Medications
WARNINGS FOR ATROPINE
Too small of a dose (< 0.5 mg) or if pushed too slowly, may initially cause the heart rate to decrease. Antihistamines and antidepressants potentiate Atropine. A maximum dose of 0.04 mg/kg should not be exceeded. For 2nd degree AV block type II and 3rd degree AV block, omit Atropine and go to external pacer.
dopamine
Dopamine should not be used in patients with pheochromocytoma or hypovolemic shock.
Amiodorone
Adult cardiac arrest • 300 mg, IV/IO bolus • For persistent VF/VT repeat 150 mg, IV/IO bolus (maximum total dose 450 mg) Adult non-cardiac arrest • 150 mg IV over 10 minutes. May repeat 150 mg IV (over 10 min) every 10 minutes. Pediatric cardiac arrest • 5 mg/kg, IV/IO bolus (maximum individual dose 300 mg) • For persistent VF/VT repeat 5 mg/kg, IV/IO bolus (maximum total dose 15 mg/kg)
Third Degree AV Block
Pace @ 80 brady , MilliAmps until you capture
Side of the heart affected v1,v2
septal
INDICATION FOR AMIDORONE
INDICATIONS: •Ventricular Fibrillation •Pulseless VT •PVC’s greater than 12 min with physician orders •Ventricular Tachycardias (Wide and narrow) with a pulse
Lasix
Anuria
Epinephrine
Dosage and administration: Adult: • Cardiac arrest: o 1 mg boluses IVP / IO repeated every 3 – 5 minutes. • Symptomatic bradycardia with hypotension, resistant to dopamine: o Start at 2 mcg/min (Mix 2mg in 500 mL NS and titrate to a systolic BP of 90 mmHg) Max dose is 4 mcg/min. • Allergic reactions: o 0.3 - 0.5 mg (0.3-0.5 cc) IVP repeated every 3 – 5 minutes.
V-Tach with Pulse stable
150 in a 50 cc bag over 10 minutes macro drip
I, AVL
lateral
CALCIUM CHLORIDE INDICATION
INDICATIONS: Calcium chloride is indicated during resuscitation for the treatment of hypocalcemia and calcium channel blocker toxicity (i.e. Verapamil or Cardizem overdose) and Magnesium Sulfate overdose. It also protects the heart from hyperkalemia as may occur in patients with end-stage renal disease.
Atropine
None in emergency situations
Magnesium Sulfate
Adult Pre-Eclampsia / Eclampsia/ Bronchospasm
• 2 grams IV infusion over 10 minutes. • Draw 4ml of Magnesium Sulfate from the vial • Add the Magnesium Sulfate to a 50ml NS IV Bag • Attach a 10gtt/ml Infusion set (Macro Drip) • Connect to the main IV line Run at 60gtts/min (1 drop every second)
Cardiac arrest (in the setting of torsades de pointes):
• 2 grams, IV/IO bolus over 1-2 minutes
asystole
epinephrine 1mg 1/10,000
II, III, AVF
INFERIOR
SODIUM BICARBONATE INDICATION
INDICATIONS: Metabolic acidosis in cardiac arrest Tricyclic overdoses with QRS > 0.1 Electrocutions Hyperkalemia Methanol / Ethylene glycol toxicity Severe ketoacidosis
Calcium Chloride
CONTRAINDICATIONS: Cardiopulmonary arrest not associated with calcium channel blocker toxicity, hypocalcaemia, or orhyperkalemia.
1mg/kg IV, repeat up to 2 more times every 8-10 minutes if necessary to a total of 3 mg/kg. For infusion mix 2 grams in 500 mL NS and run at 2-4 mg/minute (30-60 drops per minute
Mobitz 1
atropine 0.5mg
INFERIOR WALL MI WHAT MUST WE RULE OUT
RIGHT VENTRICULAR INVOLMENT
DOPAMINE INDICATION
To treat shock and correct hemodynamic imbalances, improve perfusion to vital organs and to increase cardiac output.
Lidoncaine
Lidocaine is contraindicated in second-degree heart block, Mobitz II; complete AV block; and StokesAdams syndrome. If PVC's occur in conjunction with sinus bradycardia, the bradycardia should be treated first
Diltiazem
Adult o 0.25 mg/kg slow IV bolus over 2 minutes (max dose 20 mg) o If no conversion after 15 minutes: 0.35 mg/kg slow IV over 2 minutes (max dose 25 mg)
Dopamine
• Mix 400 mg of Dopamine in 500 mL of normal saline which yields 800 mcg/mL. This will be run at 10 mcg/kg/minute (usually 60 drops per minute) and titrated to a BP of 100 mmHg systolic
DIFFERENCE IN ISCHEMIA VRS INFARCTIONS EKG CHANGES
ST DEPRESSION AND T WAVE INVERSION WITH ST ELEVATION BEING INFARCTION