ALS Management

Question 1

Management for acute bradycardia?

Answer 1

Atropine 500mcg IV

If there is an unsatisfactory response the following interventions may be used:
atropine, up to a maximum of 3mg
transcutaneous pacing
isoprenaline/adrenaline infusion titrated to response

Question 2

Management for SVT?

Answer 2

Vagal manoeuvre
Adenosine IV (6->12->18mg)
Verapamil if asthmatic
Electrical DC

Prevention:
beta-blockers
radio-frequency ablation

Question 3

Management for ventricular fibrillation and ventricular tachycardia?

Answer 3

Amiodarone 300mg

Question 4

Acute atrial fibrillation management?

Answer 4

Haemodynamically unstable -> electrical cardioversion

For haemodynamically stable patients, the management depends on how acute the AF is:
< 48 hours: rate or rhythm control
≥ 48 hours or uncertain: rate control

Question 5

Rate control meds in AF?

Answer 5

Agents used to control rate in patients with atrial fibrillation:
beta-blockers-> CI in asthma
CCBs
digoxin

Question 6

Rhythm control in AF meds?

Answer 6

Agents used to maintain sinus rhythm in patients with a history of atrial fibrillation:
beta-blockers
dronedarone: second-line in patients following cardioversion
amiodarone: particularly if coexisting heart failure