Megacode PEA Part 6

Hypovolemia

·         Look for tachycardia with narrow QRS complex

·         Assess and find bleeding sources

·         Fluid boluses with isotonic crystaloids

·         Volume expanders

·         Blood products

Hydrogen Ions (acidosis)

·         Assess ABGs

·         Bicarb 1mEq/kg

o   Known pre-existing bicarbonate responsive acidosis

o   Intubated patient with continued long arrest interval

o   Upon return of spontaneous circulation after long arrest interval

o   Tricyclic antidepressant or aspirin overdose

o   Known prexisting hyperkalemia

·         ·Treat respiratory acidosis with ventilation

Hyperkalemia

Assess serum potassium levels

Tall T waves, widened QRS

3.5-5.3             Normal

5.3-6.0             Mild

6.1-7.0             Moderate

>7.0                Severe

Hypokalemia

Hypothermia

·         Assess core temperature

·         Cardiac dysrrhythmias when < 86F (30C)

·         Many meds. are ineffective until temp >86F

·         Defibrillation ineffective unless temp >86F

·         Remember  “No patient is dead until he is warm and dead”

·         Hypothermic algorithim