What would you do?
Patient is a 5 yo post op patient in complete heart block with pacing wires set to a rate of 150. Patient's heart rate has dropped drastically and you notice patient's pacing wire broke.
What do you do?
YELL for help
Assess patient's stabiliy (BP etc)
Compressions if needed
STRIP the pacing wire-
if still not working external pacing (sedate patient!)
Three stages of a HLHS repair
What is norwood or hybrid, glenn and fontan.
Treatment for vfib
defib
All pulmonary veins drain into systemic venous vessel or chamber
TAPVR
Labs to monitor when utilizing a loop diuretic
BUN, Creatinine, K, NA
Looking at ventilator patient has no tidal volumes.
What do you do?
Suction and assess ETT! What if ETT is normally at 8cm but is now at 4cm?
Is patient irritated/ holding breath? Does patient need sedation? Bag patient.
The surgical repair of an AVC can lead to this arrythmia
complete heart block
Characterized by a prolonged PR interval
First degree heart block
Anatomy of tetralogy of fallot
PS, VSD, Overriding aorta and RV hypertrophy
Used for SVT, Ventricular arrhythmias, JET, A flutter, and fibrillation.
Amiodarone
Patient is post op TAPVR. Patient is irritable and starts to decompensate. Vitals are bp 50/30, hr 180, spo2 80, co2 60, cvp 24.
What is happening? What will you do?
PHTN Crisis
Bag, increase fio2, sedation, INO, sildenafil
What is the hybrid procedure and what are the Two goals of the hybrid procedure?
PA Bands and PDA Stent
Unrestricted systemic blood flow and restrictive pulm blood flow
Treatment of VT
Lidocaine, synchronized cardioversion, defib if no pulse
Resulted from the incomplete divison of the common great vessels during fetal life. Single large vessel arising from the ventricle. Large VSD.
Truncus
Used in low doses for renal perfusion. In high doses increases heart rate and contractility
dopamine
Patient is 8m fresh post op.
Vitals
HR 180 CVP 25 BP 50/45 RR 60 Muffled Heart sounds JVD on assessment
What is happening? What do you do?
Tamponade
CALL FOR HELP! Surgeon called.
STRIP that CHEST TUBE!
This is why we don't want a glenn intubated after surgery
high intrathoracic pressure impedes venous return
an atria arrhythmia with an Abrupt onset of regular rhythm fixed rate between 200-350
SVT
Discontinuity of the aorta
interrupted aortic arch
A potassium sparing diuretic
Aldactone
Patient has rhythmic movement of arms, lips are smacking, patient is desaturated, HR is elevated and BP is elevated
What is happening?
Seizure
Notify DOC
Be prepared to grab ativan and provide supportive care (bagging, code drugs possible etc)
What about the coronaries?
They are too close to the valve to be cut out during the move so they need to be moved individually (BUTTON)
Treatment of SVT
vagal stimulation, pacing, adenosine, synchronized cardioversion,
What is ebsteins anomaly?
TV is low lying and leaflets are malformed large RA and small RV ASD
A selective phosphodiasertase 5 inhibitor and a potent vasodilator used in patients with PHTN.
What is sildenafil.