ACLS Protocols
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| 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
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| Asystole- What is first thing you do? | Check in two leads
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| Asystole- What is the first drug given? | Epinephrine- 1:10,000 1 mg IVP q 3-5 minutes
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| Asystole- What is second drug given? | Atropine- 1 mg IVP q 3-5 min, up to 3 mg
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| 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
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| Asystole- What else should you be considering? | The causes of death...PATCH5MD
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| 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
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| 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
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| V-Fib/Pulseless V-Tach- What is first thing you do? | CPR and O2 (BVM 15 LPM)
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| V-Fib/Pulseless V-Tach- What is second thing you do? | IV Access
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| V-Fib/Pulseless V-Tach- What is third thing you do? | Defibrilate at 360J
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| V-Fib/Pulseless V-Tach- What is first drug given? | Epinephrine 1:10,000 1mg IVP q 3-5 min
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| V-Fib/Pulseless V-Tach- What is another drug given other than Epi? | Vasopressin 40U IV
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| V-Fib/Pulseless V-Tach- What is the second drug given? | Amiodarone 300mg IVP
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| V-Fib/Pulseless V-Tach- What is another drug given for a second drug? | Lidocaine 1.5mg/kg IVP
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| V-Fib/Pulseless V-Tach- What do you shock at for joule setting? | 360 Joule's
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| 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
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| 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.
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| 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
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| PEA- What is something else you should do for the patient during the assessment? | Look for reasons the patient is having a problem (PATCH5MD)
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| PEA- What is another drug you can use as a casopressor other than Epi? | Vasopressin 40U IVP
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| PEA- What if HR is < 60 bpm? | Give Atropine 1mg IVP, up to 3mg
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| V-Tach+pulse (stable)- What is the first thing you do for this? | O2 (NRB) and IV
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| V-Tach+pulse (stable)- What is the first drug you give for this? | Amiodarone 150mg over 10 min
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| V-Tach+pulse (stable)- What is the drip for Amiodarone? | 150mg infuse in 100cc w/10 gtts set = 100 gtts/min
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| V-Tach+pulse (stable)- What is the maint drip for Amiodarone? | 100mg in 100cc w/60 gtts et over 10 min = 100 gtts/min
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| 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
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| What makes a patient unstable vs. being stable? | Three things make a patient unstable: AMS, BP less than 90 systolic and Pumonary Edema
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| SVT+pulse (stable)- What is the first thing you do for this patient? | Have patient to vagal maneuvers
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| SVT+pulse (stable)- What is the second thing you do for this patient? | IV/O2
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| SVT+pulse (stable)- What is the first drug given for this patient? | Adenosine 6mg RIVP
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| SVT+pulse (stable)- What is second drug given for this patient? | After 2 minutes Adenosine 12mg RIVP
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| SVT+pulse (stable)- What is third drug given for this patient? | After 2 minutes Adenosine 12mg RIVP
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| SVT+pulse (stable)- If stable give drugs first before cardioversion | If stable give drugs first before cardioversion
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| SVT+pulse (unstable)- What is the first thing you do for this patient? | Cardiovert 100J, 200J, 300J, 360J
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| SVT+pulse (unstable)-What is the drug given for this patient? | Give Adenosone 6mg, 12mg, 12mg RIVP
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| SVT+pulse (unstable)- After cardioverting initially, what joule setting do you use? | A joule setting at 360J for all other cardioversion
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| 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
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| 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
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Created by:
robillard.james
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