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Questions and Answers
What is Atrial Flutter?
What is Atrial Flutter?
What does Pulseless Electrical Activity refer to?
What does Pulseless Electrical Activity refer to?
Sinus Bradycardia can be treated with which medication?
Sinus Bradycardia can be treated with which medication?
What should be administered if vagal maneuvers are ineffective in a patient with regular narrow-complex QRS at a rate >150 bpm?
What should be administered if vagal maneuvers are ineffective in a patient with regular narrow-complex QRS at a rate >150 bpm?
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What is the treatment for Fine Ventricular Fibrillation?
What is the treatment for Fine Ventricular Fibrillation?
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How is Asystole treated?
How is Asystole treated?
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Magnesium is indicated for VF/pulseless VT associated with __________.
Magnesium is indicated for VF/pulseless VT associated with __________.
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What should be the next action for a patient with ST-segment elevation MI and ongoing chest discomfort who has not taken aspirin?
What should be the next action for a patient with ST-segment elevation MI and ongoing chest discomfort who has not taken aspirin?
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What is the initial dose of atropine for a patient with sinus bradycardia and blood pressure of 80/60 mm Hg?
What is the initial dose of atropine for a patient with sinus bradycardia and blood pressure of 80/60 mm Hg?
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What is the second dose of amiodarone recommended for a patient in refractory ventricular fibrillation?
What is the second dose of amiodarone recommended for a patient in refractory ventricular fibrillation?
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Which action is recommended for a patient with rapid irregular wide-complex tachycardia who is asymptomatic?
Which action is recommended for a patient with rapid irregular wide-complex tachycardia who is asymptomatic?
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The recommended route for drug administration during CPR is __________.
The recommended route for drug administration during CPR is __________.
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When should bradycardia be treated?
When should bradycardia be treated?
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What should be the first drug/dose to administer in a patient with cardiac arrest and asystole?
What should be the first drug/dose to administer in a patient with cardiac arrest and asystole?
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Study Notes
Atrial Flutter
- Atrial flutter is characterized by rapid, regular atrial contractions, often visible as "sawtooth" waves on an ECG.
Pulseless Electrical Activity
- Pulseless electrical activity (PEA) occurs when the heart's electrical activity is present but there is mechanical failure to pump blood, requiring immediate CPR and identification of the underlying cause.
Sinus Bradycardia
- Sinus bradycardia is defined as a heart rate less than 60 bpm, which may or may not require treatment based on the presence of symptoms.
Sinus Tachycardia
- Sinus tachycardia presents as a regular narrow-complex QRS at a rate exceeding 150 bpm.
- If vagal maneuvers are ineffective, administer 6 mg adenosine IV.
- Synchronized cardioversion is indicated for patients who are hypotensive or exhibit altered mental status.
Monomorphic Ventricular Tachycardia
- Monomorphic ventricular tachycardia consists of consistent QRS morphology, often needing evaluation and potential treatment based on patient stability.
Second Degree Heart Block (Mobitz II)
- Mobitz II involves intermittent failure of electrical impulses to the ventricles, with a consistent PR interval and may require pacing due to the risk of complete heart block.
Fine Ventricular Fibrillation
- Fine ventricular fibrillation requires immediate defibrillation, and if necessary, follow with 1 mg epinephrine and initiate CPR.
Agonal Rhythm/Asystole
- Asystole, or flatline, is treated with high-quality CPR along with 1 mg epinephrine or 40 mg vasopressin IV/IO.
Reentry Supraventricular Tachycardia
- Characterized by rapid heart rhythm originating above the ventricles, needing accurate diagnosis for appropriate treatment.
Normal Sinus Rhythm
- Describes a heart rhythm established by the sinoatrial (SA) node, typically ranging from 60 to 100 bpm, indicating effective cardiovascular function.
Second Degree Heart Block (Mobitz I)
- Mobitz I, or Wenckebach, features progressively lengthening PR intervals until a QRS is dropped, generally well-tolerated but may require monitoring.
Polymorphic Ventricular Tachycardia
- This rhythm is defined by varied QRS shapes and may require paddles for defibrillation depending on patient stability.
Third Degree AV Block
- Complete heart block where no impulses reach the ventricles, requiring advanced interventions potentially including pacing.
Coarse Ventricular Fibrillation
- Denotes a disorganized electrical activity in the ventricles, treated promptly with defibrillation.
Atrial Fibrillation
- Atrial fibrillation is noted for irregularly irregular heartbeats, often requiring rate control or rhythm restoration strategies.
Use of Magnesium in Cardiac Arrest
- Magnesium is indicated for ventricular fibrillation or pulseless ventricular tachycardia associated with torsades de pointes.
Aspirin Administration for MI
- In case of persistent chest pain in ST-segment elevation myocardial infarction (STEMI), administer 160 to 325 mg aspirin chewed immediately.
Epinephrine in Sinus Bradycardia
- For symptomatic sinus bradycardia with a rate of 36/min, if atropine fails (3 mg total), initiate epinephrine infusion at 2 to 10 mcg/min.
Guidelines for Fibrinolytic Therapy
- If rtPA is given, do not administer aspirin for at least 24 hours to avoid bleeding risks.
Nitrate Contraindications
- Recent use of phosphodiesterase inhibitors within 12 hours contraindicates nitrate administration for patients with potential myocardial infarctions.
Drug Administration in Cardiac Arrest
- In a cardiac arrest scenario, following ineffective defibrillation for ventricular fibrillation, use 1 mg epinephrine IV for resuscitation.
Immediate Electrical Cardioversion
- Immediate electrical cardioversion is crucial for patients experiencing symptomatic tachycardia with compromised hemodynamics.
Bradycardia Treatment Indications
- Symptomatic bradycardia, presenting as chest pain or shortness of breath, requires treatment.
Vasopressin Administration
- The correct dose of vasopressin during cardiac arrest is 40 units IV or IO, used as an alternative or adjunct to epinephrine.
Initial Drug in Asystole
- For a patient in cardiac arrest with asystole, the first drug to administer is either epinephrine 1 mg or 40 units of vasopressin IV/IO.
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Test your knowledge on ACLS rhythm identification with these flashcards. Each card presents a key term related to cardiovascular rhythms and includes essential definitions crucial for emergency medicine. Perfect for students and professionals preparing for ACLS certification.
