Questions and Answers
What is one of the primary indications for administering adrenaline?
Which adverse reaction is commonly associated with adrenaline administration?
In a shockable rhythm such as VT/VF, after administering adrenaline, what is the recommended protocol?
What outcome may result from extravasation of adrenaline?
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What effect does adrenaline primarily have on cardiac output?
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In cases of non-shockable rhythms, after the first dose of adrenaline, what is the timeline for the next dose?
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What is the mechanism by which adrenaline increases perfusion pressure?
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Which condition is not indicated for adrenaline use?
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What effect does amiodarone have on cardiac rhythms during treatment?
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What is the correct initial dose of lidocaine during a cardiac arrest?
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What is a significant adverse reaction associated with the use of atropine?
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Which statement is true regarding the administration of calcium chloride/gluconate?
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Which is a primary indication for using vasopressors during CPR?
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What is the mechanism of action for lidocaine in cardiac management?
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How does atropine primarily affect heart rate?
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What is one of the adverse reactions of using amiodarone?
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What is the role of vasopressors in cardiac arrest?
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Which condition is NOT an indication for the use of amiodarone?
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Study Notes
Adrenaline
- Stimulates alpha and beta receptors, increasing cardiac output and enhancing perfusion to the brain and coronary regions.
- Indicated for asystole, pulseless electrical activity (PEA), ventricular tachycardia (VT), ventricular fibrillation (VF), and symptomatic bradycardia.
- Following a second shock in shockable rhythms, administer adrenaline at a concentration of 1:10,000 (1mg in 10ml), flush with 30mls.
- Peripheral vasoconstriction raises diastolic pressure, facilitating defibrillation and improving myocardial blood flow during CPR.
- Adverse reactions include tachycardia, hypertension, peripheral vasoconstriction, and potential for tissue necrosis if extravasation occurs.
Amiodarone
- Prolongs action potential duration and refractoriness in atrial, nodal, and ventricular tissues, effective for treating shockable rhythms like pulseless VT/VF.
- Administered for conscious VT, atrial fibrillation (AF), atrial flutter, and supraventricular tachycardia.
- Initial dose of 300mg IV/IO followed by 150mg if needed; must be delivered using a PVC-free line to avoid harm.
- Reduces cardiac oxygen demand without negative inotropic effects and slows atrioventricular conduction.
- Side effects include hypotension, bradycardia, and heart blocks.
Lidocaine Hydrochloride
- Functions as a membrane-stabilizing agent with antiarrhythmic properties to reduce automaticity in ventricular cells.
- Indications include ventricular fibrillation (VF) or pulseless VT, especially if hypersensitivity to amiodarone is present.
- Initial dosage of 1mg/kg IV after the third shock, followed by additional doses up to 200mg as required.
- Risk of adverse effects includes hypotension, bradycardia, CNS disturbances, and respiratory depression.
Calcium Chloride/Gluconate
- Indicated for hypocalcemia, with administration aimed at restoring calcium levels rapidly (Ca \15 mins).
- Potential adverse effect includes vasodilation, and the coincidental administration with adrenaline may inactivate the latter.
- Dosage ranges from 5-10mL, ensuring appropriate line management to avoid precipitate formation.
Atropine
- Reduces parasympathetic effects, indicated primarily for sinus bradycardia and symptomatic heart blocks.
- Increases heart rate by blocking the vagus nerve's actions, especially when heart rate is below 40 bpm or systolic blood pressure falls below 90 mmHg.
- Administer a rapid IV bolus of 500-600 mcg, potentially repeated as needed, with a maximum total dose limit of 3mg.
- Side effects can include tachyarrhythmias, urinary retention, excitement, and hyperthermia in large doses.
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Description
This quiz covers the indications, adverse reactions, and dosing of adrenaline in Advanced Life Support (ALS). Test your knowledge on how to properly administer adrenaline during critical situations, recognizing the signs of asystole and other related conditions.
