ACLS review: Wide Complex Tachycardia (WCT) Review Questions Part 1

1.  What are the ECG characteristics of Torsades de pointes?

2. Magnesium is the drug of choice in the treatment of what dysrhythmia?

3.  What is the dose of Procainamide used in the treatment of VT with a pulse?

4. What is the initial joule setting when performing cardioversion on a patient with monomorphic VT?

5.  What are four differences between defibrillation and cardioversion?

6. What is the initial dosage of Lidocaine used in the treatment of wide complex tachycardia?

7.  What is the initial joule setting when delivering a synchronized shock to an adult victim in unstable SVT with aberrancy?

8.  What is the maximum cumulative dosage of Lidocaine that is recommended during the treatment of stable VT?

9.  What is the dosage of magnesium used in the treatment of torsade de pointe?

10.  Adenosine is indicated in the treatment of what arrhythmias?

Answers

1.  What are the ECG characteristics of Torsades de pointes?

There are no P waves

There is no PR interval

The QRS complex appears wide, bizarre and changes from beat to beat

The amplitude of the QRS complex begins smaller and gets larger then begins to get smaller again.

The rate is usually over 150

The rhythm is irregular

2. Magnesium is the drug of choice in the treatment of what dysrhythmia?

Torsades de pointe

3.  What is the dose of Procainamide used in the treatment of VT with a pulse?

Procainamide can be administered at a rate of 20 to 50 mg/min until the arrhythmia is suppressed, hypotension develops, the QRS widens over >50%, or the maximum dose of 17 mg/kg is given.

4. What is the initial joule setting when performing cardioversion on a patient with monomorphic VT?

100 J

5.  What are four differences between defibrillation and cardioversion?

Cardioversion delivers electrical current to the heart during a specific time during the cardiac cycle

Cardioversion can be used on a variety of rhythms including SVT, A fib, Aflutter, Stable VT, and wide complex tachycardia

Defibrillation does not need to be synchronized with the ECG

Defibrillation uses higher energy levels

Defibrillation is used in the treatment of pulseless VT/VF

6. What is the initial dosage of Lidocaine used in the treatment of wide complex tachycardia?

Lidocaine 1-1.5 mg/kg IV push

7.  What is the initial joule setting when delivering a synchronized shock to an adult victim in unstable SVT with aberrancy?

50-100 J

8.  What is the maximum cumulative dosage of Lidocaine that is recommended during the treatment of stable VT?

3mg/kg IV/IO

9.  What is the dosage of magnesium used in the treatment of torsade de pointe?

1-2 grams IV/IO diluted in 10ml of D5W as a bolus or given over 5-20 minutes

10.  Adenosine is indicated in the treatment of what arrhythmias?

Stable SVT, SVT with aberrancy, Stable monomorphic VT


Reviewed 2/28/16