ACLS Heartcode
1. in cardiac arrest when do you first introduce medical intervention? which
drug <Ans> after 2 rounds of CPR/shock
after 2nd shock give 1 mg epinephrine every 3-5 minutes
2. when do you introduce amiodarone during cardiac arrest <Ans> after
the 3rd shock give 300 mg bolus of amiodarone
if second dose is needed give 150mg as second dose
3. what rhythms are shockable in cardiac arrest: VF
VT
4. what rhythms are not shockable in cardiac arrest: asystole
PEA
5. if you are in an unshockable rhythm arrest when do you give epi: 1mg epi
every 3-5 minutes after 1st round of CPR
6. what do you do after return of spontaneous circulation: 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
7. what are the 5 h's and 5 t's: hypovolemia
hypoxia
hydrogen ion (acidosis)
hypo/hyperkalemia
hypothermia
,tension pneumothorax
tamponade, cardiac
toxins
thrombosis, pulmonary
thrombosis, coronary
8. how do you treat non-symptomatic bradycardia: monitor and observe
9. what constitutes symptomatic bradycardia: hypotension
altered mental status
signs of shock
chest pain
acute heart failure
10. how do you treat symptomatic bradycardia: 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
11. what is considered a tachycardia requiring treatment: over 150 per minute
12. when do you consider cardioversion: if persistent tachycardia is causing:
hypotension
altered mental status
signs of shock
chest pain
acute heart failure
13. if persistent tachycardia does not present with symptoms what do you
need to consider: wide QRS?
greater than 0.12 seconds
14. If persistent tachycardia without symptoms DOES have a wide QRS what
to do you do <Ans> 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
15. which anti-arrhythmic drugs can be used if prolonged QT: only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours
16. if persistent tachycardia without symptoms and without wide QRS what do
you do: IV access and 12 lead EKG if available
1. in cardiac arrest when do you first introduce medical intervention? which
drug <Ans> after 2 rounds of CPR/shock
after 2nd shock give 1 mg epinephrine every 3-5 minutes
2. when do you introduce amiodarone during cardiac arrest <Ans> after
the 3rd shock give 300 mg bolus of amiodarone
if second dose is needed give 150mg as second dose
3. what rhythms are shockable in cardiac arrest: VF
VT
4. what rhythms are not shockable in cardiac arrest: asystole
PEA
5. if you are in an unshockable rhythm arrest when do you give epi: 1mg epi
every 3-5 minutes after 1st round of CPR
6. what do you do after return of spontaneous circulation: 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
7. what are the 5 h's and 5 t's: hypovolemia
hypoxia
hydrogen ion (acidosis)
hypo/hyperkalemia
hypothermia
,tension pneumothorax
tamponade, cardiac
toxins
thrombosis, pulmonary
thrombosis, coronary
8. how do you treat non-symptomatic bradycardia: monitor and observe
9. what constitutes symptomatic bradycardia: hypotension
altered mental status
signs of shock
chest pain
acute heart failure
10. how do you treat symptomatic bradycardia: 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
11. what is considered a tachycardia requiring treatment: over 150 per minute
12. when do you consider cardioversion: if persistent tachycardia is causing:
hypotension
altered mental status
signs of shock
chest pain
acute heart failure
13. if persistent tachycardia does not present with symptoms what do you
need to consider: wide QRS?
greater than 0.12 seconds
14. If persistent tachycardia without symptoms DOES have a wide QRS what
to do you do <Ans> 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
15. which anti-arrhythmic drugs can be used if prolonged QT: only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours
16. if persistent tachycardia without symptoms and without wide QRS what do
you do: IV access and 12 lead EKG if available
