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ACLS & 2010 CHANGES

ACLS data with 2010 Guidelines to study for ACLS

QuestionAnswer
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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