ACLS

What is the drug action of epinephrine/adrenaline?

peripheral vasoconstriction

Indications for the use of epinephrine?

• VF/pulseless VT

• asystole

What is the recommended dose for epinephrine?

•  Dose for 1:1,000 = 1 mg/mL every 3-5 mins

• Dose for 1:10,000 = 0.1 mg/mL

these should be given every second loop of CPR

What is the drug action of amiodarone?

prevents conduction of unwanted electrical activity by blocking potassium channels to prevent a second action potential from being generated

Indications for the use of amiodarone?

• VF/pulseless VT

What is the initial and additional dose for amiodarone?

300mg then 150mg

Drug action of verapamil?

Verapamil is a calcium-channel blocker that slows conduction through the AV node which reduces heart rate and contractility

Drug action of atropine?

• blocks the effect of the vagus nerve on the heart to increase our heart rate

Indications for atropine?

bradycardia

What is the initial dose for atropine?

0.6 mg IV

What is the drug action of adenosine?

prevents tachycardias which originate above the ventricles

Indications for adenosine?

supraventricular tachycardia

Initial and additional dose for adenosine?

6mg then 12mg after 1-2 mins

What is the drug action of calcium?

• Increases myocardial excitability and contractility

Indications for calcium?

• hypocalcaemia

• hyperkalaemia

• overdose of calcium channel blocking drugs

What is the dose range for calcium?

5-10 mL

What is the drug action of lidocaine?

blocks sodium channels to prevent depolarisation and nerve conduction

Indications for lidocaine?

• VF/pulseless VT

What is the initial and additional dose range for lidocaine?

1mg/kg then 0.5 mg/kg

What is the drug action of vasopressin/ADH?

• increases water and sodium retention and causes vasoconstriction

What arrhythmia is this?

Ventricular fibrillation

What arrhythmia is this?

Pulseless ventricular tachycardia

What arrhythmia is this?

asystole

What are the 2 shockable rhythms?

• ventricular fibrillation

• pulseless ventricular tachycardia

What are the 2 non-shockable rhythms?

• asystole

• pulseless electrical activity (PEA)

Where are the top and bottom paddles placed for defibrillation?

top paddle= right parasternal area, bottom paddle= midaxillary line

What are the 4 H’s?

hypoxaemia, hypovolaemia, hypo/hyperkalaemia, and hypo/hyperthermia

What are the 4 T’s?

Tension pneumothorax, tamponade, toxins, thrombosis

What is a tension pneumothorax?

Build-up of air in the pleural space which places pressure on our lungs, trachea, and heart

What is a cardiac tamponade?

Build-up of blood in the pericardial space which causes compression of the heart

What is an acute coronary syndrome (ACS)?

a syndrome in which there is an imbalance between the supply and demand of oxygen to the heart due to an occlusion of the coronary arteries

What is unstable angina?

chest pain which occurs during rest as a result of a partial occlusion of the coronary artery

What are the common symptoms of ACS?

• central chest pain with or without radiation to the neck, arm, and back

• SOB

• diaphoresis

• tachycardia

What is the treatment for ACS?

• maintain an SpO2 >94%

• administer NGT and morphine for vasodilation and pain management

• attach electrodes for ECG monitoring

• fibrinolytic therapy

What is a STEMI?

ST elevation myocardial infection caused by complete occlusion of the coronary artery

What is a cardiac arrest?

when the heart suddenly stops beating

Common causes of hypovolaemia?

• anaphylaxis

• bleeding

• sepsis

Hypovolaemia presentation

• flat neck veins

• hx of bleedings

Treatment for hypovolaemia

• fluids

• bloods

Common causes of hypoxia

• drowning

• opioids/sedative overdose

Hypoxia presentation

• cyanosis

• SOB

• compromised airway

Hypoxia treatment

• oxygen

• ventilation

• CPR

Common causes of hypo/hyperkalaemia?

• renal failure

• vomiting/diarrhoea

hypo/hyperkalaemia presentation

• on dialysis?

• diabetic?

• on diuretics?

Treatment for hypo/hyperkalaemia

• hypokalaemia: potassium fluid replacement

• hyperkalaemia: glucose with insulin as this pulls potassium into cells

Thrombosis (coronary) treatment

MONA: morphine, oxygen, NGT, aspirin

What is IgE mediated hypersensitivity?

A food allergy which is immediate

What are the common symptoms associated with a IgE mediated allergy?

• hives

• swelling

• itchiness

• watery nose and eyes

• difficulty breathing and swallowing

• vomiting

• LOC