ACLS/PALS/ACS
Biphasic defibrillation is standard of care. The energy needed for shocking an adult and for a pediatric patient are these
What are:
120-200J for adult
2J/kg for pediatric
A CT scan just populated noting an aortic dissection for your patient. Their goal HR and SBP is now these
What are HR <60 bpm and SBP <120 mmHg
Etomidate can be used for RSI AND procedural sedation at these doses
What are:
RSI: 0.3mg/kg
PS: 0.15mg/kg - quick on/off, great for cardioversion
Benzodiazepines are first line agents for status epilepticus, specifically this medication at this dose
Lorazepam (Ativan) 2-4mg IVP q3-5min (0.1mg/kg) doubling dose at each interval
A patient comes in with an acute history of dehydration, nausea, polyuria/polydipsia, fatigue, and is found to have a glucose of 300, bicarb of 12, K of 3.1, ketones in urine. You decide to order these medications at these doses
What are:
Insulin 0.1 U/kg/hr
IVF 20mL/kg bolus followed by 2x maintenance
Potassium: 20-40 mEq if <3.3, 20-30 mEq if between 3.3 and 5.3
You are running a code for an adult patient who had pulseless V tach. You have shocked them twice without ROSC. You consider giving these two medications at these doses.
What are:
Epinephrine 1mg IV q3-5 min (100mcg/kg)
Amiodarone 300mg IV (150mg for subsequent doses)
You decide to give an A fib w/ RVR patient this dose of metoprolol
What is 2.5-5mg IV q5min (max 15mg)
It is time to intubate your patient and you are considering these medications at these dosages for your paralytic
What are:
Succinylcholine 1-1.5mg/kg
Rocuronium 0.6-1.2mg/kg
Vecuronium 0.1mg/kg
A patient is in status epilepticus, you're considering diazepam vs midazolam at these dosages
What are:
Diazepam (Valium) 5-10mg IV q5min, 0.2-0.5mg/kg IN/PR
Midazolam (Versed) 10mg IM, 5mg IN, 0.2mg/kg IV once
**Versed is only IM option if there's no IV access**
Patient comes in with an asthma exacerbation. You consider giving duoneb and these steroids at these dosages
What are:
Duoneb - 2.5mg/3mL albuterol and 0.5mg/3mL ipratropium then repeat albuterol x2
Steroids: methylprednisolone (Solumedrol) 125 mg (1mg/kg) OR
Dexamethasone (Decadron) 10-16mg (peds 0.6mg/kg) OR
Prednisone 40-60mg
A patient is found to have a STEMI, you consider giving which medications
What are ASA, Clopidogrel (Plavix) OR Ticagrelor (Brilinta) OR Prasugrel (Effient), Nitroglycerin, Enoxaparin (Lovenox), Heparin
A patient has 10/10 tearing chest pain to the back, is sweating and hypertensive. He is found to have an aortic dissection and you decide to give him one of these two medications (and what doses)
What are
Esmolol 500mcg/kg IV bolus over 1 min then 50mcg/kg/min drip titrated by 25-5-mcg/kg/min q5min
Nicardipine continuous IV drip at 5mg/hr, titrated at 2.5mg/hr q5-15min until target BP, max dose of 15mg/hr
Ketamine can be used for RSI, post-intubation sedation, and procedural sedation at these doses
What are:
RSI: 1-2mg/kg IV, 2-4mg/kg IM
PIS: 0.05-0.5mg/kg/hr
PS: 1-2mg/kg IV
A patient in status epilepticus has failed benzo therapy so you consider switching these medications at these doses/rates for a second line therapy
What are:
Levetiracetam (Keppra) 60mg/kg IV (max 4.5g)
Valproic acid 40mg/kg IV at 10mg/kg/min
Phenytoin 20 mg/kg at 50mg/min
Fosphenytoin 20 PE/kg at 100-150 PE/min
You get notified of a critical lab value for your patient. It is a potassium of 8!!! You decide to give CaCl with either insulin/glucose vs albuterol (fastest shifting agent) at these doses (list dose for Ca gluconate too)
What are:
CaCl 20mg/kg slow, Ca Gluconate 60-100mg/kg slow
Albuterol 10-20mg over 20-60min
Insulin 0.1 U/kg (5-10 U bolus) with 1-2 amps of D50
You are treating a STEMI patient and decide to give them aspirin, Plavix (Clopidogrel), Nitroglycerin, and start Heparin at these doses
What are:
ASA 324mg chewed
Plavix 600mg PO
Nitroglycerin 0.4mg SL q5min x3
Heparin 60U/kg load (max 4000U), then 12U/kg (max 1000U/h)
**Plavix 300mg and Lovenox 1mg/kg SQ q12h are for NSTEMI**
A patient comes in with A fib RVR and you decide to give them this dose of diltiazem over 2 minutes, 5 minutes, then continuous drip
What is 0.25mg/kg (avg 20mg) over 2 min, then 0.35mg/kg (avg 25mg) over 5 min, then IV drip at 5mg/hr, titrated up to 15mg/hr to maintain rate control
Propofol can be used for RSI, Post-intubation sedation, and procedural sedation at these doses
What are:
RSI: 0.5-2mg/kg
PIS: 5-50mcg/kg/min, 20mcg/kg/min is common starting rate, may need 20-40mcg boluses until drip is set up
PS: 0.5-1mg/kg IV
You have an agitated patient and are considering droperidol vs haloperidol vs midazolam vs olanzapine at these doses
What are:
Droperidol 2.5-5mg IV OR 5-10mg IM
Haloperidol 5mg IM/IV
Midazolam 5mg IM
Olanzapine (Zyprexa) 5-10mg IM
You have an asthmatic patient who did not respond well to duoneb or steroids, so you consider these medications at these doses
What are:
MgSO4 2g over 20 min
HeliOx 20/80 or 30/70 He/O2
Nebulized epinephrine 0.5mL in 2.25% solution
Epinephrine 0.3-0.5mg IM
Procainamide is a medication used for which type of arrythmias and at this dose
What are:
A fib RVR, stable V-tach, A fib with WPW
at 20-50mg/min, up to 17mg/kg IV until arrhythmia is controlled, hypotension, or QRS widening >50%, or max dose
Even though we allegedly don't use digoxin anymore, we are still tested on it, so you would give digoxin to an a fib RVR patient at this dose
What is:
8-12 mcg/kg load (1/2 up front, then 1/4 q6-8h)
PO/IV: 0.25mg to 0.5mg once, repeat doses of 0.25mg q6h to a max of 1.5mg over 24 hours
Fentanyl can be used for RSI, post-intubation sedation, and procedural sedation at these dosages
What are:
RSI: 3-8mcg/kg
PIS: 1-2mcg/kg/hr
PS: 2-3mcg/kg IV, 1-2mcg/kg IN
You have an EXTREMELY agitated patient and are considering putting them in the K hole vs combination therapy at these doses
What are:
Ketamine 5mg/kg (requires airway monitoring)
Droperidol/midazolam 5mg/2mg IM
Haloperidol/lorazepam 5mg/2mg IM
You are managing a patient with hyperkalemia and want to be different than all the other docs so you are considering these K-binding agents vs this diuretic
What are:
Lokelma/Parotimer
Lasix (20-40mg IVP)