midterm

Question 1

treatment:
symptomatic sinus brady
junctional
1st degree
2nd degree type 1

Answer 1

atropine 0.5mg every 3-5 max of 3mg
TCP with midazolam 0.5-2.5mg
dopamine 5-20 mcg/kg/min
epi 2-10 2-10 mcg/min

Question 2

treatment:
SVT
PSVT
junctional tach

Answer 2

vagal maneuvers
(if unstable) synchronized cardiovert 50-100J
midazolam 0.5-2.5mg if cardioverting
(if stable) adenosine 6mg-repeat at 12mg
consider
cartizem .25mg/kg repeat in 15 at .35mg/kg

Question 3

treatment:
symptomatic A Fib
A flutter with RVR

Answer 3

cardizem .25mg/kg repeat at .35mg/kg

syncronized cardiovert

Question 4

treatment:
Asystole
PEA

Answer 4

CPR
epi 1mg 1:10000 every pulse check (2 minutes)
sodium bicarb

Question 5

treatment:

PVC-non symptomatic

Answer 5

no treatment

Question 6

treatment:

PVC-symptomatic or >5 per minute

Answer 6

lidocaine 1.5mg/kg every 3-5 at .75mg/kg max 3mg/kg
if successful-lidocaine infusion 1-4 mg/min
avoid treating bigeminy/trigemini

Question 7

treatment:
2nd degree type 2
3rd degree

Answer 7

(same as other blocks minus atropine)
TCP with midazolam 0.5-2.5mg
dopamine 5-20 mcg/kg/min
epi 2-10 mcg/min

Question 8

treatment:

stable or wide complex V tach with a pulse

Answer 8

stable-lidocaine 1.5mg/kg every 3-5 at .75 max 3mg/kg unstable-cardiovert 50,100,150,200,300,360 with miazolam 0.5-2.5mg

Question 9

treatment:
polymorhpic VT
torsades des pointes

Answer 9

mag sulfate 25-50mg/kg max of 2g
TCP
Lidocaine 1.5mg/kg every 3-5 at .75mg/kg max 3mg/kg
cardiovert 50,100,150,200,300,360

Question 10

treatment:
sinus tach
PAC

Answer 10

treat underlying

Question 11

treatment:

accelerated junctional

Answer 11

seldom treated

Question 12

treatment:

sinus arrest

Answer 12

pacemaker

Question 13

treatment:

pulseless V tach/Vfib

Answer 13

witnessed-defib 200J
not witnessed-2 minutes cpr then defib 
epi 1mg 1:10000
cpr/pulse check/defib 
antidysrythmIc (amio or lido)
amio 300 mg/lido 1.5
cpr/pulse check/defib
epi
cpr/pulse check/defib
amio 150 or lido .75
cpr/pulse check/defib 
epi
cpr/pulse check/defib
(out of amio or lido .75)
mag sulfate 1-2 g in 100cc bag over 5-10 
cpr/pulse check/defib
consider sodium bicarb 1meq/kg
if rosc initiate fifth protocol

Question 14

Hs and Ts

H’s

Answer 14

Hypovolemia
Hypoxia
Hydrogen ion excess (acidosis)
Hypoglycemia
Hypokalemia
Hyperkalemia
Hypothermia

Question 15

Hs and Ts

T’s

Answer 15

Tension pneumothorax
Tamponade – Cardiac
Toxins
Thrombosis (pulmonary embolus)
Thrombosis (myocardial infarction)

Question 16

epi dose:

bolus and infusion

Answer 16

1mg 1:10000

2-10 mcg/min

Question 17

atropine dose:

Answer 17

0.5 mg every 3-5 max 3mg

Question 18

dopamine dose:

Answer 18

5-20 mcg/kg/min

Question 19

adenosine dose:

Answer 19

6mg repeat at 12mg

Question 20

cardizem dose:

Answer 20

.25mg/kg over 2 minutes repeat in 15 at .35mg/kg

Question 21

sodium bicarb dose:

Answer 21

1meq/kg

Question 22

midazolam/versed dose:
(RSI)
dont give to: shock, coma,
ETOH, overdose, depressed vital signs

Answer 22

0.5-2.5 mg max 0.1mg/kg

Question 23

mag sulfate dose:

Answer 23

25-50 mg/kg max of 2G

Question 24

albuterol dose:

Answer 24

2.5 mg with 2.5 ml NaCl Nebulized max dose of 2

Tx’s

Question 25

aspirin dose:

Answer 25

160 mg- 325 mg PO

Question 26

calcium chloride dose:
give to:
Hypocalcemia, Hyperkalemia, Hypomagnesemia, beta
blocker and calcium channel blocker toxicity
dont give to:
Hypercalcemia, VF (relative), digitalis toxicity

Answer 26

500 mg- 1000 mg

Question 27

dextrose dose:

Answer 27

25G D50

Question 28

valium/diazepam dose:

sedation

Answer 28

5mg

Question 29

etomidate dose:

RSI

Answer 29

0.2-0.6 mg/kg

Question 30

fentanyl dose:

anesthesia adjunct

Answer 30

1 mcg/kg

Question 31

atrovent dose:

Answer 31

250-500 mcg max of 3 tx’s

Question 32

ketamine dose:

procedural sedation

Answer 32

1-2 mg/kg

Question 33

morphine dose:

Answer 33

2-4 mg may repeat 2-8 mg max of 10mg

Question 34

naloxone dose:

Answer 34

0.4-2mg

Question 35

nitro dose:

CP

Answer 35

0.4 mg every 3-5 max 3 doses

Question 36

succinylcholine dose:

RSI

Answer 36

1-2 mg/kg repeat in 5 for adolescents and adults only

Question 37

vecuronium dose:

RSI

Answer 37

0.1-0.2 mg/kg