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29 Cards in this Set
- Front
- Back
Algorithm for symptomatic bradycardia
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C-A-B/Determine stability
administer O2 & initiate IV *Atropine 0.5mg IVP Q3-5min or until max 0.04mg/kg (total 3mg) *Transcutaneous Pacing -OR- *Dopamine 10-20mcg/kg/min (mix 400mg/250mL D5W) -OR- *Epi drip 2-10mcg/kg/min (mix 1mg/250 D5W) |
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Algorithm for SVT
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C-A-B & Determine stability
O2 & start IV *Vagal maneuvers *Adenosine 6mg (rapid) IVP, followed by 10mL NS *Adenosine 12mg(rapid) IVP, followed by 10mL NS *Adenosine 12mg(rapid) IVP, followed by 10mL NS *(BB) Lopressor 5mg IVP *(CCB) Cardizem 0.25mg/kg IV over 2 min *If pt does not convert or becomes unstable at any time, you must ssynchronized cardiovert ***SVT as easy as ABC |
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Algorithm for V-tach (with pulse)
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C-A-B/Determine stability
O2 & proximal IV *Amiodarone 150mg over 10min (15mg/min) *If needed, repeat Amidarone 150mg over 10min *If Torsades De Points, consider magnesium sulfate 1-2 grams IVPB over 5-60min *If pt does not convert or becomes unstable, must synchronized cardiovert |
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Algorithm for PEA
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*Initiate CPR
*O2 (if needed) Establish IV *Epi 1mg IVP *CPR (2min) *Epi 1mg IVP *CPR (2 min) *Epi 1mg IVP *Consider Sodium Bicarb 1mEq/kg |
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Algorithm for asystole
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*Initiate CPR
*O2 (if needed) Establish IV *Epi 1mg IVP *CPR (2min) *Epi 1mg IVP *CPR (2 min) *Epi 1mg IVP *Consider Sodium Bicarb 1mEq/kg |
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Algorithm for pulseless v-tach/v-fib
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*CPR until defibrillator arrives
*Defib @360j monophasic or 200j biphasic *CPR 2 min *Defib @360j monophasic or 300j biphasic <establish IV & intubate> *Epi 1mg IVP -OR- 40units Vasopressin (1 time) *CPR 2 min *Defib @360j mono/bi phasic *Amiodarone 300mg -OR- Lidocaine 1-1.5mg/kg *CPR 2min *Defib @360j mono/bi phasic *Epi 1mg IVP *CPR 2min *Defib @360j mono/bi phasic *Amiodarone 150mg IVP -OR Lidocaine (1/2 original dose) *CPR 2min *Defib @360j mono/bi phasic *Epi 1mg IVP *CPR 2 min *Defib @360j mono/bi phasic *consider Lidocaine 0.5-0.75mg/kg *CPR 2 min *Defib @360j mono/bi phasic *Epi 1mg IVP *CPR 2 min *Defib @360j mono/bi phasic ***consider sodium bicarb 1mEq/kg |
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Algorithm for uncontrolled a-fib/a-flutter
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C-A-B/Determine stability
O2 & proximal IV **Control rate: Lopressor 5mg IVP (beta blocker) (use with caution if CHF or pulm disease) -OR- Cardizem 0.25mg/kg (Ca+ channel blocker) **If pt becomes unstable, must synchronized cardiovert |
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Epinepherine
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1 mg IVP q3-5min
IV drip: 1mg/250mL D5W @ 2-10mcg/min ET: 2-2 1/2 times the dose diluted in 10mL NS |
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Vasopressin
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40 units IVP (single dose)
Lasts 10-20 min |
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Lidocaine
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1-1.5 mg/kg IVP q 3-5 min
**Repeat at half the initial dose, so 0.5-0.75 mg/kg ++Max dose 3mg/kg IV drip: 2 grams/250mL D5W @ 2-4 mg/min 1mg/min = 7mL/hr on the pump ET: 2-2 1/2 the IV dose diluted with 10mL NS |
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Amiodarone for cardiac arrest r/t v-tach or v-fib
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300mg diluted in 30 mL D5W IV bolus
Repeat 150mg in 3-5 min Max cumulative dose of 2-2 grams IV over 24 hours |
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Amiodarone for (stable) wide complex tachy
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Rapid infusion: 150mg/100mL D5W IV over 10min (15mg/min)
*may repeat every 10 min as needed Slow infusion: 360mg IV over 6hrs (1mg/min) Maintenance infusion: 540mg IV over 18 hrs (0.5mg/min) IV drip: 900 mg/500 mL D5W 33.3 mL/hr x 6hrs (1mg/min) 17mL/hr x 18hrs (0.5mg/min) |
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Magnesium
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Stable: 1-2 grams/100mL D5W IVPB over 5-60min
Unstable: 1-2 grams IVP |
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Procainamide (Pronestyl)
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**antiarrythmic**
20-30 mg/min, up to 50mg/min if urgent IV drip: 2 grams/250 mL D5W @ 2-4mg/min max dose: 17mg/kg |
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Adenosine (Adenocard)
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6mg over 1-3 sec IVP
Repeat 12mg x 2 every 1-2 minutes flush with 10mL NS Elevate the extremity |
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Verapamil
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++calcium channel blocker++
2.5 - 5mg IVP repeat 5-10mg in 15-30min max 20mg ****antidote is calcium chloride |
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Cardizem
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IV Bolus 0.25mg/kg over 2 min
Repeat bolus 0.35 mg/kg over 2min Maintenance infusion 250mg/250mL D5W @ 5-15mg/hr *titrate to heart rate |
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Tenormin
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5mg IV over 5min
wait 10min, give 2nd dose 5mg IV over 5 min |
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Labetolol
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10mg IVP over 1-2 min
may repeat or double dose every 10min to max dose of 150mg |
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Lopressor
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initial dose:
5 mg slow IVP @ 5 min intervals to total 15mg |
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Nitoglycerin
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0.3-0.4 mg sublingual q5min
(max 3 doses) IV drip: 50mg/250mL D5W titrate to effect (300mcgs) |
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Morphine
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1-3 mg IVP, slowly, to desired effect
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ASA
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160-325mg PO ASAP!
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Atropine
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Brady: 0.5mg IVP q5 min
Max 0.04mg/kg ET: 2- 2 1/2 the IV dose diluted in 10mL NS |
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Dopamine
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Dopa: 1-5 mg/kg/min
Beta: 5-10 mg/kg/min Alpha: 10-20 mg/kg/min IV drip: 400mg/250 mL D5W |
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Dobutamine
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IV drip: 500 - 1000 mg/ 250mL D5W @ 2-20mg/kg/min
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Isuprel
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IV drip: 1mg/250mL D5W @ 2-10mcg/min
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Sodium Bicarb
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1 mEq/kg IVP
IV drip: 200 mEq/1000mL LR |
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Meds that can go down an ET
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Narcan
Atropine Valium Epi Lidocaine 2 - 2 1/2 times the IV dose diluted in mL NS |