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.
Signup and view all the answers
What are some signs and symptoms of VT?
Signup and view all the answers
What should a nurse monitor very closely in a patient who is throwing PVC's?
Signup and view all the answers
VF is rapidly fatal if not treated and terminated within ______ - ______ minutes.
Signup and view all the answers
What patient is at great risk for VF?
Signup and view all the answers
What might a nurse observe upon physical assessment of a patient in VF?
Signup and view all the answers
What is the treatment of choice for pulseless VT/VF?
Signup and view all the answers
What might be used in recurrent VT/VF?
Signup and view all the answers
What is the proper first dose for Amiodarone?
Signup and view all the answers
What is the second dose for Amiodarone?
Signup and view all the answers
What is the first drug you would use for a patient who is in VT/VF?
Signup and view all the answers
What should a nurse monitor for in a patient who has received Amiodarone for VT/VF?
Signup and view all the answers
What should a nurse remember about drug administration via the ET route for pulseless VT/VF?
Signup and view all the answers
If a patient doesn't convert after ____ shocks, they probably won't convert.
Signup and view all the answers
What could you do for VT with a pulse?
Signup and view all the answers
If a patient presents with VT with a pulse, they won't have a pulse for long.
Signup and view all the answers
How many rounds of CPR would you perform before checking rhythm/pulse?
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.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
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.
