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Exam (elaborations)

ACLS 2023 Latest Update with Certified Solutions

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ACLS 2023 Latest Update with Certified Solutions lidocaine initial push for cardiac arrest 1-1.5 mg/kg IVP lidocaine further doses for cardiac arrest 0.5-0.75 mg/kg IVP lidocaine max dose 3mg/kg lidocaine post arrest infusion 1-4 mg/min Magnesium Sulfate for cardiac arrest involving torsades or hypomagnesemia 1-2 g 5 to 20 mins magnesium sulfate for torsades with a pulse, or AMI with hypomagnesemia 1-2 g over 5 to 60 mins magnesium infusion to control torsades, or further dosage for AMI with hypomagnesemia 0.5-1 g/hr IV Atropine for Bradycardia 1mg/3-5 mins IVP max dose of atropine for bradycardia 3mg, or 0.04mg/kg Atropine for Organophosphate poisoning 2-5 mg IVP Dopamine for renal dose 2-5 mcg/kg/min dopamine for beta effects 5-10 mcg/kg/min dopamine for alpha effects 10-20 mcg/kg/min dopamine for post cardiac arrest care for BP 80-89 5-20 mcg/kg/min epinephorine for cardiac arrest 1 mg/3-5 mins epinephrine for symptomatic bradycardia 2-10 mcg/min epinephrine for post arrest BP maintenance at 90 0.1-0.5 mcg/kg/min amiodarone for wide stable tachycardia 150 mg over 10 mins (15mg/min) amiodarone infusion for stable wide tachycardia 1 mg/min for first 6 hrs, then 0.5 mg/min amiodarone initial dose for cardiac arrest 300 mg IVP amiodarone further push for cardiac arrest 150 mg IVP 3-5 mins after initial dose amiodarone post arrest infusion 360 mg over first 6 hrs (1mg/min) amiodarone post arrest 2nd infusion 540 mg over next 18 hrs (0.5mg/min) amiodarone max cumulative dose 2.2g/24hrs adenosine initial dose 6 mg RIVP with 20 ml flush adenosine 2nd dose 12 mg RIVP with 20 ml flush PATCH 5 MD Pulmonary embolism Acidosis Tension Pneumo Cardiac tamponade Hypovolemia hypoxia hypothermia Hyper/hypokalemia hypoglycemia Myocardial infarction Drug Overdose reversal agent for Cocaine/Stimulant OD Benzodiazepine (Valium, Ativan, Versed) Reversal agent for tricyclic antidepressants OD Fluid bolus for BP Sodium bicarb 1 mEg/kg slow IVP prepare for seizures Reversal agent for Aspirin/Salicylate OD Normal Saline, Sodium bicarbonate 1 mEg/kg Reversal agent for hyperkalemia Sodium bicarbonate, Kayexalate, Albuterol, glucose with insulin, calcium chloride/calcium gluconate Treating hyperkalemia Fluid bolus, Sodium bicarb 1 mEg/kg slow IVP, Calcium chloride 1-2 g Reversal agent for Opiate OD narcan IN 2mg, Epi 1 mg IVP Reversal agent for calcium channel blocker OD Calcium Chloride/calcium gluconate, atropine, fluids, vasopressors, IV glucagon Reversal agent for beta blocker ODd IV glucogon, atropine, fluids, vasopressors Reversal agent for hypocalcemia calcium Treating calcium channel and beta blocker OD, Hypocalcemia, and hypoglycemia Insulin 1U/kg followed by 0.5U/kg/hr, Calcium chloride 1-2 g IV, vasopressors: Epi 2-20 mcg/min Reversal agent for hypercalcemia magesium sulfate Treating hypercalcemia Fluid bolus, Lasix 1-4 mg/kg every 8 to 12 hours as needed, Prednisone, sodium bicarb 1 mEg/kg IV Reversal agent for benzodiazepine OD Romazicon Reversal agent for organophosphate atropine Treating organophosphate poisoning Sodium bicarb 1 mEg/kg slow IVP, Atropine 2-5 mg IVP every 5 mins ST segment depression, prolonged QT interval, dysrhythmia due to hypokalemia Organophosphate poisoning Reversal agent for cyanide poison Cyanocobalamin S/S of unstable pt Hypotension, chest pain, SOB, AMS, pulmonary edema/CHF Suspected MI treatment MONA: O2 nitro aspirin morphine Symptomatic bradycardia treatment Atropine 1mg TCP with sedation Dopamine 5-20 mcg/kg/min (titrate to effect- checking every 5 mins) Epi 2-10 mcg/min (Titrate) Stable tachycardia with a narrow QRS treatment Vagal manuevers Adenosine 6 mg RIVP -> 12 mg RIVP calcium channel blocker or beta blocker Stable tachycardia with wide QRS that is regular and monomorphic treatment adenosine Stable tachycardia with wide QRS that is irregular or polymorphic treat underlying cause for PVCs, antidysrhythmic Procainamide for stable wide complex tachycardia 20-50mg/min Procainamide maintenance infusion 1-4 mg/min Procainamide max dose 17 mg/kg Sotalol for wide complex tachycardia 100 mg over 1 min Lidocaine for stable wide complex tachycardia 0.5-0.75 mg/kg every 10 mins (no more than 1-1.5 mg/kg) Lidocaine maintenance infusion for stable wide complex tachycardia 1-4 mg/min BP < 90 maintenance Dopamine 5-20 mcg/kg/min *treat hypovolemia 1st* BP < 80 maintenance Epinephrine 2-10 mcg/min *treat hypovolemia 1st* BP < 70 maintenance Norepinephrine (Livofed) 0.1-0.5 mcg/kg/min *treat hypovolemia 1st* Prolonged QU interval with small, sloped T wave Hypokalemia Tall peaked T wave Hyperkalemia Prolonged QT interval hypocalcemia Shortening of the ST segment Hypercalcemia Sodium bicarb IV dosing (for everything) 1 mEg/kg slow IVP IV calcium chloride 1-2 g IV calcium gluconate 3-6 g -ime, -ine, -mil calcium channel blocker -pril ace inhibitors -olol beta blockers

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