ACLS – Flashcards

after 2 rounds of CPR/shock after 2nd shock give 1 mg epinephrine every 3-5 minutes

after the 3rd shock give 300 mg bolus of amiodarone if second dose is needed give 150mg as second dose

VF VT

asystole PEA

1mg epi every 3-5 minutes after 1st round of CPR

maintain O2 sat at 94% treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion

hypovolemia hypoxia hydrogen ion (acidosis) hypo/hyperkalemia hypothermia tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary thrombosis, coronary

monitor and observe

hypotension altered mental status signs of shock chest pain acute heart failure

1. give 0.5mg atropine every 3-5 mins to max of 3mg if that doesn't work try one of the following: transcutaneous pacing 2-10mcg/kg / minute dopamine infusion 2-10mcg/minute epinephrine infusion

over 150 per minute

if persistent tachycardia is causing: hypotension altered mental status signs of shock chest pain acute heart failure

wide QRS? greater than 0.12 seconds

IV access and 12 lead if available 6mg adenosine followed by NS flush only IF regular and monomorphic consider anti-arrhythmic infusion: - 20-50mg/min procainamide (max 17mg/kg) - 150mg amiodarone over 10 minutes - 100mg sotalol over 5 minutes

only amiodarone 150mg over 10 minutes, repeat if VT occurs follow by maintenance infusion 1mg/min for first 6 hours

IV access and 12 lead EKG if available vagal maneuvers 6mg adenosine followed by NS flush only IF regular Beta blocker or calcium channel blocker

chew 325mg aspirin O2 nitro morphine get 12 lead EKG IV access

re-perfusion door to balloon 90 minutes door to needle 30 minutes

early invasive strategy? adjunctive treatment? -nitroglycerin -heparin -beta blockers -clopidogrel -glycoprotein IIb / IIIa inhibitor

systolic > 180 diastolic > 100 right arm left arm systolic difference > 15 history of structural central nervous system disease recent head/facial trauma stroke more than 3 hours or less then 3 months ago recent trauma, surgery or bleed any history of intracranial hemorrhage bleeding, clotting problem or on blood thinners serious systemic disease

used in tachy 6mg bolus followed by 20mL normal saline 12mg can be used after 1-2 minutes

In VF/VT arrest AFTER trying CPR shock and epi/vasopressin: 300mg then 150mg In life threatening arrhythmias: 150mg over 10 minute infusion, every 10 minutes as needed

use as first line defense in sinus bradycardia 0.5mg every 3-5 minutes as needed MAX is 3mg ( think alive gets 0.5) do not use if hypothermia

2nd line drug for symptomatic bradycardia use for hypotension with signs of shock 2-20 mcg/kg per minute

in cardiac arrest: 1mg every 3-5 minutes in bradycardia or hypotension: 2-10mcg/minute infusion

alternative to amiodirone in cardiac arrest: 1-1.5 mg/kg IV for stable VT, wide complex VT: 0.5 - 0.75 mg.kg every 5-10 minutes max of 3mg/kg

use in cardiac arrest only if hypomagnesemia or torsades: 1-2g diluted in 10mL of D5W use in torsades with a pulse or AMI with hypomagnesia: 1-2g in 50 to 100 mL of D5W maintenance with 0.5g per hour infusion

cardiac arrest: 40 units can replace either 1st or 2nd dose of epi

atropine epinephrine lidocaine vasopressin

1mEq of sodium bicarb

10-20 mEq of potassium

give mag sulfate 1-2g