ACLS

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readyreg29
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268736
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ACLS
Updated:
2014-04-10 09:14:06
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ACLS
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ACLS
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MEDIC 2013
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  1. Suppression of ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation, PVC's).

    Prophylaxis against recurrence after conversion from ventricular tachycardia or
    ventricular fibrillation.

    Frequent PVC's (>than 6 per minute; 2 or more in a row; multiform PVC's; or R-on-T phenomenon).
    LIDOCAINE HCl
  2. LIDOCAINE HCL 
    Pulseless VF/VT: 
    Antidysrhythmic or rhythms with a pulse:
    • Pulseless VF/VT: IV 1.0-1.5 mg/kg 3-5 min to total of 3 mg/kg 
    • Antidysrhythmic or rhythms with a pulse: 
    • IV 1.0-1.5mg/kg to 0.5-0.75mg/kg every
    • 5-10min to a total of 3 mg/kg.
  3. LIDOCAINE HCL
    Maintenance Infusion:
    • 1 gm in  250mL NS or 5% dextrose or premixed solution (2 gm in 500 mL)
    • Initiate drip 2-4 mg/min according to concentration.

    • ** Patients > 70 years or with hepatic, renal disease or poor perfusion state, reduce
    • maintenance infusion by half. 
  4. MAGNESIUM SULFATE 
    Indications
    • Torsade de pointes
    • VF/Pulseless VT refractory to lidocaine and/or amiodarone
    • Hypomagnesemia
    • Pre-term labor (PTL)
    • Pregnancy-induced hypertension
    • Hyperreactive Airway - Severe Asthma
  5. MAGNESIUM SULFATE 
    Dosages
    • Torsade de pointes
    • VF/Pulseless VT

    • 1-2 Gm IV diluted in 50-100 ml NS or D5W, administered over 1-2
    • minutes.
  6. ADENOSINE 
    Indications 
    Dosage
    • Conversion of supraventricular tachycardias 
    • IV: 6 mg rapid bolus over 1-3 seconds
    • Follow immediately with 20 ml NS flush 

    **If no response in 1-2 minutes repeat 12 mg twice 
  7. Drug used for Treatment of: defibrillation-refractory VF/pulseless VT, polymorphic VT, and wide complex tachycardia of uncertain origin
    &
    Dosage
    • AMIODARONE 
    • VF/Pulseless VT
    • 300 mg IV push over 30 – 60 seconds, may repeat in 3-5 minutes with 150 mg IV push
  8. AMIODARONE Adult dosage: 
    (if Adenosine is ineffective)
    Wide-Complex Tachycardias, Atrial Flutter, Atrial Fibrillation, SVT with cardioversion
    IV: 150mg in 50mL of D5W over 10 minutes (may repeat every 10 minutes)
  9. ACS/Chest Pain/Angina alogrhythm drugs:
    • Asprin: 325mg
    • Nitroglycerin: 0.4mg (x3 max.)
    • Morphine: IV 2-4mg to 10mg max.
    • or
    • Fentanyl: IV 50-100 mcg to 200 mcg max.
    •              IM/IN 2mcg/kg to 200 mcg max
  10. ATROPINE SULFATE 
    Indications & Dosages
    • Symptomatic Bradycardia
    • IV – 0.5 mg every 5 minutes.
    • Do NOT exceed a total dose of 3 mg
  11. EPINEPHRINE HCl 
    Indications
    • Cardiac arrest
    • Anaphylaxis
    • Severe bronchospasm
    • Hypotension unresponsive to other therapy
    • Bradycardia 
    • Croup
  12. EPINEPHRINE HCl 
    Dosages
    • Pulseless Arrest –
    • IV/IO: 1 mg of 1:10,000 solution repeat every 3 - 5 minutes  
    • Continuous Infusion for Hypotension or Symptomatic Bradycardia:
    • 1 mg added to 500 mL of NS administered at 1 mcg/min titrated to desired hemodynamic response (range 2-10 mcg/min) 

    Anaphylaxis and asthma: IM 0.3 - 0.5 mg of 1:1,000
  13. NITROGLYCERIN 
    Indications
    • Angina
    • Myocardial infarction
    • Congestive heart failure with pulmonary edema
  14. NITROGLYCERIN
    Dosages
    • SL for Chest pain: (0.4 mg) tablet or one full spray, may repeat x 3
    • SL for Pulmonary edema:
    • (0.4 mg) tablets SL every 5-10 minutes
    • BP is greater 90-100 systolic
  15. ACETYLSALICYLIC ACID, ASPIRIN, ASA 
    Indications & Dosages
    • Chest pain or signs/symptoms suggestive of acute myocardial infarction
    • Unstable angina
    • Pain, discomfort, fever (adult patient only)

    • Cardiac: 160- 325 mg (chewable tabs)
    • Pain/discomfort/fever: 325 mg (chewable tablets)
  16. STEMI
    • ST 
    • Elevation
    • Myocardial
    • Infarction
  17. Formula to convert pounds to Kg
    Pounds divided by 2.2046
  18. The two main arteries of the heart
    Right and Left coronary artery
  19. Leads II, III, aVF focus on the:
    Inferior wall of the left ventricle
  20. Leads V1, V2 focus on the:
    Septal wall
  21. Leads V3, V4 focus on the:
    Anterior wall of the left ventricle
  22. Leads V5, V6, I, aVL focus on the:
    Lateral wall of the left ventricle
  23. Prevents clots in the blood vessels before or after surgery or during certain medical procedures. Also treats certain blood, heart, and lung disorders and helps diagnose and treat certain bleeding disorders. This medicine is a blood thinner
    Heparin
  24. Symptomatic Bradycardia alogrhythm
    • Atropine: IV 0.5mg every 5mins (3mg max)
    • TCP
    • Dopamine 2 - 10 mcg/kg/min
    • or
    • Epinephrine 2 - 10 mcg/min
  25. Narrow Regular QRS Tachycardia alogrhythm:
    • Vagal maneuver
    • Adenosine: IV 6mg followed by 20mL NS
    • 2nd Dosage - 12mg
    • Diltiazem: .25mg/kg over 2 min (20mg max)
    • or
    • Verapamil: IV 2-2.5mg over 1-2 mins
  26. Shockable rhythms
    • Ventricle fibrillation 
    • Ventricle tachycardia
  27. Non-shockable rhythms
    • Asystole
    • Pulseless electronic activity (PEA)
  28. The systematic approach uses what survey to determine the patient's level of consciousness for the initial assessment
    • If unconscious: BLS survey
    • If conscious: ACLS survey
  29. The BLS survey stresses what two actions:
    • CPR
    • Early defibrillation
  30. The BLS survey steps:
    • Check responsiveness
    • Activate the emergency response system
    • Check the carotid pulse
    • Defibrillation
  31. Try to limit these interruptions (for no longer than):
    Chest compressions
    Defibrillation
    Advanced airway
    Prolonged rhythm analysis
    Frequent or inappropriate pulse checks
    Taking too long to give breaths 
    Unnecessarily moving the patient
    10 seconds
  32. The adult chain of survival:
    • Immediate recognition of cardiac arrest and EMS activation
    • Early CPR w/ chest compressions
    • Rapid defibrillation
    • Effective ALS
    • Integrated post-cardiac arrest care
  33. Contraindications of NITROGLYCERIN
    • Hypovolemia
    • Increased Intra cranial pressure 
    • Systolic BP > 90-100
  34. O2 saturation should be what % before administering O2
    94
  35. A non-surgical widening of the coronary artery, using a balloon catheter to dilate the artery from within. To open blocked coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue.
    Percutaneous coronary intervention (PCI)
  36. The 8 D's of stroke care:
    • Detection
    • Dispatch
    • Delivery
    • Door
    • Data
    • Decision
    • Drug
    • Disposition
  37. The major types of STROKE:
    • Ischemic
    • Hemorrhagic
  38. Occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases.
    Ischemic stroke
  39. Occurs when a weakened blood vessel ruptures. Most commonly caused by uncontrolled hypertension.
    Hemorrhagic stroke
  40. Caused by a temporary clot. Often called a “mini stroke”
    TIA (transient ischemic attack)
  41. Signs and symptoms of possible STROKE:
    • Sudden:
    • Weakness/numbness of face, arm, leg (especially one side of the body)
    • Confusion
    • Trouble speaking or understanding
    • Seeing (1 or both eyes)
    • Severe headache
    • Walking
    • Dizziness, loss of balance or coordination

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