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Exam (elaborations)

ACLS Heartcode questions and answers Rated A

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ACLS Heartcode Exam

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ACLS Heartcode questions and
answers Rated A+

in cardiac arrest when do you first introduce medical intervention? which drug? -
answers after 2 rounds of CPR/shock
after 2nd shock give 1 mg epinephrine every 3-5 minutes

when do you introduce amiodarone during cardiac arrest? -answers after the 3rd shock
give 300 mg bolus of amiodarone
if second dose is needed give 150mg as second dose

what rhythms are shockable in cardiac arrest -answers VF
VT

what rhythms are not shockable in cardiac arrest -answers asystole
PEA

if you are in an unshockable rhythm arrest when do you give epi -answers 1mg epi
every 3-5 minutes after 1st round of CPR

what do you do after return of spontaneous circulation -answers maintain O2 sat at 94%
treat hypotension (fluids vasopressor)
12 lead EKG
if in coma consider hypothermia
if not in coma and ekg shows STEMI or AMI consider re-perfusion

what are the 5 h's and 5 t's -answers hypovolemia
hypoxia
hydrogen ion (acidosis)
hypo/hyperkalemia
hypothermia

tension pneumothorax
tamponade, cardiac
toxins
thrombosis, pulmonary
thrombosis, coronary

how do you treat non-symptomatic bradycardia -answers monitor and observe

what constitutes symptomatic bradycardia -answers hypotension
altered mental status

, signs of shock
chest pain
acute heart failure

how do you treat symptomatic bradycardia -answers 1. give 0.5mg atropine every 3-5
mins to max of 3mg

if that doesn't work try one of the following:
transcutaneous pacing
2-10mcg/kg / minute dopamine infusion
2-10mcg/minute epinephrine infusion

what is considered a tachycardia requiring treatment -answers over 150 per minute

when do you consider cardioversion -answers if persistent tachycardia is causing:
hypotension
altered mental status
signs of shock
chest pain
acute heart failure

if persistent tachycardia does not present with symptoms what do you need to consider
-answers wide QRS?
greater than 0.12 seconds

If persistent tachycardia without symptoms DOES have a wide QRS what to do you do?
-answers IV access and 12 lead if available

6mg adenosine followed by NS flush only IF regular and monomorphic

consider anti-arrhythmic infusion:
- 20-50mg/min procainamide (max 17mg/kg)
- 150mg amiodarone over 10 minutes
- 100mg sotalol over 5 minutes

which anti-arrhythmic drugs can be used if prolonged QT -answers only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours

if persistent tachycardia without symptoms and without wide QRS what do you do -
answers IV access and 12 lead EKG if available
vagal maneuvers

6mg adenosine followed by NS flush only IF regular

Beta blocker or calcium channel blocker

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