Advances Cardiac Life Support

Question 1

What medications are used for VT/VF (shockable rhythms) without a pulse?

Answer 1

1. Epi
2. Amiodarone (K+: class 3)
3. Lidocaine (Na+: class 1b)

Question 2

How are medications administered when in cardiac arrest?

Answer 2

IV or IO

Question 3

What medications are used for PEA/ asystole (non-shockable rhythms) without a pulse?

Answer 3

Epi

Question 4

What is the dosing of Epi for cardiac arrest (no pulse)?

Answer 4

1 mg IV Q 3-5 min for as long as the code lasts (no max dose)

Question 5

What is the dosing of Amiodarone for VT/VF without a pulse?

Answer 5

1st dose: 300mg IV push
2nd dose (if still in shockable rhythm): 150mg IV push

Question 6

What is the dosing of Lidocaine for VT/VF without a pulse?

Answer 6

1st dose: 1-1.5 mg/kg (usually given as 100mg dose)
Cumulative max dose: 3mg/kg

Question 7

When is Magnesium Sulfate used as an adjunct in ACLS?

Answer 7

Torsades de Pointe

Question 8

When is Dextrose used as an adjunct in ACLS?

Answer 8

Hypoglycemia

Question 9

When is Calcium Chloride used as an adjunct in ACLS?

Answer 9

Hypo/ Hyperkalemia

Question 10

When is sodium bicarb used as an adjunct in ACLS?

Answer 10

severe acidosis, hyperkalemia, toxidromes

Question 11

When should Epi be started in VF/VT without a pulse?

Answer 11

After the second shock delivered

Question 12

When should Amiodarone and/or Lidocaine be given in VF/VT without a pulse?

Answer 12

After 3rd shock delivered

Question 13

When should Epi be started in PEA/ asystole (non-shockable rhythms) without a pulse?

Answer 13

As soon as rhythm is determined to be unshockable

Question 14

What are reversible factors for cardiac arrest?

Answer 14

Hs and Ts:
Hypovolemia
Hypoxia
Hydrogen (acidosis)
Hypo/erkalemia
Hypothermia
Tension pneumothorax
Tamponade cardiac
Thrombosis, pulmonary/cardiac

Question 15

What is 1st-degree AV block?

Answer 15

Prolonged PR interval but no missed beats

Question 16

What are the types of second degree AV block?

Answer 16

Wenckebach Mobitz I - Progressively increasing PR interval then dropped beat
Mobitz II- PR interval consistent then dropped beat

Question 17

What is 3rd degree AV block?

Answer 17

Atria impulses do not reach ventricles, ventricle pacemaker takes over

Question 18

What medications are used for bradycardia with a pulse if Atropine is ineffective?

Answer 18

1. Dopamine
2. Epi/NE

Question 19

What is dosing of Atropine for bradycardia with a pulse?

Answer 19

1st dose: 1mg bolus repeat Q 3-5 min
max dose: 3mg

Question 20

When should the first dose of Atropine be given?

Answer 20

when the patient becomes symptomatic

Question 21

What are the symptoms of brady cardia?

Answer 21

1. hypotension
2. acute altered mental status
3. signs of shock
4. ischemic chest discomfort
5. acute heart failure

Question 22

What treatments are used for asymptomatic tachycardia with a pulse and narrow QRS?

Answer 22

1. vagal maneuvers
2. Adenosine
3. beta-blocker or CCB

Question 23

What treatments are used for asymptomatic tachycardia with a pulse and wide QRS?

Answer 23

1. Procainamide IV
2. Amiodarone IV
3. Sotalol IV

Question 24

What is dosing of Adenosine for asymptomatic narrow-QRS tachycardia?

Answer 24

1st dose: 6mg
2nd dose: 12mg

Question 25

What is the treatment for symptomatic tachycardia with a pulse?

Answer 25

Synchronized cardioversion

Question 26

What is a wide QRS?

Answer 26

> /= 0.12 sec