ACLS VFIB/PULSELESS VTACH Flashcards

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Questions and Answers

What is the ACLS algorithm for pulseless VT and VF?

Initiate CPR first until you can get defibrillator, defibrillate the patient (120-200 J), perform CPR for 2 minutes, check rhythm, administer Epinephrine every 3-5 minutes, administer Amiodarone.

How many J's do you normally shock a patient with when you are biphasic defibrillating?

120-200

Pulseless VT can occur in what patients?

Patients with ischemic heart disease, MI, cardiomyopathy, hypokalemia, hypomagnesemia, valvular heart disease, drug toxicity.

VT normally occurs right before a patient goes into VF.

True Signup and view all the answers

What are some signs and symptoms of VT?

Shock, chest pain, hypotension, shortness of breath, pulmonary congestion, CHF, acute MI. Signup and view all the answers

What should a nurse monitor very closely in a patient who is throwing PVC's?

Vital signs Signup and view all the answers

VF is rapidly fatal if not treated and terminated within - minutes.

3 - 5 Signup and view all the answers

What patient is at great risk for VF?

MI patients Signup and view all the answers

What might a nurse observe upon physical assessment of a patient in VF?

Fainting, loss of consciousness, pulselessness, apnea, seizures, fixed/dilated pupils, cold and mottled skin. Signup and view all the answers

What is the treatment of choice for pulseless VT/VF?

Shock (monophasic defibrillation at 360 J or biphasic at 120-200 J), followed by CPR. Signup and view all the answers

What might be used in recurrent VT/VF?

Antiarrhythmic drugs such as Amiodarone 300 mg followed by 150 mg. Signup and view all the answers

What is the proper first dose for Amiodarone?

300mg Signup and view all the answers

What is the second dose for Amiodarone?

150mg Signup and view all the answers

What is the first drug you would use for a patient who is in VT/VF?

Epinephrine 1 mg push repeated every 3-5 minutes during cardiac arrest. Signup and view all the answers

What should a nurse monitor for in a patient who has received Amiodarone for VT/VF?

Hypotension Signup and view all the answers

What should a nurse remember about drug administration via the ET route for pulseless VT/VF?

Drug amount is 2-2 1/2 times the IV route. Signup and view all the answers

If a patient doesn't convert after ____ shocks, they probably won't convert.

3 Signup and view all the answers

What could you do for VT with a pulse?

Synchronized cardioversion, Amiodarone. Signup and view all the answers

If a patient presents with VT with a pulse, they won't have a pulse for long.

True Signup and view all the answers

How many rounds of CPR would you perform before checking rhythm/pulse?

5 Signup and view all the answers

Study Notes

ACLS Algorithm for Pulseless VT and VF

Initiate CPR immediately until a defibrillator is available.
Administer defibrillation at 120-200 J.
Perform CPR for 2 minutes after the first shock.
Assess if the rhythm is still shockable; if yes, shock again.
Continue CPR for another 2 minutes.
Administer Epinephrine every 3-5 minutes.
If the rhythm remains shockable, shock again after 2 minutes of CPR.
Administer Amiodarone as needed during resuscitation.

Defibrillation Parameters

Biphasic defibrillation is performed at 120-200 J.

Risk Factors for Pulseless VT

Occurs in patients with ischemic heart disease, myocardial infarction (MI), cardiomyopathy, hypokalemia, hypomagnesemia, valvular heart disease, and drug toxicity.

VT and VF Relationship

Ventricular Tachycardia (VT) often precedes Ventricular Fibrillation (VF).

Signs and Symptoms of VT

Symptoms may include shock, chest pain, hypotension, shortness of breath (SOB), pulmonary congestion, congestive heart failure (CHF), and acute MI.

Monitoring Patients with PVCs

Vital signs should be closely monitored in patients experiencing premature ventricular contractions (PVCs) due to risk of progression to VT or VF.

VF Treatment Timeline

VF can be rapidly fatal if not treated within 3-5 minutes.

High-Risk Patients for VF

Especially high risk in MI patients, those with myocardial ischemia, hypokalemia, hypomagnesemia, and those experiencing electrocution.

Physical Assessment of VF Patients

Signs include faintness, loss of consciousness, pulselessness, apnea, possible seizures, fixed/dilated pupils, and cold/mottled skin.

Treatment for Pulseless VT/VF

The primary treatment is shock, using monophasic defibrillation at 360 J or biphasic at 120-200 J, followed by CPR during defibrillator charging.
Resume CPR immediately after each shock while reassessing rhythm and pulse.

Antiarrhythmic Drugs for Recurrent VT/VF

Amiodarone is used for recurrent cases (300 mg followed by 150 mg if necessary after initial shock).

Amiodarone Dosing

Initial dose of Amiodarone is 300 mg, followed by a second dose of 150 mg.

First Drug During Cardiac Arrest

Administer epinephrine 1 mg push every 3-5 minutes.

Monitoring After Amiodarone Administration

Watch for hypotension as a potential side effect.

ET Drug Administration

For administration via the endotracheal route, use 2-2.5 times the IV drug dosage.

Shocks and Conversion

If a patient does not convert after three shocks, conversion is unlikely.

Treatment for VT with Pulse

Options include synchronized cardioversion and Amiodarone.

VT with Pulse Prognosis

Patients with VT and a pulse may not maintain it for long; be prepared to initiate CPR.

CPR Rounds Before Rhythm Check

Perform 5 cycles of CPR before checking rhythm or pulse if a physician is unavailable.

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Description

Test your knowledge on the ACLS algorithm for pulseless VT and Vfib with these flashcards. The quiz covers essential steps such as CPR initiation, defibrillation, and medication administration. Perfect for healthcare professionals preparing for emergencies.