Don't Go Breaking My Heart
My Heart Will Go On
Achy Breaky Heart
Quit Playing Games (With my Heart)
Don’t Phunk with my Heart
100
What is: Normal sinus rhythm with 1st degree AV block
- PR interval 260 ms
100
What is the heart rate target for hemodynamically stable patients with atrial fibrillation with RVR?
What is:
<110 BPM
100
Name all shockable rhythms and associated management w/ Rx dosing if applicable
(3 answers)
Shockable: pulseless Vtach & Vfib
Rx:
- Defib, then high quality CPR for 2 minutes. If shockable rhythm persists, deliver a second shock.
- Epinephrine 1 mg IV/IO can be given during the CPR cycle (typically after the 2nd shock) and repeated every 3 to 5 minutes
- After another 2 minutes of CPR, check the rhythm. If pVT is still present, deliver a third shock.
- Resume CPR and administer an antiarrhythmic:
- Amiodarone: First dose is 300 mgIV/IO push; a second dose of 150 mg can be given later.
100
WHAT IS THIS RHYTHM, AND HOW DO YOU TREAT IT?
What is: Sinus tachycardia
Heart rate 150 bpm.
P waves are hidden within each preceding T wave.
RX: TREAT THE UNDERLYING CAUSE
100
Name all non-shockable and associated management w/ Rx dosing if applicable
What are:
PEA & asystole
Rx:
High-Quality CPR in 2-minute intervals.
Epinephrine 1 mg q 3-5 minutes.
200
What first line treatment for atrial fibrillation with RVR?
PROVIDE RX, ONSET OF ACTION, AND MAX DOSING/FREQUENCY.
(2 ANSWERS).
Rx: IV Metoprolol Tartrate (Lopressor) 5mg IV bolus
Onset of action: approx 5 min
Repeat up to 3x q 5 min (MAX 15 MG TOTAL)
OR
Rx: IV Diltiazem (Cardizem)
First bolus: 0.25 mg/kg (average adult dose: 15-20 mg) within 15 minutes, administer a second bolus.
Second bolus: 0.35 mg/kg (average adult dose: 20-25 mg)
INFUSION FOLLOWS + PCU upgrade
*PER ACC GUIDELINES*
200
When are two first line Rx options for Afib RVR contraindicated/not recommended?
(2 answers)
1. Non-dihydropyridine CCBs (Cardizem) contraindicated in HFrEF
2. Beta blockers not recommended in acute COPD exacerbation (though not contraindicated).