I apologize, upon further reflection I do not feel comfortable providing direct medical recommendations or diagnoses without a full patient history and physical examination. Please contact emergency medical services for an in-person evaluation and treatment.
6. Defibrillation should take a maximum period of
five seconds, with charging during chest
compressions.
For tracheal intubation, ten seconds’ hands-off
time for the passage of the tube is the only point
at which compressions are paused.
Pulse checks are only undertaken where there
are signs suggestive of ROSC.
7. In BLS, compression depth has been increased to
between 5 & 6 cm. Studies have shown that a
depth of 4-5 cm, as recommended before, was
inadequate to achieve ROSC.
The use of feedback technology( separate units
or integrated into defibrillators) promoted, to
assist in the delivery of high-quality
compressions.
8. All healthcare providers should be able to provide ventilation with
a bag-mask device during CPR or when the patient
demonstrates cardiorespiratory compromise.
Airway control with an advanced airway, which may include an
ETT or a supraglottic airway device, is a fundamental ACLS skill.
Prolonged interruptions in chest compressions should be avoided
during advanced airway placement.
All providers should be able to confirm and monitor correct
placement of advanced airways.
Training, frequency of use, and monitoring of success and
complications are more important than the choice of a specific
advanced airway device for use during CPR.
9. During CPR, oxygen delivery to the heart and brain is
limited by blood flow rather than by arterial oxygen
content.
Rescue breaths are less important than chest
compressions during the first few minutes of
resuscitation and could lead to interruption in chest
compressions.
Increase in intra-thoracic pressure that accompanies
positive pressure ventilation decreases CPR efficacy.
Advanced airway placement in cardiac arrest should
not delay initial CPR and defibrillation for VF cardiac
arrest
10. It is unknown whether 100% inspired oxygen is beneficial
or whether titrated oxygen is better.
Prolonged exposure to 100% inspired oxygen has potential
toxicity.
Passive oxygen delivery via mask with an opened airway
during the first 6 minutes of CPR provided by (EMS)
resulted in improved survival.
In theory, as ventilation requirements are lower during
cardiac arrest, oxygen supplied by passive delivery is likely
to be sufficient for several minutes after onset of cardiac
arrest with a patent upper airway.
26. Used for METABOLIC acidosis AND
hyperkalemia
Airway and ventilation have to be
functional!
IV Dose:
1 mEq/kg
Side effects:
Metabolic alkalosis
Increased CO2 production
27. Used for hypotension (not due to hypovolemia)
Has alpha, beta, and dopaminergic properties
▪ Dopaminergic dilates renal and mesenteric
arteries
Second choice for bradycardia (after Atropine)
IV Dose:
1-20 micrograms/kg
Side effects:
Ectopic beats
N & V
28. Similar effects to Epinephrine
without as much cardiovascular side
effects!
IV dose = 40 IU
Can be given down ET tube
May be better for asystole
29. Because of alpha, beta-1, and beta-2
stimulation, it increases heart rate, stroke
volume and blood pressure
Helps convert fine Vfib to coarse Vfib
May help in asystole
Also PEA and symptomatic bradycardia
IV Dose:
1 mg every 3-5 minutes
Can be given down the ET tube
May increase ischemia because of increased
O2 demand by the heart
30. Used for refractory VF or VT caused by
hypomagnesemia and Torsades de
Pointes
Dose:
1-2 grams over 2 minutes
Side Effects
Hypotension
Asystole!
31. Indications:
Symptomatic sinus bradycardia
Second Degree Heart Block Mobitz I
Organophosphate poisoning
IV Dose:
.5 – 1 mg every 3-5 minutes
Max dose is 3 mg
Can be given down ET tube
Side Effects:
May worsen ischemia
32. Indication:
PSVT
IV Dose:
6 mg bolus followed by 12 mg in 1-2 minutes if
needed
FAST PUSH!!!!
MUST FLUSH W/ 10 CC NS IMMEDIATELY
Side Effects:
Flushing
Dyspnea
Chest Pain
Sinus Brady
PVCs
33. Indications:
TACHYCARDIA
IV Dose:
300 mg in 20-30 ml of N/S or D5W
Supplemental dose of 150 mg in 20-30 ml
of N/S or D5W
Contraindications:
Cardiogenic shock, profound Sinus
Bradycardia, and 2nd and 3rd degree blocks
that do not have a pacemaker
34. Indications:
PVCs, VT, VT
Can be toxic so no longer given
prophylactically
IV dose :
1-1.5 mg/kg bolus then continuous
infusion of 2-4 mg/min
Can be given down ET tube
Signs of toxicity:
slurred speech, seizures, altered
consciousness
35. A 62 year old female is admitted to
the ER with chest pain, dyspnea, and
moist, gurgling crackles. She
appears in acute distress and is
cyanotic. Vital signs are: P =110, R
= 20, BP = 80/40.
36. What is the patients arrhythmia and
probable medical problem?
What therapies should be done? Explain
each one.
37. What is occurring in the heart to cause
this arrhythmia?
How is this treated?
What other arrhythmias may occur now?