ACLS AHA
A patient has a rapid *irregular wide-complex tachycardia*;
The ventricular rate is 138/min.;
It is asymptomatic, with a BP of 110/70 mmHG;
He has a h/o angina;
What action is recommended next? - a) Giving Adenosine: 6 mg IV bolus;
b) Giving Lidocaine: 1.5 mg IV bolus;
c) Performing synchronized cardioversion;
d) *Seeking expert consultation ✅*;
What tests should be performed for a patient with a suspected stroke within 2 hours of
arrival? - non contrast CT scan of the head
SVT types - 1) Atrial fibrillation (A-fib);
2) Paroxysmal Supraventricular Tachycardia (PSVT):
3) Atrial Flutter (A-flutter);
4) Wolff-Parkinson-White syndrome;
The patient is in *cardiac arrest*.
High-quality chest compressions are being given.
The patient is intubated, and an IV is being started.
The rhythm is *asystole*.
What is the first drug/dose to administer? - *Epinephrine 1 mg IV/IO*
*Transcutaneous Pacing* - Aka external pacing: is a temporary means of pacing a
patient's heart during a medical emergency.
It is accomplished by *gradually delivering pulses* of electric current (*50-100 mA*)
through the patient's chest until capture is reached (usually at a selected rate of 70),
which stimulates the *heart to contract* at a regular pace.
Which intervention is most appropriate for the treatment of a patient in *asystole*? -
*Epinephrine*
A patient with sinus *bradycardia* and a heart rate of 42/min is diaphoretic and with a
blood pressure of 80/60 mm Hg.
What is the *initial dose of atropine*? - *0.5 mg* of *Atropine*
A patient has sinus *bradycardia* with a heart rate of 36/min. *Atropine* has been
administered to a total dose of 3 mg. A *transcutaneous pacing* has failed to capture.
The patient is confused, and her BP is *88/56 mmHg*. Which therapy is now indicated?
- *Epinephrine infusion: 2-10 mcg/min*.
A monitored patient in the ICU developed a sudden onset of *regular narrow-complex
tachycardia* at a rate of 220/min.
The patient's BP is 128/88 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry
reading is 98%.
, ACLS AHA
There is a vascular (IV) access in the left arm, and the patient has not been given any
basic active drugs.
A 12-lead ECG confirms *SVT* with no evidence of ischemia or infraction.
The HR has not responded to vagal maneuvers.
What is your next action? - Administer *adenosine 6 mg* IV push
A patient with possible STEMI has ongoing chest discomfort. What is a *contraindication
to nitrate* administration? - Use of a *phosphodiesterase inhibitors* (eg. Viagra) within
the previous 24 hours
A patient is in *pulseless V-tach* (PEA). 2 shocks and 1 dose of epinephrine have been
given.
Which drug should be given next? - *Amiodarone 300 mg* (first dose)
What is the indication for the use of *magnesium* in cardiac arrest? - Pulseless V-tach
associated with *Torsades des pointes*
Which is one way to minimize interruptions in chest compressions during CPR? -
Continue CPR while the defibrillator charges
A 35-years-old woman has palpitations, light-headedness, and a stable *tachycardia*.
The monitor shows a *regular-narrow-monomorphic-complex QRS* at a rate of
180/minutes.
Vagal maneuvers have not been effective in terminating the rhythm.
An IV has been established.
Which drug should be administered? - *Adenosine 6 mg* (first dose)
Antiarrhythmic *Infusion* for Stable Wide-QRS Tachycardia: - 1) Procainamide IV: 20
(max 50) mg/min;
2) Amiodarone IV: 150mg/10 min.;
3) Sotalol IV: 100 mg/5 min.;
A 57-years-old woman has palpitations, chest discomfort, and *tachycardia*. The
monitor shows a *regular wide-complex QRS* at a rate of 180/min.
She becomes diaphoretic, and her BP is 80/60 mm Hg.
Which action do you take next? - Perform *Synchronized Cardioversion* at 100J
ROSC - Return to spontaneous circulation after BLS.
A patient is in *refractory V-fib* and has received multiple appropriate defibrillation
shocks;
Epinephrine 1 mg IV twice;
An initial dose of amiodarone 300 mg IV.
The patient is intubated.
Which best describes the recommended (IV) *2nd dose of amiodarone* for this patient?
- *150 mg* (half);
A patient has a rapid *irregular wide-complex tachycardia*;
The ventricular rate is 138/min.;
It is asymptomatic, with a BP of 110/70 mmHG;
He has a h/o angina;
What action is recommended next? - a) Giving Adenosine: 6 mg IV bolus;
b) Giving Lidocaine: 1.5 mg IV bolus;
c) Performing synchronized cardioversion;
d) *Seeking expert consultation ✅*;
What tests should be performed for a patient with a suspected stroke within 2 hours of
arrival? - non contrast CT scan of the head
SVT types - 1) Atrial fibrillation (A-fib);
2) Paroxysmal Supraventricular Tachycardia (PSVT):
3) Atrial Flutter (A-flutter);
4) Wolff-Parkinson-White syndrome;
The patient is in *cardiac arrest*.
High-quality chest compressions are being given.
The patient is intubated, and an IV is being started.
The rhythm is *asystole*.
What is the first drug/dose to administer? - *Epinephrine 1 mg IV/IO*
*Transcutaneous Pacing* - Aka external pacing: is a temporary means of pacing a
patient's heart during a medical emergency.
It is accomplished by *gradually delivering pulses* of electric current (*50-100 mA*)
through the patient's chest until capture is reached (usually at a selected rate of 70),
which stimulates the *heart to contract* at a regular pace.
Which intervention is most appropriate for the treatment of a patient in *asystole*? -
*Epinephrine*
A patient with sinus *bradycardia* and a heart rate of 42/min is diaphoretic and with a
blood pressure of 80/60 mm Hg.
What is the *initial dose of atropine*? - *0.5 mg* of *Atropine*
A patient has sinus *bradycardia* with a heart rate of 36/min. *Atropine* has been
administered to a total dose of 3 mg. A *transcutaneous pacing* has failed to capture.
The patient is confused, and her BP is *88/56 mmHg*. Which therapy is now indicated?
- *Epinephrine infusion: 2-10 mcg/min*.
A monitored patient in the ICU developed a sudden onset of *regular narrow-complex
tachycardia* at a rate of 220/min.
The patient's BP is 128/88 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry
reading is 98%.
, ACLS AHA
There is a vascular (IV) access in the left arm, and the patient has not been given any
basic active drugs.
A 12-lead ECG confirms *SVT* with no evidence of ischemia or infraction.
The HR has not responded to vagal maneuvers.
What is your next action? - Administer *adenosine 6 mg* IV push
A patient with possible STEMI has ongoing chest discomfort. What is a *contraindication
to nitrate* administration? - Use of a *phosphodiesterase inhibitors* (eg. Viagra) within
the previous 24 hours
A patient is in *pulseless V-tach* (PEA). 2 shocks and 1 dose of epinephrine have been
given.
Which drug should be given next? - *Amiodarone 300 mg* (first dose)
What is the indication for the use of *magnesium* in cardiac arrest? - Pulseless V-tach
associated with *Torsades des pointes*
Which is one way to minimize interruptions in chest compressions during CPR? -
Continue CPR while the defibrillator charges
A 35-years-old woman has palpitations, light-headedness, and a stable *tachycardia*.
The monitor shows a *regular-narrow-monomorphic-complex QRS* at a rate of
180/minutes.
Vagal maneuvers have not been effective in terminating the rhythm.
An IV has been established.
Which drug should be administered? - *Adenosine 6 mg* (first dose)
Antiarrhythmic *Infusion* for Stable Wide-QRS Tachycardia: - 1) Procainamide IV: 20
(max 50) mg/min;
2) Amiodarone IV: 150mg/10 min.;
3) Sotalol IV: 100 mg/5 min.;
A 57-years-old woman has palpitations, chest discomfort, and *tachycardia*. The
monitor shows a *regular wide-complex QRS* at a rate of 180/min.
She becomes diaphoretic, and her BP is 80/60 mm Hg.
Which action do you take next? - Perform *Synchronized Cardioversion* at 100J
ROSC - Return to spontaneous circulation after BLS.
A patient is in *refractory V-fib* and has received multiple appropriate defibrillation
shocks;
Epinephrine 1 mg IV twice;
An initial dose of amiodarone 300 mg IV.
The patient is intubated.
Which best describes the recommended (IV) *2nd dose of amiodarone* for this patient?
- *150 mg* (half);
