Cardiology

Question 1

Intervention by ems for bradycardia rhythm may not be necessary unless the pt is?

Answer 1

Symptomatic

S/s such as hypotensive, altered loc with inadequate perfusion, chest pain

Question 2

Bradycardia can be caused from? List 5

Answer 2

Hypoxia, mi, sick sinus syndrome, heart blocks, other ectopy not producing a pulse

Question 3

In bradycardia the palpable pulse is?

Answer 3

Below 50 bpm

Question 4

Treatment for symptomatic brady with b/p below #⃣#⃣?

Answer 4

90 systolic

Question 5

Atropine dose for bradycardia is?

Answer 5

0.5 mg ivp, io. Max 3 mg

Question 6

Epi drip for bradycardia is?

Answer 6

2-10 mcg/ min

Question 7

Dopamine dose for bradycardia is?

Answer 7

5-20 mcg/ kg/ min

Weight, drop the zero, subtract 2

Question 8

External transcutaneous pacing dose is?

Answer 8

Set rate at 70 bpm
Conscious: 5ma and increase by 5ma
Unconscious: 20ma increase by 20ma

Question 9

Sedation for pacing?

Answer 9

Versed
2-4 mg ivp, io
4 mg MAD

Question 10

What is sick sinus syndrome

Answer 10

Sick sinus syndrome is a collection of heart rhythm disorders that include:
•
Sinus bradycardia – slow heart rates from the natural pacemaker of the heart

•
Sinus pauses or arrest – when the natural pacemaker of the heart stops working for periods of time

People with these disorders may also have other abnormal heart rhythms, such as:
•
Atrial tachycardia – fast heart rate that starts in the upper chambers of the heart (atria)

•
Bradycardia-tachycardia – alternating slow and fast heart rhythms

Question 11

In cardiac arrest what are the two most important things to accomplish?

Answer 11

CPR and Defibrillation

Question 12

What is the Compression/Respiration ratio of a non intubated patient in cardiac arrest?

Answer 12

30:2

Question 13

What is the Compression/Respiratory ratio for a intubated patient in cardiac arrest?

Answer 13

100 compressions/min

8-10 breaths/min

Question 14

Unless extenuating circumstances onscene time for a chest pain/MI should be?

Answer 14

15 minutes or less

Question 15

OPQRST?

Answer 15

Onset/Origin
Provokes
Quality
Region
Severity
Time

Question 16

12 other important symptoms/factors relating to Chest Pain?

Answer 16

SOB, Dizziness, Arm pain, Neck pain, Back pain, Jaw pain, n/v, Syncope, Sweating, Skin color, Weakness, Past medical history

Question 17

Treatment for Inferior or RV Infarct with hypotension, JVD and clear lung sounds?

Answer 17

NS bolus of 300-500ml
Oxygen
324mg of asprin

Question 18

Preferred type of IV cath with a STEMI?

Answer 18

Twin Cath

Question 19

Dose of NTG Spray/Tab

Answer 19

.4mg SL every 5 Mins if B/p is above 90 Systolic and IV established (max dose 3)

Question 20

When is nitro paste indicated?

Answer 20

For all normotensive (> 90 systolic) or Hypertensive patients with chest pain when

1. Chest pain persists despite 3 doses of SL NTG or
2. Chest pain gone after 1 or more doses of SL NTG whether given by medic or patient self medicated.

Question 21

All nitrates should be used with caution with?

Answer 21

Acute inferior STEMI (Normotensive: B/P above 90 systolic

Question 22

For pain control of chest pain consider this drug and dose?

Answer 22

Fentanyl 1mcg/kg IVP/IO every 3-5 mins. (100mcg max per dose, 200mcg total max)

Question 23

In a patient with suspected MI and PVC’s present, if the heart rate is 60 or above, and no 2ed or 3rd degree block is present, institue the following?

Answer 23

Amiodarone Mix 150mg in 100ml of 0.9NS over 10 minutes (15mg/min)

Question 24

What is a potential cause of cardiac arrest in dialysis pt’s?

Answer 24

Hyperkalemia

Question 25

2 drugs that should be considered in a Dialysis patient that is in cardiac arrest?

Answer 25

Sodium Bicarbonate and Calcium Chloride

Question 26

What is the dose of Sodium Bicarbonate while a Dialysis patient is in Cardiac arrest?

Answer 26

100mEq IVP, IO | And flush with 50-100ml of NS

Question 27

What is the dose of Calcium Chloride while a Dialysis patient is in Cardiac arrest?

Answer 27

1gm IVP, IO

Question 28

Borderline Hypertension is ***/**. Elderly?

Question 29

Explain Nitro spray/tabs use in Hypertension? | When is treatment not indicated?

Answer 29

NTG Spray/tabs .4mg Max 3 doses or until 1. Pt diastolic is less than or equal to 100mmhg 2. Pt becomes hypotensive 3. Pt develops severe headache

Question 30

While treating hypertension, if a pt's diastolic pressure remains above 100mmHg after 3 NTG sprays what is your treatment?

Answer 30

1" Nitro Paste

Question 31

After giving NTG if a patient develops a systolic b/p of less then 90mmHg what is their treatment?

Answer 31

300-500ml NS bolus

Question 32

SVT can originate from where?

Question 33

Treatment for stable SVT?

Question 34

Preferred IV site to administer adenosine

Answer 34

Ante cubical site

Question 35

Treatment for unstable SVT?

Answer 35

Synchronized cardio version | 50, 100, 200, 300, 360

Question 36

Med/dose used for sedation prior to synchronized cardio version?

Question 37

Post resuscitation hypotension treatment?

Question 38

Consider in all ROSC situations unless contraindicated?

Answer 38

Induced hypothermia

Question 39

When is Amiodarone indicated in post resusitation? | Whats the dose?

Question 40

What are the indications for amiodarone in relation to PVCs?

Answer 40

Heart rate above 60 and

Question 41

Treatment for stable v-tach with a pulse?

Question 42

Treatment for unstable vtach with a pulse?

Question 43

What is the first action of a witnessed and unwitnessed arrest?

Answer 43

Witnessed-Defib 200j | Not Witnessed- CPR for 2 mins then Defib 200j

Question 44

Dose of Epi in V-fib, Pulseless V tach

Answer 44

1:10,000 1mg IVP repeat every 3-5 mins | 2-2.5mg ET

Question 45

Dose of Vasopression in V-fib, Pulseless V tach

Answer 45

40 Units to replace 1st or second dose of epi

Question 46

Dose of Amiodarone in V-fib, Pulseless V Tach

Answer 46

300mg, CPR,Defib,Epi, 150mg

Question 47

Dose for Sodium Bicarb in V-fib, Pulselss V tach and when to consider

Answer 47

1meq/kg, prolonged down time

Question 48

Mag Sulfate Cardiac indications and Dose

Answer 48

Torsades de pointes 1-2g

Question 49

Defib dose for V-Fib, Pulseless V Tach

Answer 49

200, 300, 360 joules NOT STACKED

Question 50

Proper placement of Defib Pads

Answer 50

Right of sternum at the 2nd intercostal space and anterier axillary line at the 5th intercostal space

Question 51

Placement of V1-V6 leads

Answer 51

V1-4th intercostal space at right sternal border V2-4th intercostal space at left of sternal border V3-Directly between V2 and V4 V4-5th intercostal space at midclavicular line V5-Level with V4 at left anterior axillary line V6-Level with V5 at left midaxillary line

Question 52

CPR Sequence

Answer 52

C-A-B Circulation, Airway, Breathing

Question 53

CPR Depth of Compressions

Answer 53

Adults- At least 2 inches | Pedi-1/3 of chest

Question 54

To interrupt pacing and view the patients intrinsic rhythm do this?

Answer 54

Press the pause button- this causes the pacer to pace at 25% of the set rate. Press pause again to resume pacing at the set rate

Question 55

Eligible patients for Induced hypothermia

Answer 55

- Adult 16 year or greater - Intubation - Non traumatic etiology with endotracheal tube - ROSC - Not pregnant - Pt is not responding to pain

Question 56

Ventilations During ROSC induced hypothermia

Answer 56

10resp/min or maintain Spco2 between 35-35mmhg

Question 57

Fluid dose during induced hypothermia?

Answer 57

40ml/kg or max od 2L

Question 58

Sedation during induced hypothermia?

Answer 58

Versed 1-2mg | Vecuronium 0.1 mg/kg max of 10mg

Question 59

Contraindications to using Adenosine?

Answer 59

2nd and 3rd degree blocks, Sick sinus syndrome, Us caution with asthma patients, may cause bronchospasms.