ACLS review: Pulseless Electrical Activity- part 8

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

Tablets

·         Assess for drug overdose

·         Assess for hx of drug use

·         Consult poison control

Tablets: Calcium Channel Blockers

·         Hypotension

·         Bradycardia with variable heart block

·         Altered mental status

·         EKG: slow rate, prolonged PRI, AV blocks

·         Rx Calcium chloride 10% 1-4G slow IV

·         Fluid resuscitation, vasopressor agents, atropine, transvenous pacing

Tablets: Beta blockers

·         Hypotension

·         Bradycardia with variable heart block

·         EKG: slow rate, prolonged PRI

·         Rx Glucagon 3-10mg IV bolus followed by infusion 2-5mg/hr

Tablets: Tricyclic Antidepressants

·         Amitriptyline, Doxepine, Trazadone, Nortriptyline

·         Prolonged QT, Widened QRS

·         3Cs & 1A - Cardiac dysarrhythmias, Convusions, Coma, & Acidosis

·         Rx NaHCO3 bolus or infusions

·         Maintain pH > 7.45


Reviewed 2/28/16