ACLS review: Pulseless VF/VT Review questions Part 3

Pulseless VF/VT Review Questions Part 3

21. When are the acceptable times for interrupting chest compressions during a pulseless arrest?

22.   What is the maintenance dosage of Amiodarone in the post arrest setting?

23.  What is the maintenance dose of Lidocaine that can be given to a patient after returning to spontaneous circulation?

24. What are some factors that affect transthoracic resistance or impedance during defibrillation and cardioversion?

25. What is the most frequent initial rhythm seen in out-of-hospital witnessed sudden cardiac arrest?

26.  What is the difference between a monophasic and a biphasic defibrillator?

27.  What is the next medication may be considered when VF/VT is unresponsive to CPR, defibrillation, and vasopressor therapy?

28.  What is the advantage of performing CPR prior to defibrillating a patient in VF/VT?

29. What should the health care provider do for a patient that remains in refractory VF/VT after giving an initial dose of Lidocaine?

30. What is the treatment strategy for treating a patient with a long QT interval baseline that is found to be in VT that is torsades de pointes?

Answers

21.

During pauses for ventilations

During rhythm checks

During delivery of actual shocks

22.  

Begin with an IV loading dose of 150mg IV over 10 minutes

Follow by a slow infusion of 360mg IV over the next 6 hrs.  (1mg/min)

Follow this with a maintenance infusion of 540mg IV over the next 18 hours (0.5mg/min)

23. 

Maintenance dose of Lidocaine 1-4mg/min

Reduce maintenance dose (not loading dose) in presence of impaired liver function or left ventricular dysfunction

Discontinue infusion immediately if signs of toxicity develop

24.

Paddle size

Chest size

Distance between the paddles

Paddle pressure

Presence of conductive gel

Lower joule settings

25. Ventricular fibrillation

26.  Monophasic defibrillators deliver current in one direction of current flow and require a higher joule setting.  Whereas biphasic defibrillators deliver current in two directions of current flow and require a lower joule setting.

27.  Amiodarone 300mg push IV/IO

28.  A brief period of chest compressions can deliver oxygen and energy substrates to the myocardium, thus increasing the likelihood that a perfusing rhythm will return after shock delivery.

29. If pulseless VF/ VT persists, an additional doses of 0.5 to 0.75 mg/kg IV push may be administered at 5- to 10-minute intervals to a maximum dose of 3 mg/kg.

30. Stop medications known to prolong the QT interval.

Correct electrolyte imbalance

Treat any other precipitating causes such as drug overdose or poisoning



Reviewed 2/28/16