ACLS Heartcode ( Updated 2024 ) Complete Questions & Answers (Solved) 100% Correct
- in cardiac arrest when do you first introduce medical intervention? which drug?
Answer:
after 2 rounds of CPR/shock after 2nd shock give 1 mg epinephrine every 3-5 minutes
- when do you introduce amiodarone during cardiac arrest?
Answer:
after the 3rd shock give 300 mg bolus of amiodarone if second dose is needed give 150mg as second dose
- what rhythms are shockable in cardiac arrest
Answer: VF VT
- what rhythms are not shockable in cardiac arrest
Answer: asystole PEA
- if you are in an unshockable rhythm arrest when do you give epi
Answer: 1mg epi every 3-5 minutes after 1st round of CPR
- what do you do after return of spontaneous circulation
Answer: maintain O2 sat at 94%
treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion
- what are the 5 h's and 5 t's
Answer: hypovolemia hypoxia
hydrogen ion (acidosis) hypo/hyperkalemia hypothermia
tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary thrombosis, coronary
- how do you treat non-symptomatic bradycardia
Answer: monitor and observe
- what constitutes symptomatic bradycardia
Answer: hypotension altered mental status
signs of shock chest pain acute heart failure
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- how do you treat symptomatic bradycardia
Answer:
- give 0.5mg atropine every 3-5 mins to max of 3mg
if that doesn't work try one of the following:
transcutaneous pacing 2-10mcg/kg / minute dopamine infusion 2-10mcg/minute epinephrine infusion
- what is considered a tachycardia requiring treatment
Answer: over 150 per minute
- when do you consider cardioversion
Answer: if persistent tachycardia is causing: hypotension altered mental status signs of shock chest pain acute heart failure
- if persistent tachycardia does not present with symptoms what do you need to consider
Answer: wide QRS?
greater than 0.12 seconds
- If persistent tachycardia without symptoms DOES have a wide QRS what to do you do?
Answer: IV access and 12 lead if available
6mg adenosine followed by NS flush only IF regular and monomorphic consider anti-
arrhythmic infusion:
- 20-50mg/min procainamide (max 17mg/kg)
- 150mg amiodarone over 10 minutes
- 100mg sotalol over 5 minutes
- which anti-arrhythmic drugs can be used if prolonged QT
Answer: only amiodarone
150mg over 10 minutes, repeat if VT occurs follow by maintenance infusion 1mg/min for first 6 hours
- if persistent tachycardia without symptoms and without wide QRS what do you do
Answer: IV access and 12 lead EKG if available
vagal maneuvers 2 / 3
6mg adenosine followed by NS flush only IF regular Beta blocker or calcium channel blocker
- patient comes in with symptoms of ACS what do you do first
Answer:
chew 325mg aspirin O2 nitro morphine
get 12 lead EKG IV access
- IF ACS patient has EKG showing ST elevation and symptoms are less than 12 hours then
what
Answer: re-perfusion
door to balloon 90 minutes door to needle 30 minutes
- If ACS patient has EKG showing non ST elevation MI or high risk unstable angina then
what
Answer: early invasive strategy?
adjunctive treatment?-nitroglycerin -heparin -beta blockers -clopidogrel -glycoprotein IIb / IIIa inhibitor
- what are the contraindications to fibrinolytics in ACS treatment
Answer:
systolic > 180 diastolic > 100 right arm left arm systolic difference > 15 history of structural central nervous system disease recent head/facial trauma stroke more than 3 hours or less then 3 months ago recent trauma, surgery or bleed any history of intracranial hemorrhage bleeding, clotting problem or on blood thinners serious systemic disease
- adenosine
Answer: used in tachy
6mg bolus followed by 20mL normal saline 12mg can be used after 1-2 minutes
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