Cardiac Arrest Pharmacology & CPR Guidelines

In the context of cardiac arrest, if epinephrine fails to achieve the desired hemodynamic effects, what alternative vasopressor might be considered, and why is it not the primary choice?

For a patient in refractory VF/pVT, what is the weight-based dosing range for a second dose of lidocaine, and why is it crucial to adhere to this range?

In the treatment of Torsades de Pointes, what is the rationale behind administering magnesium sulfate as a rapid IV push, and what specific electrophysiological mechanism does it target?

In managing hyperkalemia, how do calcium chloride and calcium gluconate differ in their mechanism of action, and why might one be preferred over the other in specific clinical scenarios?

During CPR, if PETCO2 levels consistently remain below the specified threshold, what three specific adjustments to CPR technique should be prioritized to improve oxygen delivery and ventilation?

Explain the significance of the '1-3-5 Rule' mnemonic in epinephrine dosing during cardiac arrest. Why is adherence to this timing critical for optimizing patient outcomes?

After achieving ROSC, an immediate and sustained spike in ETCO2 levels is observed. What physiological event does this indicate, and what is the typical numeric threshold for this diagnostic rise?

List three specific, measurable improvements in CPR quality that should be targeted if ETCO2 levels consistently remain below the target of 65%, despite adherence to standard CPR protocols.

Describe how to assess IVC collapsibility to determine volume responsiveness. If the IVC collapse is less than 80%, what are the next steps to optimize the patient's condition?

Post-ROSC, what specific ECG findings would necessitate immediate transcutaneous pacing, and what is the underlying rationale for this intervention in the post-arrest period?

In a post-arrest patient with labile blood pressure, why is esmolol preferred over other beta-blockers, and what key pharmacokinetic property enables its suitability in this clinical context?

Following resuscitation, what is the recommended timeframe for monitoring lactate clearance, and what percentage decrease per hour suggests effective resuscitation and improved tissue perfusion?

Identify three absolute contraindications to hypothermia therapy (HTTM) after cardiac arrest, and explain the physiological rationale behind each contraindication.

If a post-arrest patient requires emergent PCI during HTTM, should there be any delay in performing PCI, and what is the rationale for this decision?

What specific monitoring considerations should be implemented when initiating anticoagulation post-ROSC, and why are these precautions necessary?

Outline the 'ABCs of ROSC' mnemonic for post-arrest care priorities, detailing the specific goals and interventions associated with each component.

During CPR, what are the three key parameters to monitor to ensure the effectiveness of chest compressions, and what are the recommended target ranges for each?

In the context of suspected tension pneumothorax, how can ETCO2 monitoring be used to confirm the effectiveness of needle decompression, and what specific change in ETCO2 should be expected?

In cases of pseudo-PEA, what is the preferred vasopressor, and what is the rationale for its use over other vasopressors in this specific clinical scenario?

Explain the concept of permissive hypertension in the immediate post-ROSC period. What is the target MAP range, and why is this strategy employed?

Identify three predictors of poor neurologic outcome after cardiac arrest, and explain the pathophysiological significance of each marker.

List three key criteria that would make a patient a suitable candidate for ECPR, highlighting the factors that contribute to improved outcomes with this intervention.

Identify three potential complications associated with ECPR, detailing the mechanisms by which these complications can arise during and after the procedure.

What is the recommended duration for EEG monitoring post-arrest, and what is the primary reason for this extended monitoring period?

Why might vasopressin be considered as an alternative to epinephrine? What is the main concern with this drug?

What are the specific chest compression rate and depth?

How is the effectiveness of needle decompression in a tension pneumothorax confirmed through ETCO2 monitoring?

What is the primary vasopressor of choice for pseudo-PEA, and why is it preferred?

What is the initial approach to managing post-ROSC hypertension, and within what MAP range should blood pressure be maintained initially?

What three clinical findings observed 72 hours post-arrest strongly predict a poor neurologic outcome?

What are three key criteria for identifying potential ECPR candidates, emphasizing factors that can improve outcomes?

Describe three significant complications associated with ECPR, detailing the mechanisms by which these can arise.

How long should EEG monitoring continue post-arrest, and why is this duration important?

For a patient who has achieved ROSC but continues to exhibit signs of shock despite adequate fluid resuscitation, what vasopressor would be most appropriate as a first-line agent, and why?

In the context of targeted temperature management (TTM) post-cardiac arrest, how does the presence of active bleeding influence the decision to initiate cooling, and what alternative strategies might be considered?

During mechanical ventilation following cardiac arrest, what specific adjustments to ventilator settings should be made if plateau pressure exceeds 30 cm H2O, and why is this adjustment necessary?

Describe the key differences in the initial management of a patient with post-ROSC hypertension versus a patient with post-ROSC hypotension, and explain the rationale for these differing approaches.

If a post-arrest patient develops refractory seizures despite treatment with first-line anti-epileptic drugs, what alternative or adjunctive therapies should be considered, and what are the potential risks and benefits of each?

In assessing volume responsiveness using dynamic measures, how does pulse pressure variation (PPV) correlate with fluid responsiveness in mechanically ventilated patients, and what limitations should be considered?

Beyond standard ACLS protocols, what are three key interventions or considerations specific to post-cardiac arrest care that can significantly impact long-term neurologic outcomes and survival?

In the context of post-cardiac arrest care, why is esmolol preferred over other beta-blockers in patients with labile blood pressure?

Explain the physiological rationale behind the recommendation for permissive hypertension (MAP 65-90 mmHg) in the immediate post-ROSC period.

Detail the significance of an abrupt increase in ETCO2 during CPR and explain the physiological mechanisms that lead to this change.

Describe the '1-3-5 Rule' mnemonic for epinephrine dosing during cardiac arrest, and explain the rationale for the frequency and dosage of epinephrine administration.

Outline the key candidate criteria for ECPR and elaborate on the rationale behind selecting patients with witnessed arrest, bystander CPR, and initial shockable rhythm for this intervention.