CPAN CAPA CERT EXAM III COMPREHENSIVE
STUDY GUIDE
◉ ventricular tachycardia treatment.
Answer: magnesium, lidocaine, or isoproterenol infusion to shorten
QT interval
◉ causes of local anesthestic systemic toxicity.
Answer: inadvertant vascular injection of drug from nerve blocks
and occasional result from continuous infusion and accumulation of
drug for days
◉ Second degree AV block Type 1 (Wenckebach).
Answer: PR interval gets progressively longer until the ventricular
beat is dropped
- irregular rhythm
◉ Stable tachycardia treatment.
Answer: Adenosine 6mg IV push followed by fluid bolus
- 12mg dose may be administered twice after initial 6mg dose
◉ Unstable tachycardia treatment.
,Answer: sedation if conscious and synchronized cardioversion
followed by ACLS strategies
◉ atrial fibrillation/ atrial flutter.
Answer: no organized atrial activities therefore no P waves
◉ afib/a flutter treatment.
Answer: anticoagulants
cardizem or amiodarone to control rate
if unstable: cardioversion
◉ dantrolene dosing for maligent hyperthermia.
Answer: 2.5mg/kg IV bolus repeated every 5-10 minutes until
symptoms improve
- dosing as high as 10mg/kg may be needed
◉ 2 different concentrations of dantrolene.
Answer: - Dantrium/Revonto [20mg/vial] reconstituted with 60 mL
sterile water for injection
- Ryanodex [250 mg/vial] reconstituted with 5 mL sterile water for
injection
◉ CPR quality.
,Answer: - push hard (at least 2 inches) and fast (at least 100)
- allow full chest recoil
- minimize interruptions
- avoid excessive ventilation
- if no advanced airway 30:2
◉ shock energy for defibrillation.
Answer: give 1 shock: biphasic 120-200J
second and subsequent shocks should be equivalent
◉ ACLS epinephrine dose.
Answer: 1mg every 3-5 minutes
◉ ACLS amiodarone dose.
Answer: first dose: 300mg bolus
second dose: 150mg
◉ ACLS lidocaine dose.
Answer: first dose: 1-1.5mg/kg
second dose: 0.5-0.75mg/kg
◉ reversible causes (H's).
, Answer: hypovolemia
hypoxia
hydrogen ion (acidosis)
hyperkalemia
hypothemia
◉ reversible causes (T's).
Answer: tension pneumothorax
tamponade cardiac
toxins
thrombosis pulmonary
thrombosis coronary
◉ respiration rate for continuous CPR in infant/child with advanced
airway.
Answer: 1 breath every 2-3 seconds (20-30/minute)
◉ lipid emulsion therapy rescue for LAST.
Answer: initial bolus of 20% lipid emulsion: dose 1.5mL/kg rapidly
over 1 minute, followed by continuous infusion at 0.25mL/kg/min
- continue lipid emulsion infusion for at least 10 minutes after
patient is stabilized
STUDY GUIDE
◉ ventricular tachycardia treatment.
Answer: magnesium, lidocaine, or isoproterenol infusion to shorten
QT interval
◉ causes of local anesthestic systemic toxicity.
Answer: inadvertant vascular injection of drug from nerve blocks
and occasional result from continuous infusion and accumulation of
drug for days
◉ Second degree AV block Type 1 (Wenckebach).
Answer: PR interval gets progressively longer until the ventricular
beat is dropped
- irregular rhythm
◉ Stable tachycardia treatment.
Answer: Adenosine 6mg IV push followed by fluid bolus
- 12mg dose may be administered twice after initial 6mg dose
◉ Unstable tachycardia treatment.
,Answer: sedation if conscious and synchronized cardioversion
followed by ACLS strategies
◉ atrial fibrillation/ atrial flutter.
Answer: no organized atrial activities therefore no P waves
◉ afib/a flutter treatment.
Answer: anticoagulants
cardizem or amiodarone to control rate
if unstable: cardioversion
◉ dantrolene dosing for maligent hyperthermia.
Answer: 2.5mg/kg IV bolus repeated every 5-10 minutes until
symptoms improve
- dosing as high as 10mg/kg may be needed
◉ 2 different concentrations of dantrolene.
Answer: - Dantrium/Revonto [20mg/vial] reconstituted with 60 mL
sterile water for injection
- Ryanodex [250 mg/vial] reconstituted with 5 mL sterile water for
injection
◉ CPR quality.
,Answer: - push hard (at least 2 inches) and fast (at least 100)
- allow full chest recoil
- minimize interruptions
- avoid excessive ventilation
- if no advanced airway 30:2
◉ shock energy for defibrillation.
Answer: give 1 shock: biphasic 120-200J
second and subsequent shocks should be equivalent
◉ ACLS epinephrine dose.
Answer: 1mg every 3-5 minutes
◉ ACLS amiodarone dose.
Answer: first dose: 300mg bolus
second dose: 150mg
◉ ACLS lidocaine dose.
Answer: first dose: 1-1.5mg/kg
second dose: 0.5-0.75mg/kg
◉ reversible causes (H's).
, Answer: hypovolemia
hypoxia
hydrogen ion (acidosis)
hyperkalemia
hypothemia
◉ reversible causes (T's).
Answer: tension pneumothorax
tamponade cardiac
toxins
thrombosis pulmonary
thrombosis coronary
◉ respiration rate for continuous CPR in infant/child with advanced
airway.
Answer: 1 breath every 2-3 seconds (20-30/minute)
◉ lipid emulsion therapy rescue for LAST.
Answer: initial bolus of 20% lipid emulsion: dose 1.5mL/kg rapidly
over 1 minute, followed by continuous infusion at 0.25mL/kg/min
- continue lipid emulsion infusion for at least 10 minutes after
patient is stabilized
