Identify the appropriate electrical intervention for the following EKG rhythms

Identify the appropriate electrical intervention for the following EKG rhythms

1.

a.   Defibrillate with 200 J (monophasic)
b.  Transvenous pacing with 200 J with demand rate 80 bpm
c.  Electrical intervention inappropriate for this rhythm
d.  Transcutaneous pacing at 60 bpm


2.

a.   Synchronized cardioversion with 100 J
b.   Deliver an unsynchronized shock at 120 J
c.   Defibrillation with 360 J monophasic and increase joules for refractory rhythms
d.   Standby demand pacing with rate of 60 bpm

3.

Unstable wide complex tachycardia

a.   Transcutanous pacing with 120 mA and a fixed rate of 80
b.   Consider cardioversion at 100 J
c.   Deliver an unsynchronized shock at 300 J monophasic
d.  Defibrillation with 300 J monophasic

4.

a.   Electrical intervention is inapproprate for this rhythm
b.  Immediate defibrillation at 360 J (monophasic)
c.  Attempt transcutaneous pacing with 200 mA
d.  Cardiovert with 200 J and increase joules in a step-wise manner for refractory rhythm

5.

a.  Immediate cardioversion with 360 J (monophasic)
b.  Fixed rate pacing at 100 bpm and increase mA until mechanical capture is obtained
c.  Defibrillation with 120-200 J and increase joule settings for refractory rhythm
d.  Electrical interventions inappropriate for this rhythm



Answers
1.  d.  Transcutaneous pacing at 60 bpm
2.  d.   Standby demand pacing with rate of 60 bpm
3.  b.   Consider cardioversion at 100 J
4.  b.  Immediate defibrillation at 360 J (monophasic)
5.  c.  Defibrillation with 120-200 J and increase joule settings for refractory rhythm


Reviewed on 3/2/16