ACLS

http://www.unc.edu/~rvp/old/RP_Anesthesia/Basics/ACLSAlgorithms.html

What is the time cycle for compressions? 2 minutes

What is the mnemonic for the interventions in asystole? P E A

In the asystole intervention mnemonic, what is 'P'? Problem Search

In the asystole intervention mnemonic, what is 'E'? Epinephrine

In the asystole intervention mnemonic, what is 'A'? Atropine

What is the dose of Epinephrine given during asystole? 1mg IV q3-5 min

What is the dose of vasopressin given during asystole? 40U IV once

When can vasopressin be given in place of epinephrine when coding asystole? Vasopressin may be given in place of the first or second dose. What is the dose of atropine given during asystole? 1 mg IV q3-5 min

What is the maximum dose of atropine that may be given when coding asystole? 3mg

What are the indications for starting a code for bradycardia? Absolute or relative bradycardia

What is the mnemonic for coding bradycardia? Pacing Always Ends Danger

In the bradycardia intervention mnemonic, what is 'P'? Pacing

In the bradycardia intervention mnemonic, what is 'E'? Epinephrine

In the bradycardia intervention mnemonic, what is 'A'? Atropine

In the bradycardia intervention mnemonic, what is 'D'? Dopamine

What are the indications for transcutaneous pacing in bradycardia? symptomatic bradycardia atropine fails to increase rate

What is the dose of atropine given while coding bradycardia? 0.5 mg IV 3-5 min

What is the dosage of epinephrine given while coding bradycardia? 2-10 µg/min

What is the dosage of dopamine given while coding bradycardia? 2-10 µg/kg/min

What is the recourse for failed transcutaneous pacing in bradycardia? transvenous pacing

What is the mnemonic for the differential diagnosis of acute coronary syndrome? PATCH 4 MD

In the ACLS differential diagnosis mnemonic, what is 'P'? Pulmonary Embolism

In the ACLS differential diagnosis mnemonic, what is 'A'? Acidosis

In the ACLS differential diagnosis mnemonic, what is 'T'? Tension Pneumothorax

In the ACLS differential diagnosis mnemonic, what is 'C'? Cardiac Tamponade

In the ACLS differential diagnosis mnemonic, what is 'H4'? Hyperkalemia Hypovolemia Hyperkalemia Hypoxia

In the ACLS differential diagnosis mnemonic, what is 'M'? Myocardial Infarct

In the ACLS differential diagnosis mnemonic, what is 'D'? Drugs

In the ACLS differential diagnosis mnemonic, what is 'S'? Shivering (hypothermia)

What is the mnemonic for the treatment of hyperkalemia? ICK BADD

In the hyperkalemia mnemonic, what is 'I'? Insulin

In the hyperkalemia mnemonic, what is 'C'? Calcium

In the hyperkalemia mnemonic, what is 'K'? Kayexalate

In the hyperkalemia mnemonic, what is 'B'? Bicarbonate

In the hyperkalemia mnemonic, what is 'A'? Albuterol nebulizer

In the hyperkalemia mnemonic, what is 'D'? Dialysis Diuresis

What is the 'holy trinity' of the ED? O2, monitor, IV

What is the first step in the algorhythm for tachycardia? Is the rate stable?

What should be done if a patient is unstable and tachycardic? 1. Stable? Yes ↓ next question No, unstable = Immediate electrical cardioversion 2. Narrow? Yes ↓ next question No, wide = Consult an expert (QRS ≥0.12 sec) 3. Regular? Yes ↓ see mnemonic No, irregular = Consult an expert Yes 1-2-3, think SVT, then V-A-C ↓  Vagal maneuvers, if this fails.. ↓  Adenosine 6mg rapid IV push (may repeat x2, q1-2min. at 12mg) ↓  Cardizem (diltiazem) managed by an expert if stable, narrow, regular tachyarrhythmia continues Perform immediate electrical cardioversion if a patient becomes unstable at any time. For sinus tachycardia consider possible causes and treat accordingly.

Consult an Expert Most stable tachycardia rhythms require management by an expert due to the challenge of accurately determining and safely treating tachyarrhythmias. A sampling of rhythms and possible expert interventions are listed below.

Stable Narrow Irregular Tachycardia Atrial Fibrillation, Multifocal Atrial Tachycardia, possibly Atrial Flutter Rate Control: diltiazem or beta blocker

Stable Narrow Regular Tachycardia Recurrent SVT, Atrial Flutter, Junctional or Ectopic Atrial Tachycardia Rate Control: diltiazem or beta blocker

Stable Wide Irregular Tachycardia (Avoid calcium channel blockers and digoxin due to possible AF+WPW) Consider amiodarone. Magnesium 2g IV over 5min. for torsades

Stable Wide Regular Tachycardia If VT, amiodarone 150mg IV over 10min. repeat prn (max 2.2g IV/24hr), elective synchronized cardioversion