ACLS review

196.  In what circumstances would you consider changing your initial dose of Adenosine?

The initial dose of Adenosine should be reduced to 3mg in patients taking dipyrimadole or carbamazepine.  Larger initial doses may be required for patients with higher blood levels of caffeine, theophylline, or theobromide. 

197.  What are two initial interventions in the treatment of narrow complex tachycardias?

Vagal maneuvers

Adenosine

198.  After delivering a synchronized shock to a patient you notice that the patient’s heart rhythm changes to VF.  What would you do?

If the patient develops VF then deliver an unsynchronized high energy shock at 200 J and follow the pulseless VF/VT algorithm.

199.  What are the cardinal rules for evaluating wide complex tachycardia?

Rule No 1:  Wide complex tachycardia is VT until proven otherwise

Rule No 2:  Always remember rule No 1

200.  What is the initial and subsequent dose of Lidocaine used in the treatment of symptomatic VT?

An initial bolus of 1.0 to 1.5 mg/kg IV

Additional bolus of 0.5 to 0.75 mg/kg can be given over 3 to 5 minutes

Total dose should not exceed 3 mg/kg (or >200 to 300 mg during a 1-hour period

A continuous infusion of initiated at 1 to 4 mg/min.


Reviewed 2/28/16