Questions and Answers
Which of the following are reversible causes of cardiac arrest? (Select all that apply)
What is one symptom of symptomatic bradycardias?
What does the acronym 'PUPPY DOGS EAT' stand for in the context of narrow QRS bradycardia?
Atropine, Pacing, Dopamine, Epinephrine
Adenosine should be administered ____ mg RIVP for narrow QRS tachycardia.
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What is the maximum total dose of Lidocaine for monomorphic ventricular tachycardia?
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Synchronized cardioversion for unstable monomorphic ventricular tachycardia starts at 100 joules.
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What must be done for irregular narrow QRS tachycardia in a stable patient with no signs of WPW?
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In adult cardiac arrest, assess CAB's (breathing & pulse for __ seconds)
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What is the depth requirement for high-quality CPR?
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Study Notes
Reversible Causes of Cardiac Arrest
- Five H's: Hypovolemia, Hypoxia, Hydrogen Ion (acidosis), Hypo/Hyperkalemia, Hypothermia
- Five T's: Tension Pneumothorax, Cardiac Tamponade, Toxins (drug overdose), Thrombosis (pulmonary & coronary)
- Alternative mnemonics: PATCHx4MD includes pulmonary embolus, acidoses, and myocardial infarction.
Symptomatic Bradycardias
- Signs include hypotension, altered mental status, shock symptoms, ischemic chest discomfort, acute heart failure.
Narrow QRS Bradycardia
- Treatment options: Atropine 0.5-1.0 mg IVP every 3-5 minutes (max 3 mg total), pacing at 70 bpm (increase mA until capture), dopamine infusion (2-10 mcg/kg/min), epinephrine infusion (2-10 mcg/min).
Wide QRS Bradycardia
- Treatment follows similar protocols: pacing at 70 bpm, dopamine infusion (2-10 mcg/kg/min), epinephrine infusion (2-10 mcg/min).
Symptomatic Tachycardias
- Determine if symptoms are present, stability (stable/unstable), QRS width (wide/narrow), rhythm regularity, and polymorphic or monomorphic QRS.
Wide Complex Tachycardia (Unknown Origin) - Stable Patient
- Adenosine 6 mg RIVP with 20 mL NS flush, may repeat with 12 mg after 1-2 minutes, treatment is contingent upon rhythm evaluation (monomorphic tachycardia).
Monomorphic Ventricular Tachycardia - Stable Patient
- Amiodarone 150 mg diluted in 50-100 mL NS over 10 minutes; may switch to lidocaine (1-1.5 mg/kg IVP) with specific repeat doses depending on stabilization.
Monomorphic Ventricular Tachycardia - Unstable Patient
- Consider sedation and proceed with synchronized cardioversion starting at 100 joules escalating to 360 joules based on manufacturer specifications.
Polymorphic Ventricular Tachycardia
- Administer magnesium sulfate 2 g diluted in 50-100 mL NS over 5-10 minutes; if necessary, use unsynchronized defibrillation starting at 200 joules.
Regular Narrow QRS Tachycardia - Stable Patient
- Initiate vagal maneuvers followed by adenosine 6 mg RIVP; consider diltiazem (0.25 mg/kg SIVP) or verapamil (2.5-5 mg SIVP) with specific dosing parameters.
Regular Narrow QRS Tachycardia - Unstable Patient
- Administer adenosine while preparing for immediate synchronized cardioversion, escalating from 50 joules to 360 joules.
Irregular Narrow QRS Tachycardia - Stable Patient (No WPW)
- Attempt vagal maneuvers; administer diltiazem or verapamil, avoiding use of adenosine for WPW patients.
Irregular Narrow QRS Tachycardia - Unstable Patient
- Consider sedation and synchronized cardioversion beginning at 120 joules and increasing to 360 joules.
Irregular Narrow QRS Tachycardia - Stable Patient (With WPW)
- Attempt vagal maneuvers; administer amiodarone 150 mg diluted in 50-100 mL NS over 10 minutes, avoiding diltiazem or verapamil.
Adult Cardiac Arrest
- Assess CAB (circulation, airway, breathing) within 10 seconds; ensure quality CPR with specific depth (2-2.4 in or 5-6 cm) and rate (100-120/min).
- Minimize interruptions in chest compressions and maintain airway with OPA and BVM ventilating every 5-6 seconds.
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Description
This quiz focuses on the reversible causes of cardiac arrest, exploring the critical 5 H's and T's as well as the PATCHx4MD mnemonic. Test your knowledge and retention of these essential emergency medical concepts to improve your ACLS skills.
