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1. Ventricular Tachycardia
CPR, Defibrilate, amiodarone, epi: What is this rhythm and how is it treated?
2. Ventricular fibrillation
CPR, Amiodarone, Defibrilate, Epi: What is this rhythm and how is it treated?
3. Asystole
CPR & Epinephrine: What is this rhythm? and how is it treated?
4. PVC or premature ventricular contraction
Treat the underlying cause:
1. hypoxemia (o2)
2. Ischemia (12 lead to confirm)
3. electrolyte imbalance (Mg+ or K+ replacement): What is this rhythm? and how is it treated?
5. AFib
"control the rate and anticoagulate"
Synchronized Cardioversion and anticoagulation: What is this rhythm and how is it treated
if unstable?
6. Give an antidysrhythmic (amiodarone)
Cardizem/Diltiazem
We don't defib because we are worried a clot has formed in the appendages
which will travel to the brain or lungs when shocked: How is stable Afib treated?
7. AFib RVR
This is Afib plus tachycardia and it is treated as unstable Afib
Cardiovert: What is this rhythm? and how is it treated?
8. 30%: What percent of cardiac output is lost due to Afib and loss of "atrial kick"?
9. this is a calcium channel blocker it decreases BP & decreases HR it is often
given to help reduce the HR in Afib RVR along with Heparin/Warfarin: What does
Cardizem/Diltiazem do?
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10. 1. Protamine
2. Vitamin K
3. if there is an active bleed or they are going to need surgery: What is the antidote
for heparin?
What is the antidote for Warfarin?
When do we reverse anticoagulation?
11. 1. recognition of sudden cardiac arrest ck for pt responsiveness and breath-
ing
2. Activate the emergency response system (call a code or rapid)
3. CPR if no pulse, and while waiting on the crash cart to arrive. (Remember
30 compressions to 2 breaths)
4. Defibrillate- as soon as possible: what are the steps to BLS CPR?
12. 2 leads ds: How many leads must Asystole be confirmed in?
13. Vasoconstrictor and (+) Inotrope: what is Epinephrine?
14. pacer spikes with no P or QRS
Usually a problem with battery or lead in the wrong place. the PM fires but
doesn't cause a contraction
use an external pacemaker and call the Dr.
Turn up the the miliamps: What is failure to capture on a pacemaker?
15. The PM is unable to sense where or when the heart is depolarizing or
repolarizing and delivers spikes at an inappropriate time
Pacer rep needs to be called to interrogate the PM: What is failure to sense?
16. this is called a R on T phenomenon
Causes vtach or torsades de point: What happens if pt is shocked mid repolarization between the
S-T?
17. CO= HR x SV: What is the cardiac output formula?
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18. CO- 4-6
pink warm and dry
>30 ml/hr UO
SBP >90
AOx4
MAP >60
Skin perusing cap refill <2second: What are signs and symptoms that cardiac output is good?
19. CVP 2-6 mmHg
Hypo/hypervolemic: What is the range for CVP?
20. signs of hyper/hypovolemia
hypovolemic=
skin tenting & dry mucous membranes
decreased CVP < 2
Hypervolemic=
Fluid overload/edema
increased CVP >6: What are signs and symptoms of a preload problem?
21. - if hypovolemic give fluids, albumin, blood
-if hypervolemic give a diuretic: How are CO problems related to Preload/SV treated?
22. 1. is CO low?
2. Did the HR change?
3. Preload: What is CVP? hypo/hypervolemic s/s?
If normal move on...
4. Afterload, what is their BP? High or low?
if normal must be contractility...
5. (+) inotrope needed to increase contractility: What are the steps to determine the cause of
low cardiac output?
23. BP over 140