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ACLS Protocols

QuestionAnswer
Asystole- What is protocol? Check in two leads, 2 Minutes CPR, IV/O2 (BVM 15 LPM), Epinephrine 1:10,000 1 mg IVP q 3-5 minutes, Atropine 1 mg IVP q 3-5 min, up to 3 mg, CPR Continued
Asystole- What is first thing you do? Check in two leads
Asystole- What is the first drug given? Epinephrine- 1:10,000 1 mg IVP q 3-5 minutes
Asystole- What is second drug given? Atropine- 1 mg IVP q 3-5 min, up to 3 mg
Asystole- What is another drug given? Sodium Bicarbonate 8.4% (Alkalinizer)- 1 mEq/kg (1 ml/kg) followed by 0.5 mEq/kg q 10 minutes
Asystole- What else should you be considering? The causes of death...PATCH5MD
What is PATCH5MD? P-Pulmonary Embolism, A-Acidosis, T-Tension Pneumo, C-Cardiac Tamponade, H-Hypovolemia, H-Hyper/hypokalemia, H-Hypoglycemia, Hypo/hyperthermia, H-Hypoxia, M-MI, D-Drug overdose
All dead people get what drugs? Epinehrine 1:10,000 1 mg IVP q3-5 min and Atropine 1 mg IVP q 3-5 min, up to 3 mg
V-Fib/Pulseless V-Tach- What is first thing you do? CPR and O2 (BVM 15 LPM)
V-Fib/Pulseless V-Tach- What is second thing you do? IV Access
V-Fib/Pulseless V-Tach- What is third thing you do? Defibrilate at 360J
V-Fib/Pulseless V-Tach- What is first drug given? Epinephrine 1:10,000 1mg IVP q 3-5 min
V-Fib/Pulseless V-Tach- What is another drug given other than Epi? Vasopressin 40U IV
V-Fib/Pulseless V-Tach- What is the second drug given? Amiodarone 300mg IVP
V-Fib/Pulseless V-Tach- What is another drug given for a second drug? Lidocaine 1.5mg/kg IVP
V-Fib/Pulseless V-Tach- What do you shock at for joule setting? 360 Joule's
V-Fib/Pulseless V-Tach- What is the protocol? CPR/O2, IV Access, Defib 360, CPR, Epi 1:10, 1mg q 3-5 min, Defib 360J, CPR, Amiodarone 300mg IVP, Defib 360J, CPR, Amiodarone 150mg IVP, Defib 360J
PEA- What is it? Any rhythm other than asystole, v-fib and pulseless v-tach. Pulseless Electrical Activity. The heart is not able to perfuse properly but has electrical conductivity.
PEA- What is the protocol? CPR/IV/O2(BVM), Epi 1:10,000 1mg IVP q 3-5 min, consider H's and T's
PEA- What is something else you should do for the patient during the assessment? Look for reasons the patient is having a problem (PATCH5MD)
PEA- What is another drug you can use as a casopressor other than Epi? Vasopressin 40U IVP
PEA- What if HR is < 60 bpm? Give Atropine 1mg IVP, up to 3mg
V-Tach+pulse (stable)- What is the first thing you do for this? O2 (NRB) and IV
V-Tach+pulse (stable)- What is the first drug you give for this? Amiodarone 150mg over 10 min
V-Tach+pulse (stable)- What is the drip for Amiodarone? 150mg infuse in 100cc w/10 gtts set = 100 gtts/min
V-Tach+pulse (stable)- What is the maint drip for Amiodarone? 100mg in 100cc w/60 gtts et over 10 min = 100 gtts/min
V-Tach+pulse (unstable)- What is unstable protocol? O2/IV, cardiovert 100J, 200J, 300J, 360J, Lidocaine 1mg/kg IVP, cardiovert 360J, Lidocaine 1mg/kg IVP, Cardiovert 360J, Lidocaine 1mg/kg IVP, (if conversion before step 6 Lidocaine bolus @ 1mg and maint drip @ 2
What makes a patient unstable vs. being stable? Three things make a patient unstable: AMS, BP less than 90 systolic and Pumonary Edema
SVT+pulse (stable)- What is the first thing you do for this patient? Have patient to vagal maneuvers
SVT+pulse (stable)- What is the second thing you do for this patient? IV/O2
SVT+pulse (stable)- What is the first drug given for this patient? Adenosine 6mg RIVP
SVT+pulse (stable)- What is second drug given for this patient? After 2 minutes Adenosine 12mg RIVP
SVT+pulse (stable)- What is third drug given for this patient? After 2 minutes Adenosine 12mg RIVP
SVT+pulse (stable)- If stable give drugs first before cardioversion If stable give drugs first before cardioversion
SVT+pulse (unstable)- What is the first thing you do for this patient? Cardiovert 100J, 200J, 300J, 360J
SVT+pulse (unstable)-What is the drug given for this patient? Give Adenosone 6mg, 12mg, 12mg RIVP
SVT+pulse (unstable)- After cardioverting initially, what joule setting do you use? A joule setting at 360J for all other cardioversion
SVT+pulse (unstable)-What is the protocol for this rhythm? Cardiovert at 100J Cardiovert 200J Cardiovert 300J Cariovert 360J Adenosine 6mg RIVP Cardiovert 360J Adenosine 12mg RIVP Cardiovert 360J Adenosine 12mg RIVP Cardiovert 360J
Brady+pulse (symptomatic)- What is the protocol for this rhythm? O2/IVAtropine .5mg IVP up to 3mgTCP 80 ma 80 bpmDopamine 5-10mcg.kg/min IVP
Created by: robillard.james