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ACLS & 2010 CHANGES
ACLS data with 2010 Guidelines to study for ACLS
| Question | Answer |
|---|---|
| Ventricular Fibrillation VF | Ventricles are "quivering" No P, QRS, T waves Rate 150-500 fine = 2-5mm coarse = 10-15 |
| Pulseless Electrical Activity PEA | Organized electrical activity, no pulse |
| Asystole | No rhythm seen, no QRS |
| PEA MNEMONIC 5H 5T | Hypovolemia, Hypothermia, Hypoxia, Hydogen Ion Acidosis, Hypo/Hyperkalemia. Toxins, Tamponade, Tension pneumothorax, Thrombosis coronary, Thrombosis, pulmonary. |
| PEA MNEMONIC "PATCH(5)MED" | Pulmonary embolus Acidosis Tension pneumothorax Cardiac tamponade Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia Myocardial infarction Electrolyte derangements Drugs |
| SINUS TACHYCARDIA | >100BPM |
| ATRIAL FIBRILLATION | 300-400 Atrial rate, Atria "quivering" |
| ATRIAL FLUTTER | 220-350 Atrial rate, Circular, usuall in set ratio to ventricular activity |
| SVT or SUPRAVENTRICULAR TACHYCARRHYTHMIA | comes from "above" or from atria QRS normal |
| REENTRY TACHYS | P-waves hard to see or absent |
| MONOMORPHIC VT | Every QRS is the same, WIDE QRS, no PR, |
| POLYMORPHIC VT | QRS CHNAGES, WIDE QRS |
| TORSADES DE POINTES | UNDULATING AMPLITUDE; MAG SULFATE |
| 1° AV BLOCK | PR INTERVAL >0.20 |
| 2° TYPE I AV BLOCK or MOBITZ I or WENCKEBACH | PROGRESSIVE LENGTHENING OF PR UNTIL ONE QRS IS DROPPED |
| 2° TYPE II AV BLOCK or MOBITZ II | PR IS CONSTANT AND SET |
| 3° AV BLOCK | AV DISSOCIATION; ATRIA AND VENTRICLES CONTRACT INDEPENDENTLY |
| ESTIMATING RATES ON PAPER | 300, 150, 100, 75, 50 |
| IDENTIFYING RHYTHMS | IS THERE A P? IS PR NORMAL? ARE P:QRS = 1:1? QRS WIDE OR NARROW? |
| SHOCKABLE RHYTHMS | VT OR VF, SVT (AFIB, AFLUT) |
| NON-SHOCKABLE RHYTHMS | ASYSTOLE OR PEA |
| ASYSTOLE OR PEA ALGORITHM | CPR 2min; EPI 3-5min; shockable?; NO:CPR 2 MIN YES:SHOCK, CPR 2min; etc |
| VF / VT ALGORITHM | CPR 2min; SHOCK?; CPR 2min, epi; SHOCK?; Amioderone 300/150; Vasopressin 40units may be sub for EPI |
| ADENOSINE | FAST/FLUSH; NARROW QRS VT/VF/SVT; 6MG/12MG in 1-2 mins |
| COMPRESSION / VENT RATIO BAG/MASK | 30 / 2 |
| COMPRESSION / VENT RATIO INTUBATION | 1 VENT Q6-8 SECONDS NO PAUSE |
| VENT RATE FOR RESP ARREST WITH PULSE | 1 VENT Q5-6 SECONDS |
| MAY BE GIVEN BY ENDOTRACHEAL TUBE | VASOPRESSIN; EPI; LIDOCAINE |
| BRADYCARDIA | ATROPINE 0.5mg IV up to 3mg; TCPACING; DOPAMINE 2-10mcg/kg/min; EPI 2-10mcg/min |
| ERRATIC VT/VF | ONE SHOCK |
| STABLE TACHY | VAGAL |
| UNSURE OF PULSE | 2 MIN OF CPR!!! |
| REPERFUSION #1 | WITH SUSPECTED OR CONFIRMED MI |
| HYPERTHERMIA | PROVIDES BEST OUTCOME FOR MI |
| MI DRUGS | 02; ASPRIN; NITRATES; MORPHINE |
| EPI | (vp)1 MG IV / IO AFTER DEFIB OF ANY CARDIAC ARREST |
| VASOPRESSIN | (vp) USED IN CARDIAC ARREST AS AN ALTERNATIVE TO FIRST OR SECOND DOSE EPINEPHRIN |
| LIDOCAINE | ANTIARRHYTHMIC TO SLOW CONDUCTION AND REPOLARIZATION VF/FT 1-1.5 mg/kg IV INSTEAD OF AMIODARONE |
| AMIODARONE | USED TO RESOLVE A&V TACHY VT/VF |
| CA BLOCKERS: verapamil;cardizem | svt/afib/aflut with fast ventricular response |
| BETA BLOCKERS | RECURRENT VT/VR AND REFRACTORY SVT |
| DIGOXIN DOPAMINE DOBUTAMINE ISOPROTERONOL EPI AMIODARONE | INCREASE HR, BP, PERFUSION; ALSO O2 COMSUPTION |
| ASA & MI | 160-325 MG CHEWED IMMED IF NO CONTRAINDS |
| AMIODARONE | (a-ar) 300MG IV/IO / 150 MG IV/IO |
| ATROPINE | EG TUBE OK; SYMPTOMATIC BRADYCARDIA; not MOBITZ II |
| DOPAMINE | SYMPTOMATIC BRADY after ATROPINE; HYPOTENSION W/ S/S SHOCK 2-20mcg/kg/min |
| EPINEPHRINE | VF, PEA, PULSELESS VT, ASYSTOLE; may infuse for brady instead of dopamine 0.1-0.5mcg/kg/min; profound brady 2-10 mcg per min |
Created by:
TAKORN
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