ACLS review

86.  An adult patient in unstable SVT does not respond to an initial cardioversion attempt at 50 J.  What would the next step be in the treatment of this patient?

Activate synchronized button on the monitor

Increase the joule setting to 100 J and cardiovert the patient again

87.  What are three precautions to keep in mind before giving Atropine in unstable bradycardia?

Doses of atropine sulfate of <0.5 mg may paradoxically result in further slowing of the heart rate

Atropine will not work on denervated hearts (heart transplants). 

Atropine may be considered, but if 2nd degree type II or 3rd degree block present, it may extend the block to 3rd degree or asystole

88. Give 5 examples of narrow complex tachycardia.

Sinus tachycardia, SVT, atrial fibrillation, atrial flutter, junctional tachycardia

89. What is the role of cricoid pressure during intubation? 

Cricoid pressure may reduce the risk if aspiration during intubation but it is no longer recommended.

90.  What are the indications for transcutaneous pacing?

Standby for clinically stable bradycardia

Therapeutic bridge until placement of a transvenous pacemaker is inserted

Hemodynamically unstable bradycardia


Reviewed 2/28/16