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End Tidal CO2 - Answer: the maximum CO2 concentration at the end
of each tidal breath, which can be used to assess disease severity and
response to treatment. Reflects cardiac output during CPR. Can be
used to measure the effectiveness of cardiac compressions and
assessment of return of spontaneous circulation (ROSC) after cardiac
event
,ROSC - Answer: Return of spontaneous circulation is established with
the presence of palpable pulse, blood pressure, abrupt sustained
increase in end tidal CO2 (typically > 40mmHg) after cardiac arrest
therapeutic hypothermia - Answer: Core temperature 32-36 C (89.6-
96.8 F)
joules for defibrillation - Answer: Defibrillation Joules: 200 joules
joules for cardioversion - Answer: Cardioversion joules: 200 joules
Physicians may order 75-120-150-200 for conditions not covered in
ESO policy
For the patient not following commands after 120 minutes of ROSC -
Answer: Consider initiation of therapeutic hypothermia
Treatment of pulseless arrests - Answer: Provide 2 minutes of CPR-
avoiding interruptions in compressions
Asystole treatment - Answer: i. CPR (2 min.)
ii. O2 at 15 L/min. ambu bag
,iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5
minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
Unstable Bradycardia - Answer: i. O2 at minimum 10 L/min. NRBM
ii. If transvenous leads or epicardial pacing wires present, connect to a
pulse generator and initiate pacing per protocol.
If no response, perform the following:
iii. Atropine 1 mg IVP/IO, repeat q 3-5 minutes max 3 mg
iv. Transcutaneous pacing as soon as possible
If above algorithm is ineffective:
v. Start dopamine 400 mg/250 ml D5W infusion at 5 mcg/kg/minute.
Titrate to patient response up to 20mcg/kg/minute
If above algorithm is ineffective, start epinephrine 2 mg/ 250 ml NS @
2 mcg/min., titrate to patient response up to 10 mcg/minute
Pulseless Electrical Activity - Answer: i. CPR 2 minutes and assess for
possible causes
The H's:
-Hypovolemia
-Hypoxia
, -Hydrogen ion (acidosis)
-Hypokalemia
-Hyperkalemia
-Hypoglycemia
-Hypothermia
The T's:
-Toxins
-Cardiac Tamponade
-Thrombosis
-Trauma
-Tension pneumothorax
ii. O2 at 15 L/min ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL), repeat q 3-
5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
v. If hypovolemia known or suspected, infuse 250 mL NS may be
substituted with LF if currently infusing). Repeat in 5 minutes if no
clinical improvement.
vi. Stat CXR