Megacode Pulseless VF/VT Part 3
Continuing
with the above senario.
6/25/12
11:30. Vasopressin is given and CPR is continued in order to circulate the
medication. Although ventilations are adequate, preparations are made to
intubate the patient. Given the patient's malnourished appearance, his blood
sugar is checked and found to be 62. An amp of D50 is administered.
 |
| EKG waveform caused by compressions |
.
21. If multiple rescuers are available how often
should they rotate the task of compressions?
22. What
is the advantage of performing CPR prior to defibrillating a patient in VF/VT?
23. What
are some advantages of placing an endotracheal tube?
a.
b.
c.
d.
e.
f.
24. Describe
the correct hand placement when performing chest compressions.
25. If a
bystander is not trained in CPR, what is an acceptable technique for performing
CPR?
Continuing with the above scenario.
6/25/12 11:33. After circulating the Vasopression the rhythm check shows the patient’s rhythm to be unchanged. The defibrillator is charged and a 3rd shock is given at 360 J. The following rhythm is noted after the 3rd shock.
The patient remains in refractory Torsades de pointe. CPR is restarted.
26. What is the first antiarrhythmic and dosage that can be administered during a VF arrest?
27. What is the initial dosage of Lidocaine used in the treatment of pulseless VT/VF?
28. What is the dosage of magnesium used in the treatment of torsade de pointe?
29. How does defibrillation convert VF/VT to an organized rhythm?
30. What are the most common initial rhythms in witnessed sudden cardiac arrest?
21. If multiple rescuers are available how often should they rotate the task of compressions?
Every 2 minutes.
22. What is the advantage of performing CPR prior to defibrillating a patient in VF/VT?
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.
23. What are some advantages of placing an endotracheal tube?
a. Keeps the airway patent
b. Permits suctioning of airway secretions
c. Enables delivery of a high concentration of oxygen
d. Provides an alternative route for the administration of some drugs
e. Facilitates delivery of a selected tidal volume
f. With use of a cuff, may protect the airway from aspiration
24. Describe the correct hand placement when performing chest compressions.
The health care provider should place the heel of one hand on the center of the victim's chest and the heel of the other hand on top of the first so that the hands are overlapped.
25. If a bystander is not trained in CPR, what is an acceptable technique for performing CPR?
The bystander should provide Hands-Only (chest compression only) CPR, with an emphasis on "push hard and fast," or follow the directions of the emergency medical dispatcher.
26. What is the first antiarrhythmic and dosage that can be administered during a VF arrest?
Amiodarone 300mg IV/IO push. If necessary, may be repeated in 3-5 minutes at 150mg IV push.
27. What is the initial dosage of Lidocaine used in the treatment of pulseless VT/VF?
Lidocaine 1-1.5 mg/kg IV push
28. What is the dosage of magnesium used in the treatment of torsade de pointe?
1-2 grams IV/IO diluted in 10ml of D5W as a bolus or given over 5-20 minutes
29. How does defibrillation convert VF/VT to an organized rhythm?
Defibrillation stuns the heart and briefly terminates the electrical activity, including VF/VT, so that the normal pacemaker may eventually resume electrical activity and return to profusing heart rhythm.
30. What are the most common initial rhythms in witnessed sudden cardiac arrest?
VF or rapid pulseless VT are the most common rhythms observed in witnessed sudden cardiac arrest. When pulseless VT is present, it will rapidly deteriorate to VF and VF will deteriorate to asystole if not treated.
Answers to Questions
Every 2 minutes.
22. What is the advantage of performing CPR prior to defibrillating a patient in VF/VT?
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.
23. What are some advantages of placing an endotracheal tube?
a. Keeps the airway patent
b. Permits suctioning of airway secretions
c. Enables delivery of a high concentration of oxygen
d. Provides an alternative route for the administration of some drugs
e. Facilitates delivery of a selected tidal volume
f. With use of a cuff, may protect the airway from aspiration
24. Describe the correct hand placement when performing chest compressions.
The health care provider should place the heel of one hand on the center of the victim's chest and the heel of the other hand on top of the first so that the hands are overlapped.
25. If a bystander is not trained in CPR, what is an acceptable technique for performing CPR?
The bystander should provide Hands-Only (chest compression only) CPR, with an emphasis on "push hard and fast," or follow the directions of the emergency medical dispatcher.
26. What is the first antiarrhythmic and dosage that can be administered during a VF arrest?
Amiodarone 300mg IV/IO push. If necessary, may be repeated in 3-5 minutes at 150mg IV push.
27. What is the initial dosage of Lidocaine used in the treatment of pulseless VT/VF?
Lidocaine 1-1.5 mg/kg IV push
28. What is the dosage of magnesium used in the treatment of torsade de pointe?
1-2 grams IV/IO diluted in 10ml of D5W as a bolus or given over 5-20 minutes
29. How does defibrillation convert VF/VT to an organized rhythm?
Defibrillation stuns the heart and briefly terminates the electrical activity, including VF/VT, so that the normal pacemaker may eventually resume electrical activity and return to profusing heart rhythm.
30. What are the most common initial rhythms in witnessed sudden cardiac arrest?
VF or rapid pulseless VT are the most common rhythms observed in witnessed sudden cardiac arrest. When pulseless VT is present, it will rapidly deteriorate to VF and VF will deteriorate to asystole if not treated.
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