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  1. Shockable Rythms
    • VTach without a rhythm
    • VFib
  2. NonShockable Rythms
    • PEA - Pulseless electrical activity
    • Asystole
    • (CANNOT give Atropine with these rhythms)
  3. If you have a client with tachycardia, HR 200, other vitals ok, what do you do first?
    Get a 12 lead EKG
  4. If client C/O chest pain and vitals are w/in range, what's your 1st step?
    Get a 12 lead EKG
  5. Client C/O epigastric pain, vitals are ok. What is your next test?
    12 lead EKG
  6. How do you obtain an appropriate sized OPA?
    Measure from corner of mouth to angle of mandible
  7. Client has bradycardia, what is correct Dopamine dose?
    2-10 mcg/kg/min
  8. Client has bradycardia and poor vitals, first drug is?
    Atropine 0.5 g
  9. Minimum systolic BP to stop CPR
    90 mm hg
  10. How fast should chest compressions be?
    AT LEAST 100 per minute
  11. Client has VTach. What do you do?
    Initiate CPR because there is a small amount of blood flow to heart
  12. How can you keep quality of chest compressions up?
    Switch compressors every 2 minutes or 5 cycles
  13. If the AED doesn't promptly analyze the rhythm, what do you do?
    Continue compressions
  14. What is a fatal mistake often made in CPR
    Prolonged interruptions in chest compressions
  15. Longest interval you can go between chest compressions
    No more than 10 seconds
  16. WHat do you do while AED is charging?
    Continue compressions
  17. If there is electrical activity but no pulse, what do you do?
    Chest compressions
  18. Client suddenly loses consciousness and isn't breathing.  You aren't sure if they have a pulse.  What do you do?
  19. Client is non responsive, not breathing, no pulse.  What do you do?
  20. What don't you want to do while inserting ET tube?
    Apply cricoid pressure
  21. If client has refractory VF, what do you give?
    First dose of Amiodarone - 300 mg
  22. 2nd dose of Adenosine for Refractory SVT
    12 mg
  23. What is treatment of choice for asystole?
  24. Recommended dose of aspirin for suspected acute coronary syndrome
    160 mg - 325 mg
  25. How can you get drugs quickly into system during compressions?
    IV/IO infused rapidly
  26. After defib with VF of pulseless VT what do you do
    Chest compressions
  27. WHat allows for more rapid defibrillation
    Hands free pads
  28. Client has electrical activity, no pulse and compressions have begun.  What is next step
    Epinephrine 1 mg
  29. Preferred method of access for epinephrine
    Peripheral IV
  30. Post cardiac arrest, ROSC, when is therapeutic hypothermia contraindicated?
    Client responds to verbal commands
  31. Target body temp for Hypothermia
    32-34 degrees C
  32. What is recommended IV bolus if hypotensive post arrest
    1-2 liters
  33. Client is pulseless, CPR and ventilation have begun.  What is next step?
    Insert iv or io
  34. Primary purpose of MET/RRT
    Improving outcomes by identifying and treating early clinical deterioration
  35. What can high levels of O2 cause
    Oxygen toxicity
  36. How long do you check for carotid pulse
    No more than 5-10 seconds
  37. After 2 minutes of CPR, you see an organized rhythm.  What do you do next?
    Have team member palpate carotid pulse
  38. What does PetcO2 and capnography do?
    Allows for monitoring of CPR
  39. What should PetcO2 show if CPR is being done effectively
  40. Ususal post arrest target for PetcO2 with pulse is?
    35-40 mm Hg
  41. What is most reliable way to check for correct ETT placement
    Coninuous waveform capnography
  42. What type of facility should patient go to after ROSC?
    Facility with PCI capability
  43. Client has symptoms of stroke and CT scanner is broken, what do you do?
    Divert to hospital within 15 minutes away that has a CT
  44. CLient has symptoms of stroke with positive prehospital stroke assessment.  What is next step?
    Non contrast CT scan
  45. What is first intervention for narrow complex tachycardia
    Vagal maneuver
  46. If patient is hypotensive.  What could he deteriorate to?
    Unstable SVT
  47. 2nd dose of adenosine with Stable narrow complex tachycardia
    12 mg
  48. Why would you stop resuscitative efforts?
    Safety threat to the provider
  49. Client has VF for 25 minutes and is now asystole.  WHat is next step
    Consider stopping after consulting medical control
  50. Treatment for unstable VT
  51. What is 1st treatment after ROSC
    Optimizing ventilation and oxygenation
  52. Client has respiratory failure and becomes apneic, pulse is good but drops to 30.  Next step?
    Simple airway maneuver and assisted ventilation
  53. Strategy for CPR with advanced airway
    Compressions without pause, 10 ventilations per minute
  54. Maximum time to withdrawal suction
    10 seconds
  55. Ventilation rate for advanced airway
    8-10 breaths per minute
  56. Rate of ventilations with a pulse
    1 breath every 5-6 seconds
  57. Client has wide complex tachycardia and is hypotensive. What is next step?
    Synchronized cardioversion
  58. No pulse.  Torsades appearing.  What do you do?
  59. Supraventricular vs. ventricular
    • Supra - occurs in atrium (Narrow complex)
    • Venticular - occurs in ventricles (Wide complex)
  60. Supraventricular Tachycardia
    Regular heart beat where rate is 150-250
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