Questions and Answers
Which of these rhythms indicates a chaotic electrical activity in the heart?
What is the immediate treatment for a patient experiencing Ventricular fibrillation?
What does the acronym COACHED stand for in the context of defibrillation preparation?
After defibrillation, what should be the immediate priority for an unresponsive patient?
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Which rhythm is characterized by the absence of electrical activity in the heart?
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Under what circumstances should Adrenaline be administered in cardiac emergencies?
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Which rhythm indicates a rapid heartbeat that is often assessed in patients with tachycardia?
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What is the primary purpose of performing synchronized cardioversion?
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What medication is correctly indicated after the second shock in a Torsades de Point arrest?
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In a VF/pulseless VT arrest situation, after how many shocks is Amiodarone typically administered?
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Which is the correct dose of IV Amiodarone in a pulseless VT arrest?
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If a patient is hypersensitive to Amiodarone, what is the recommended alternative?
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Why is Adrenaline administered during a cardiac arrest?
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In the absence of IV access during a cardiac arrest, which route and dose of Adrenaline is appropriate?
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At what heart rate is Atropine indicated for the management of bradyarrhythmia?
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What is the most critical factor that improves survival during a cardiac arrest as per the chain of survival?
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In a scenario where the patient shows unresponsiveness and abnormal breathing, which rhythm is most likely?
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In the case of a potentially reversible cardiac situation, what is the most suitable intervention?
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Study Notes
Cardiac Rhythms and Conditions
- Atrial fibrillation features irregular heart rhythms with no pattern.
- Complete heart block leads to a failure of transmission from the atria to the ventricles.
- Sinus bradycardia is characterized by a heart rate below 60 beats per minute.
- Ventricular fibrillation shows chaotic electrical activity in the ventricles, preventing effective pumping.
Immediate Treatments
- Administering Adrenaline 1mg is essential in certain arrhythmic emergencies.
- Defibrillation is the immediate treatment for shockable rhythms like ventricular fibrillation.
- Synchronized cardioversion is used for tachyarrhythmias but not for VF or pulseless VT.
- Lignocaine is used primarily in specific ventricular arrhythmias.
COACHED Protocol for Defibrillation
- COACHED stands for:
- Cease compressions
- Oxygen away
- All others away
- Charging
- Hands off
- Examine the patient
- Defibrillate.
Post-Defibrillation Protocol
- Following defibrillation, resuming chest compressions is the top priority for an unresponsive patient.
Identifying Cardiac Rhythms
- Asystole indicates complete cardiac standstill, while ventricular standstill is also a possible rhythm.
- Sinus rhythm is recognized by a consistent heart rate and rhythm.
Adrenaline Administration Guidelines
- Adrenaline is given post-second DC shock in cases of VF/pulseless VT.
- For non-shockable rhythms, Adrenaline is administered during the initial CPR cycle and repeated every second cycle.
Arrhythmic Treatment
- Amiodarone is typically used in pulseless VT arrest after the third shock, following adrenaline.
- Lignocaine serves as a first-line drug in VF/pulseless VT arrest after the second shock.
Dosage Considerations
- The correct dose of IV amiodarone in pulseless VT arrest is 300 mg in 20 mL normal saline over 1-2 minutes.
- For known hypersensitivity to amiodarone, Lignocaine at 300 mg (with an additional 150 mg if needed) is an alternative.
Role of Adrenaline
- Adrenaline causes vasoconstriction, raising diastolic BP, and increases coronary perfusion pressure.
- It may also enhance the effectiveness of defibrillation during CPR efforts.
Administration Without IV Access
- When IV access is unavailable, adrenaline can be given as a 1mg dose (1:10000 dilution) via intraosseous route.
Atropine Use in Bradyarrhythmias
- Atropine is indicated for bradyarrhythmias when heart rate drops below 60 bpm or when systolic BP is under 90 mmHg.
Chain of Survival
- Early CPR with high-quality chest compressions is critical for improving survival odds during cardiac arrests.
Recognizing and Responding to Rhythms
- Pulseless Electrical Activity (PEA) indicates cardiac electrical activity without effective heart contractions.
- Identifying and treating the underlying cause is essential for potentially reversing PEA.
Monitor Alarms Response
- Be alert to monitor alarms as they may signal critical changes in the patient's condition, necessitating immediate assessment.
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Description
Test your knowledge on emergency cardiology, focusing on different heart rhythms and immediate treatment protocols. This quiz includes questions about rhythm recognition and defibrillation procedures. Perfect for medical students and healthcare professionals.
