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117 Cards in this Set
- Front
- Back
What is this algorithm for?
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Ventricular Fibrillation and Ventricular Tachycardia WITHOUT a pulse after the basic ABCDs (Primary ABCDs) have been started, and there is defibrillator on scene
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If you see a person collapse, what do you do?
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Shock Immediately?
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If you get to the scene, and you see the person go into a shockable rhythm, what do you do?
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Shock Immediately
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What is a shockable rhythm?
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V-Fib or V-Tach WITHOUT A PULSE
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What kinds of cardioversion are there?
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Electrical
Chemical |
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What kinds of cardioversion are there?
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Synchronized
Unsynchronized |
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What kinds of defibrillators are there?
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Automatic
or Manual |
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If a patient is in V-Tach or V-Fib, what kind of cardioversion do you use?
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Unsynchronized?
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What is the first thing you do for V-Fib/V-Tach without a pulse?
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Shock
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What are the different kinds of cardioverters are there?
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Monophasic
and Biphasic |
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What is a monophasic defibrillator?
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Electricity goes one way (Forward)?
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What is a biphasic defibrillator?
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Electricity goes both ways (Forward and back)
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If using a monophasic defibrillator, how much power do you use for the first shock?
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360 Joules
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If using a monophasic defibrillator, how much power do you use for second and following shocks?
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360 Joules
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If necessary, how often should you shock a patient with V-Fib/V-Tach without a pulse?
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Every two minutes
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What is the second step in the V-Fib/V-Tach without a pulse algorithm?
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CPR
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For V-Fib/V-Tach without a pulse, when should you do CPR?
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Immediately after shock!
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When using a basic airway how many compressions/respirations do you give?
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30 Compressions/Two Breaths
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At what speed do you give compressions?
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100 per minute
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At what speed do you give respirations?
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12-20 per minute
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If you give a breath every three seconds, how many breaths are you giving per minute?
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20
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If you give a breath every four seconds, how many breaths are you giving per minute?
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15
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If you give a breath every five seconds, how many breaths are you giving per minute?
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12
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If you are using an advanced airway, how many compressions do you give?
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100 Compressions
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If you are using an advanced airway, how many respirations do you give?
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12-20
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When giving CPR, how long should you give it?
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Two minutes
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When doing CPR, what should you do every two minutes?
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Check heart rhythm and pulse
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If a patient shows electrical activity on the ECG, then their heart is always beating...true or false?
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FALSE!...just because there is electrical activity on the ECG THAT DOESN'T MEAN THERE IS A PULSE!
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When doing CPR, you should always use an advanced airway...true or false?
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FALSE!...if the patient is getting enough oxygen using a basic airway you can keep using it?
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What is the third step in the V-Fib/V-Tach without a pulse?
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Check heart rhythm and pulse
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When doing CPR, how often should you check pulse and heart rhythm?
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Every two minutes
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When doing CPR, make sure you check the heart rhythm while CPR is in progress...true or false?
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FALSE! Never check heart rhythm while CPR is in progress
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Why shouldn't you check the heart rhythm while CPR is in progress?
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You will get an inaccurate rhythm
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When doing CPR, you should check the heart rhythm while CPR is in progress...true or false?
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FALSE!...the patient's heart should be circulating blood, not you!
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After two minutes of CPR and checking heart rhythm and pulse, what do you do?
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SHOCK AGAIN if the rhythm is not corrected!
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When should you check pulse?
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If there is an organized or unshockable rhythm
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What is the next step in the V-Fib/V-Tach without a pulse algorithm?
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Start advanced ABCs (Secondary ABCDs)
Continue this algorithm if necessary Give drugs Minimize interruptions in compressions Think about differential diagnosis |
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What are the advanced ABCs (Secondary ABCDs)?
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Airway
Breathing Circulation Differential Diagnosis |
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When should you continue this algorithm?
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If V-Fib or V-Tach without a pulse continues
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If chest compressions have to be interrupted, what is the MOST amount of time it can be interrupted?
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<10 seconds
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What is the VF/PVT protocol for?
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Ventricular Fibrillation
or Ventricular Tachycardia With No Pulse (Pulseless Ventricular Tachycardia) |
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What is V-Fib?
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When the heart's electricicity becomes disorganized, and the ventricles squeeze fast and out of rhythm (AKA they "flutter" instead of beat).
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What does V-Fib look like?
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What are the types of V-Fib??
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Course
and Fine |
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What does fine V-Fib look like?
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V-Fib with small waves?
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What does course V-Fib look like?
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V-Fib with medium to large waves?
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During V-Fib, the heart pumps twice as much blood, true or false?
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False, DURING V-FIB THE HEART PUMPS LITTLE OR NO BLOOD?
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What is "Pulseless Ventricular Tachycardia"?
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A fast heartbeat that comes from one or both? of the ventricles of the heart, and there is no pulse.
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What does "Pulseless Ventricular Tachycardia" (PVT) look like?
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Is PVT the same as VT?
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What is the acronym for the VF/PVT protocol?
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SCREAM
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What does "SCR EAM" stand for?
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Shock
CPR Rhythm (At this point, do secondary ABCD's, continue the protocol if necessary,and do problem search?) Epinephrine Antiarrhythmic Medications (Antiarrhythmic and Medications are together) |
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When do you use the VF/PVT protocol?
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IF THERE IS V-FIB OR PVT, and;
PRIMARY ABCD's are started, and; You have an AED or manual defibrillator. |
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What is the first step in the VF/PVT protocol?
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PRIMARY ABCD's
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What is the second step in the VF/PVT protocol?
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Get AED or manual defibrillator?
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What is the third step in the VF/PVT protocol?
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Check rhythm.
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If rhythm is VF or PVT what do you do?
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Use "SCREAM".
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What is the first step in "SCREAM"?
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Shock
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For the first and following shocks, how much power should you use?
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The manufactur's recomendation, but if that is not available:
360J Monophasic 200J Biphasic (Depending on model) |
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How many times do you shock and do a cycle of CPR before you give drugs in the VF/PVT protocol?
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TWO TIMES:
Shock CPR Shock CPR Drugs (During CPR?) Shock |
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If a manual defibrillator is biphasic, how much power should you use?
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Manufacturer's recomendation?, or 200J if recomendation not available.
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If manual defibrillator is biphasic, and manufactur's recomendation is unavailable, how much power should you use?
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200J for first shock, and same or more power for following shocks.
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After the first shock, how many more times should you shock?
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Until problem is solved, or given to higher care?
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After the first shock, how often should you do it?
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Every two minutes if necessary (In between cycles of CPR?)?
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After the first shock, what do you do?
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CPR
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How do you do CPR with a basic airway?
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30 compressions and 2 breaths.
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How do you do CPR with an advanced airway?
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100 compressions per minute with 8-10 breaths per minute?
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During CPR, you should check rhythm and pulse, true or false?
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False, you should check neither DURING CPR.
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After the first two minutes of CPR and every following cycle, what do you do?
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Check heart rhythm and speed?, and shock if necessary.
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You should check for a pulse after every two cycles of CPR, true or false?
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False, YOU SHOULD ONLY CHECK PULSE IF THERE IS AN ORGANIZED OR UNSHOCKABLE RHYTHM.
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After checking the rhythm, what should you do?
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Start the SECONDARY ABCD's, and continue protocol if necessary.
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When can you give drugs in the VF/PVT protocol?
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During CPR, and before or after shock.
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Twenty seconds is the longest you should stop chest compressions, true or false?
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False, TEN seconds is the absolute most you should stop chest compressions.
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In between the "R" and "E" in "SCREAM", what should you do?
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Secondary ABCD's, continue protocol if necessary, and problem search?
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After secondary ABCD's, continuing protocol if necessary, and problem search what do you do?
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"E"...Epinephrine or Vasopressin
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When should you use epinephrine for the VF/PVT protocol?
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???
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When should you use vasopressin for the VF/PVT protocol?
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???
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How much epinephrine should you give for the VF/PVT protocol?
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1mg IV or IO push
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In the VF/PVT protocol, how often should you give epinephrine?
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Every 3-5 minutes
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What is the maximum amount of epinephrine you should give in the VF/PVT protocol?
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???
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Is there any time you SHOULD NOT use epinephrine in the VF/PVT protocol?
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???
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If you choose to give vasopressin, how much should you give?
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40 Units IV or IO push
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If you choose to give vasopressin, how often should you give it?
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You must wait ten minutes after giving it to give another drug.
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When can you use vasopressin in the VF/PVT protocol?
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In place of the first or second dose of epinephrine.
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If you choose to use vasopressin, how many times can you give it?
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ONCE
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What is the most vasopressin you can give in the VF/PVT protocol?
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40 Units (Because you can only give it ONCE)
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After epinephrine or vasopressin, what is the next step in the VF/PVT protocol?
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Antiarrhythmic Medicines
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What are the antiarrhythmic medicines used in the VF/PVT protocol?
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Amiodarone
Lidocaine Magnesium Sulfate |
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What is the acronym for the anitarrhythmic medicines used in the VF/PVT protocol?
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Any Legitimate Medication
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What does "Any Legitimate Medication" stand for?
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Amiodarone
Lidocaine Magnesium Sulfate |
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What is a "Unit"?
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???
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After epinephrine, what is the first drug you should give for VF/PVT?
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"Any"...Amiodarone
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If you use amiodarone for the VF/PVT protocol, how much should your first dose be?
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300 mg IV or IO push
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What is the most amiodarone you can give a patient in the VF/PVT protocol?
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450mg in TWO DOSES.
First Dose=300mg Second Dose=150mg |
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If you give a second dose of amiodarone for the VF/PVT protocol, how much should it be?
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150 mg
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How often should you give amiodarone in the VF/PVT protocol?
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Every 3-5 minutes.
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After epinephrine, what is another drug you can give for VF/PVT protocol if amiodarone is unavailable?
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"Legitimate"...Lidocaine
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When should you give lidocaine in the VF/PVT protocol?
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ONLY IF AMIODARONE IS UNAVAILABLE?
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If you give lidocaine, how much should the first dose be for the VF/PVT protocol?
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1 - 1.5mg/kg IV or IO push
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What is the most doses of lidocaine you can give for VF/PVT?
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A total of THREE.
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If a second and third dose of lidocaine is needed for VF/PVT, how much should you give?
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0.5 - 0.75mg/kg IV or IO push
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What is the maximum lidocaine loading dose you can give in the VF/PVT protocol?
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3mg
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If you have to give a second and third dose of lidocaine for VF/PVT, how often should you give it?
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Every 5-10 minutes
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What is the maximum LOADING dose of lidocaine for the VF/PVT protocol?
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3mg/kg
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What is a loading dose?
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A large first dose of a drug, or series of doses given to build up a therapeutic amount of the drug in the body.
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After epinephrine and lidocaine, what is another drug you can give in the VF/PVT protocol?
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"Medication"...Magnesium Sulfate
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What are the only things you can give magnesium sulfate for in the VF/PVT protocol?
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Tordades de Pointes
Hypomannesemia |
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What is torsades de pointes?
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A kind of V-Tach that changes more than once?, and in which the QRS waves are different from beat to beat.
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What does torsades de pointes look like?
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(Is this from lead II?)
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How do you tell the difference between V-Fib/PVT and Torsades?
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???
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What is hypomagnesemia?
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Not enough magnesium.
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What are the signs and/or symptoms of hypomagnesemia?
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Muscle Cramps
Weakness Tremors Irregular Heartbeats |
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If a patient has torsades de pointes or hypomagnesemia, how much magnesium sulfate should you give for the VF/PVT protocol?
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1-2g IV or IO push diluted in 10 ml D5W
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What is D5W?
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5% sugar (Dextrose) in water?
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If you give magnesium sulfate in the VF/PVT protocol, how long should you take inject it into an IV or IO port?
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5-20 minutes
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If you give magnesium sulfate in the VF/PVT protocol, how many times should you give it?
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???
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According to Doogie, if you witness the VF/PVT after you get there, what should you do?
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Shock immediately.
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According to Doogie, if you don't witness the VF/PVT after you get there, what should you do?
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Two minutes of CPR, and then shock?
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