Adult Cardiac Arrest protocol what is the cycle of treatments for a Shockable Rhythm?

Answer 143

Epinephrine/Vasopressin, Amiodarone, Shock, CPR

Question 144

According to the Adult Cardiac Arrest protocol what is the cycle of treatments for an Unshockable Rhythm?

Answer 144

Epinephrine/Vasopressin, CPR

Question 145

According to the Adult Cardiac Arrest protocol what are the capnography goals?

Answer 145

35-45mmHg ideally

Question 146

According to the Adult Cardiac Arrest protocol what does a capnography <10mmHg indicate?

Answer 146

Inadequate CPR/Ventilation | Poor Outcome

Question 147

According to the ROC Research Guidelines what is the pt age requirement?

Answer 147

18 years and older

Question 148

According to the ROC Research Guidelines what kind of cardiac arrest qualifies?

Answer 148

Non-traumatic

Question 149

According to the ROC Research Guidelines when may an automatic CPR device be used?

Answer 149

After 10 minutes of manual CPR

Question 150

According to the ROC Research Guidelines when should pads be placed on the pt?

Answer 150

Within the first minue

Question 151

According to the ROC Research Guidelines what lead should the monitor be in?

Answer 151

Paddle mode

Question 152

According to the ROC Research Guidelines when should the first dose of Epinephrine/ Vasopressin be given?

Answer 152

Within 10 minutes

Question 153

According to the ROC Research Guidelines when can an advanced airway (King airway/ ET tube) be established?

Answer 153

After 600 compressions (6 minutes of CPR)

Question 154

According to the ROC Research Guidelines what should you avoid during advanced airway placement?

Answer 154

Stopping CPR

Question 155

According to the ROC Research Guidelines what should occur every 2 minutes?

Answer 155

Switch compression provider

Question 156

According to the ROC Research Guidelines what should not happen for the first 10 minutes?

Answer 156

Moving the pt

Question 157

According to the ROC Research Guidelines what rate should compressions be performed at?

Answer 157

100-120 compressions per minute (use metronome)

Question 158

According to the ROC Research Guidelines at what rate should ventilation be performed?

Answer 158

8-10 respirations per minute

Question 159

According to the ROC Research Guidelines how should compressions be given?

Answer 159

Continuously

Question 160

According to the ROC Research Guidelines at what % of pt contact should compressions occur?

Answer 160

75%

Question 161

According to the ROC Research Guidelines how long should the pre-shock pause last?

Answer 161

<5 seconds

Question 162

According to the ROC Research Guidelines how long should the post-shock pause last?

Answer 162

<5 seconds

Question 163

According to the ROC Research Guidelines what is the overall goal concerning compressions?

Answer 163

Never be off the chest >10 seconds unless moving the pt

Question 164

According to the ROC Research Guidelines what should occur with ROSC?

Answer 164

Start hypothermia

Question 165

According to the ROC Research Guidelines what should occur if EMS witnesses the arrest with pads on the pt?

Answer 165

Shock without delay

Question 166

According to the ROC Research Guidelines what is the overall goal?

Answer 166

Perform quality CPR for the first 6 minutes Establish airway Move pt after 10 minutes

Question 167

According to the Adult Cardiac Arrest protocol what should be done if the scene is deemed unsafe in anyway?

Answer 167

Do what is necessary to keep the crew and the pt safe

Question 168

According to the Adult Cardiac Arrest protocol what are the 5 H's of Adult Treatable Causes?

Answer 168

1. Hypovolemia 2. Hypoxia or ventilation problems 3. Hydrogen ion (acidosis) 4. Hypo/Hyperkalemia 5. Hypoglycemia

Question 169

According to the Adult Cardiac Arrest protocol what are the 5 T's of Adult Treatable Causes?

Answer 169

1. Toxins 2. Tamponade (cardiac) 3. Tension pneumothorax 4. Thrombosis (coronary or pulmonary) 5. Trauma (hypovolemia, increased ICP)

Question 170

According to the Hypothermic Protocol after ROSC what are the 4 indications for its use?

Answer 170

1. Adult (age>18) medical cardiac arrest 2. Persistent coma 3. Less than 1 hour from collapse to ROSC 4. Unable to follow simple commands (hold up one finger, wiggle toes, answer simple yes/no questions, etc.)

Question 171

According to the Hypothermic Protocol after ROSC what are the 6 contraindications for its use?

Answer 171

1. Traumatic/ hemorrhagic related arrests 2. Apparent pregnancy 3. Refractory cardiogenic shock (SBP<90) 4. Initial temperature 34 degrees C (93 degrees F) 5. Refractory ventricular arrhythmias 6. Underlying terminal illness

Question 172

According to the Hypothermic Protocol after ROSC what are the 3 procedures?

Answer 172

1. Remove clothing (undergarments may remain for pt privacy) 2. Place ice pack into axilla and groin direcly on skin for maximum cooling 3. Rapidly infuse 30ml/kg IV/IO cold saline (33-39 degrees F) (Max 2 L) via pressure infuser

Question 173

According to the Hypothermic Protocol after ROSC if during hypothermia treatment pt begins to shiver what is your treatment option?

Answer 173

Versed

Question 174

According to the Hypothermic Protocol after ROSC by what route it Versed given if during hypothermia treatment pt begins to shiver?

Answer 174

IV/IO IN IM

Question 175

According to the Hypothermic Protocol after ROSC what is the IV/IO adult dose of Versed?

Answer 175

2.5-5mg Every 2-3 minutes Max 3 doses

Question 176

According to the Hypothermic Protocol after ROSC what is the IN adult dose of Versed?

Answer 176

2.5-5mg Every 2-3 minutes Max 3 doses

Question 177

According to the Hypothermic Protocol after ROSC what is the IM adult dose of Versed?

Answer 177

5mg Every 10-15 minutes Max 2 doses

Question 178

According to the Hypothermic Protocol after ROSC should transport be delayed for cooling?

Answer 178

NO

Question 179

According to the Hypothermic Protocol after ROSC what should you obtain if able?

Answer 179

Initial temperature

Question 180

According to the Hypothermic Protocol after ROSC if able to monitor pt temperature what is the goal?

Answer 180

90-93 degrees F

Question 181

According to the Hypothermic Protocol after ROSC if pt temperature drops below 90 degrees F what should occur?

Answer 181

Discontinue cooling

Question 182

According to the Hypothermic Protocol after ROSC what should you avoid when providing for respirations for the pt?

Answer 182

Hyperventilation

Question 183

According to the Hypothermic Protocol after ROSC what level should you keep your ETCO2 around during ventilation?

Answer 183

40mmHg

Question 184

According to the Hypothermic Protocol after ROSC which takes precedence Chilled Saline or ROSC drips?

Answer 184

Chilled Saline

Question 185

According to the Hypothermic Protocol after ROSC can both liters of chilled saline be given simultaneously?

Answer 185

YES

Question 186

According to the Hypothermic Protocol after ROSC where should the pt receiving hypothermic treatment be transported?

Answer 186

Facility able to continue hypothermic treatment