Present : PGY 王 淳 峻 Supervisor: F1 王 德 皓

Size: px
Start display at page:

Download "Present : PGY 王 淳 峻 Supervisor: F1 王 德 皓 991109"

Transcription

1 Present : PGY 王 淳 峻 Supervisor: F1 王 德 皓 Interventions to prevent cardiac arrest + Airway management + Ventilation support + Treatment of bradyarrhythmias & Tachyarrhythmias Treat cardiac arrest + Immediate recognition and activation of emergency response + Early CPR + Rapid defibrillation to further increase the likelyhood of ROSC with drug therapy + Advanced airway management and physiologic monitoring Improve outcomes of patients who achieve ROSC + Integrated post cardiac arrest care 8.1: Adjuncts for airway control and ventilation 8.2: Management of Cardiac arrest 8.3: Management of Symptomatic Bradycardia and Tachycardia + Continuous quantitative waveform capnography is recommended for confirmation and monitoring of endotracheal tube placement + Cardiac arrest algorithms are simplified and redesigned to emphasize the importance of high quality CPR : 1. chest compressions of adequate rate and depth 2. Complete chest recoil after each compression 3. minimizing interruptions in chest compressions 4. Avoiding excessive ventilation + Atropine is no longer recommended in the management of PEA/asystole + Emphasis on physiologic monitoring to optimize CPR quality and detect ROSC + Chronotropic drug infusions are recommended as an alternative to pacing in symptomatic and unstable bradycardia. + Adenosine is recommended as a safe and potentially effective therapy in the initial management of stable undifferentiated regular monomorphic wide complex tachycardia. + When treating VF/pulseless VT, do CPR first. + A brief chest compression can provide oxygen and energy substrate to the hypoxic myocardium, thus able to increase the likelihood of successful shock delivery. After shock, resume chest compression immediately. + When VF/pulseless VT persists after 1 shock then can consider drug therapies. + Think PEA Pitressin (vasopressin) Epinephrine Amiodarone improve the rate of ROSC with refractory VF/pulseless VT. Follow the protocol

2 + Vasopressor can be given as soon as feasible. + IMPORTANT: evidence have suggested that the routine use of atropine during PEA or asytole have little therapeutic benefits. Therefore, atropine has been removed from algorithm. 5H + 1) Hypovolemia 1) Tensiop neumothorax + 2) Hypoxia 2) Tamponade, cardiac + 3) Hypo/hyper K+ 3) Toxins + 4) Hypothermia 4) Thrombosis, pulmonary + 5) Hydrogen ion 5) Thrombosis, coronary 5T Mechanical parameter + Rate, depth of compression and rate of ventilation Physiologic parameter + ECG & Pulse check are the only physiologic parameter + Animal & human studies indicate that monitoring of Petco2, coronary perfusion pressure (CPP), and central venous oxygen saturation (Scvo2) provides valuable information. + An abrupt increase in any of these parameters is a sensitive indicator of ROSC that can be monitored without interrupting chest compression. (Class IIb, LOE C) Pulse + No more than 10s End Tidal CO2 (Petco2) + concentration of CO2 in exhaled air at the end of expiration + Noraml range: mmhg + Petco2 may be altered by NaHCO3 therapy (increase) and Vasopressin therapy (decrease) + Low Petco2 (<10mmHg) during CPR in intubated patients indicates that cardiac output is inadequate to achieve ROSC. + Abrupt increase in Petco2 during CPR is an indicator of ROSC. (Class IIa) + Use quatitatve waveform capnography in intubated patients to monitor CPR quality, optimize chest compression, and detect ROSC. (Class IIb)

3 Timing of IV/IO access Peripheral IV drug delivery Central IV drug delivery + The appropiately trained provider may consider placement of a central line (internal jugular or subclavian) during cardiac arrest, unless there are contraindications. (Class IIb) + Advantage: 1. peak drug concentration are higher and drug circulation times shorter compared with peripheral IV catheter. 2. can monitor Scvo2 and estimate CPP during CPR + Disadvantage: 1. can interrupt CPR 2. relative contraindication for fibrinolytic therapy in patients with ACS Endotracheal drug delivery + Drugs that can be absorbed via the trachea: lidocaine, epinephrine, atropine, naloxone, and vasopressin. (No amiodarone) + If IV or IO access cannot be established, epinephrine, vasopressin and lidocaine may be administered by endotracheal route during cardiac arrest. (Class IIb) + The optimal endotracheal dose of most drugs is unknown, but times IV dose could be given. + Deliver at least 100 compression per minute continuously without pauses for ventilation. + Delivering ventilations should give 1 breath every 6 8 seconds (8 10 breaths per minutes) + Avoid delivering an excessive number of ventilations. + There is evidence, at any stage during management of Vf, pulseless VT, PEA, or asystole increased rate of ROSC. + No difference in outcomes with vasopressin (40 U IV) versus epinephrine (1 mg) as a first line vasopressor in cardiac arrest. Epinephrine + 1mg dose of IV/IO epinephrine every 3 5 minutes during adult cardiac arresr (Class II b) Vasopressin + Because the effects of vasopressin have not been shown to differ frome those of epinephrine in cardiac arrest, 1 dose of vasopressin 40 units IV/IO may replace either the first or second dose of epinephrine. (Class II b) Amiodarone + May be considered for Vf or pulseless VT unresponsive to CPR, defibrillation, and a vasopressor therapy. (Class II b) + An initial dose of 300mg IV/IO can be followed by 1 dose of 150 mg IV/IO. Lidocaine + Lidocaine may be considered if amiodarone is not available. (Class II b) + The initial dose is mg/kg IV. + If VF/pulseless VT persisted, additional doses of mg/kg IV push may be administered at 5 10 minute intervals to a maximum dose of 3 mg/kg. Magnesium Sulfate + IV Magnesium sulfate can facilitate termination of torsades de pointes (irregular/polymorphic VT associated with prolonged QT interval). + Optimal dosing regimen has not been established. + When VF/pulseless VT cardiac arrest is associated with torsades de pointes, IV/IO bolus of magnesium sulfate at a dose of 1 2 g diluted in 10ml D5W may be administered. (Class II b) + Routine administration of magnesium sulfate is NOT recommended (Class III) unless torsades de pointes is present. Atropine + Decrease HR & AV node conduction + Available evidence suggests that routine use of Atropine during PEA or asystole is unlikely to have a therapeutic benefit. (Class II b)for this reason, atropine has been removed from the cardiac arrest algorithm. Sodium Bicarbonate + Tissue acidosis and resulting acidemia during cardiac arrest and resuscitation are dynamic process resulting from no blood flow during arrest and low blood flow during CPR. + Mainstays of restoring acid base balance are restoration of oxygen content with appropriate ventilation with oxygen, support of some tissue perfusion and some cardiac output with high quality chest compression.

4 Calcium + Routine administration of calcium for cardiac arrest is not recommended. (Class III) Fibrinolysis + For use during cardiac arrest to treat both coronary thrombosis (ACS) with presumably complete occlusion of a proximal coronary artery and major life threatening pulmonary embolism. + Some studies showed an increased risk of intracranial bleeding associated with the routine use of fibrinolytics during cardiac arrest. + Not be routinely used in cardiac arrest. (Class III) + When pulmonary embolism is presumed or known to be the cause of cardiac arrest, empirical fibrinolytic therapy can be considered. (Class II a) IV fluid + If cardiac arrest is associated with extreme volume losses, hypovolemic arrest should be suspected and intravascular volume should be promptly restored. Pacing + Electric pacing is generally not effective in cardiac arrest. + Not recommended for routine use. (Class III) Precordial Thump + When administered for VF/VT or PEA arrest it was ineffective but resulted in no apparent harm. + May be considered for termination of witnessed monitored unstable ventricular tachyarrhythmia when a defibrillator is not immediately ready for use. (Class II b) but should not delay CPR and shock delivery. + Emphasize the importance of clinical evaluation Key principles of arrhythmia recognition and management in adults: 1. Bradycardia with S/S: initial treatment is Atropine (Class II a) if unreponsive, then try IV infusion of B adrenergic agonists with rate accelerting effects (dopamine, epinephrine)or transcutaneous pacing (TCP). (Class II a) 2. Tachycardia with unstable and S/S related to a suspected arrhythmia : Immediate cardioversion (Class I) 3. Regular narrow complex tachycardia with unstable S/S : a trial of adenosine before cardioversion is reasonable to consider (Class II b) Evaluation: + Generally Bradycardia cause symptoms at the rate of less than 50 bpm + Hypoxemia is a common cause of bradycardia + Initial evaluation should focus on signs of: 1. increase work of breathing (eg. Tachypnea) 2. Oxyhemoglobin saturation (determined by pulse oximetry) Therapy Atropine + Atropine remains the first line drug for acute symptomatic bradycardia (Class II a) + Recommended Atropine dose for bradycardia is 0.5 mg IV every 3 5 mins to a maximun total dose of 3 mg. + Use atropine cautiously in the presence of Acute coronary iscehmia or MI, because increase HR may worsen ischemia or increase infarction size. + Atropine does not work in patients who have undergone cardiac transplanation, because it lacks vagal innervation. Therapy Pacing + Initiate TCP in unstable patients who do not respond to atropine. (Class IIa) + Immediate pacing might be considered in unstable patients with high degree AV block when IV access is not available. (Class IIb) + If the patient does not respond to drugs or TCP, transvenous pacing is probably indicated. (Class IIa) Alternative Drugs to consider + Dopamine or epinephrone or isoproterenol infusion may be used for patients with symptomatic bradycardia, particularly if associated with hypotension, in whom atropine may be inappropriate or after atropine fails. (Class II b) + Dopamine infusion at 2 10 mcg/kg/min and titrate to patient response. + Epinephrine infusion at 2 10 mcg/min and titrate to patient resposnse. + Isoproterenol infusion at 2 10mcg/min and titrated according to HR & rhythm.

5 Narrow QRS complex (SVT) tachycardias (QRS 0.12s) + Sinus tachycardia + Atrial fibrillation + Atrial flutter + AV nodal reentry + Accessory pathway mediated tachycardia + Atrial tachycardia (including automatic and reentry forms) + Multifocal atrial tachycardia (MAT) + Junctional tachycardia (rare in adults) Wide QRS complex tachycardias (QRS 0.12 second) + Ventricular tachycardia (VT) and ventricular fibrillation (VF) + SVT with aberrancy + Pre excited tachycardias (Wolff Parkinson White [WPW] syndrome) + Ventricular paced rhythms Synchronized cardioversion and unsynchronized shocks + Synchronized cardioversion is recommended to treat unstable SVT, unstable Af, unstable Atrial flutter, and unstable monomorhpic (regular) VT. + If cardioversion is needed and it is impossible to synchronize a shock, use high energy unsynchronized shock (defibrillation doses). Waveform and Energy + The recommended initial biphasic energy dose for cardioversion of Af is J (Class IIa) + Cardioversion of atrial flutter and other SVTs generally requires less energy; an initial energy of J + Monomorphic VT (regular form and rate) with a pulse responds well to monophasic or biphasic waveform cardioversion (synchronized) shocks at initial energies of 100 J. + If a patient has polymorphic VT, treat therhythm as VF and deliver high energy unsynchronized shocks. Sinus Tachycardia treat underlying diseases Supraventricular Tachycardia (Reentry SVT) + Supraventricular origin: narrow QRS complex (<0.12s) or broad QRS complex and preexisting bundle branch block. Vagal maneuvers + Vagal maneuvers and adenosine are the preferred initial therapeutic choices for the termination of stable PSVT. Adenosine + If PSVT does not respond to vagal maneuvers, give 6mg of IV adenosine as a rapid IV push through a large vein followed by a 20ml saline flush. (Class I) + If the rhythm does not convert within 1 to 2 minutes, give a 12mg rapid IV push. Calcium channel blockers and B blocker + Use longer acting AV nodal blocking agents such as nondihydropyridine Ca channel blockers (Verapamil and diltiazem) or B Blockers if adenosine and vagal maneuver fails. (Class II a) + For Verapamil, give 2.5mg to 5mg IV bolus over 2 mins.(3mins in older patients) + Verapamil should be given only to patients with narrow complex reentry SVT or arrhythmias known with certainty to be supraventricular origin. Calcium channel blockers and B blocker (conts) + For diltiazem, give a dose of 15mg to 20mg (0.25mg/kg) IV over 2 minutes.

6 + QRS 0.12 seconds + VT or VF + SVT with aberrancy + Pre excited tachycardias (associated with or mediated by an accessory pathway) + Ventricular paced rhythms

Cardiac Arrest VF/Pulseless VT Learning Station Checklist

Cardiac Arrest VF/Pulseless VT Learning Station Checklist Cardiac Arrest VF/Pulseless VT Learning Station Checklist VF/VT 00 American Heart Association Adult Cardiac Arrest Shout for Help/Activate Emergency Response Epinephrine every - min Amiodarone Start CPR

More information

ACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC. BLS Changes

ACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC. BLS Changes ACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC CPR Chest compressions, Airway, Breathing (C-A-B) BLS Changes New Old Rationale New science indicates the following order:

More information

ACLS PRE-TEST ANNOTATED ANSWER KEY

ACLS PRE-TEST ANNOTATED ANSWER KEY ACLS PRE-TEST ANNOTATED ANSWER KEY June, 2011 Question 1: Question 2: There is no pulse with this rhythm. Question 3: Question 4: Question 5: Question 6: Question 7: Question 8: Question 9: Question 10:

More information

ACLS Study Guide BLS Overview CAB

ACLS Study Guide BLS Overview CAB ACLS Study Guide The ACLS Provider exam is 50-mutiple choice questions. Passing score is 84%. Student may miss 8 questions. For students taking ACLS for the first time or renewing students with a current

More information

Official Online ACLS Exam

Official Online ACLS Exam \ Official Online ACLS Exam Please fill out this form before you take the exam. Name : Email : Phone : 1. Hypovolemia initially produces which arrhythmia? A. PEA B. Sinus tachycardia C. Symptomatic bradyarrhythmia

More information

ACLS PHARMACOLOGY 2011 Guidelines

ACLS PHARMACOLOGY 2011 Guidelines ACLS PHARMACOLOGY 2011 Guidelines ADENOSINE Narrow complex tachycardias or wide complex tachycardias that may be supraventricular in nature. It is effective in treating 90% of the reentry arrhythmias.

More information

American Heart Association ACLS Pre-Course Self Assessment Dec., 2006. ECG Analysis. Name the following rhythms from the list below:

American Heart Association ACLS Pre-Course Self Assessment Dec., 2006. ECG Analysis. Name the following rhythms from the list below: American Heart Association ACLS Pre-Course Self Assessment Dec., 2006 ECG Analysis This pre-test is exactly the same as the pretest on the ACLS Provider manual CD. This paper version can be completed in

More information

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor.

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor. This is a SAMPLE of the pretest you can access with your AHA PALS Course Manual at Heart.org/Eccstudent using your personal code that comes with your PALS Course Manual The American Heart Association strongly

More information

Crash Cart Drugs Drugs used in CPR. Dr. Layla Borham Professor of Clinical Pharmacology Umm Al Qura University

Crash Cart Drugs Drugs used in CPR. Dr. Layla Borham Professor of Clinical Pharmacology Umm Al Qura University Crash Cart Drugs Drugs used in CPR Dr. Layla Borham Professor of Clinical Pharmacology Umm Al Qura University Introduction A list of the drugs kept in the crash carts. This list has been approved by the

More information

ACLS Cardiac Arrest Algorithm Neumar, R. W. et al. Circulation 2010;122:S729-S767

ACLS Cardiac Arrest Algorithm Neumar, R. W. et al. Circulation 2010;122:S729-S767 ACLS Cardiac Arrest Algorithm Neumar, R. W. et al. Circulation 2010;122:S729-S767 Copyright 2010 American Heart Association ACLS Cardiac Arrest Circular Algorithm Neumar, R. W. et al. Circulation 2010;122:S729-S767

More information

PRO-CPR. 2015 Guidelines: PALS Algorithm Overview. (Non-AHA supplementary precourse material)

PRO-CPR. 2015 Guidelines: PALS Algorithm Overview. (Non-AHA supplementary precourse material) PRO-CPR 2015 Guidelines: PALS Algorithm Overview (Non-AHA supplementary precourse material) Please reference Circulation (from our website), the ECC Handbook, or the 2015 ACLS Course Manual for correct

More information

IU Health ACLS Study Guide

IU Health ACLS Study Guide IU Health ACLS Study Guide Preparing for your upcoming ACLS Class REVISED SEPTEMBER 2011 ON APRIL 1, 2011 WE BEGAN TEACHING THE 2010 AHA GUIDELINES. WE HIGHLY RECOMMEND REVIEWING THE NEW ALGORYHMS FOUND

More information

Advanced Cardiac Life Support

Advanced Cardiac Life Support Advanced Cardiac Life Support Dr Teo Wee Siong NATIONAL RESUSCITATION COUNCIL Singapore Guidelines 2006 Prof Anantharaman A/Prof Lim Swee Han Dr Chee Tek Siong A/Prof Peter Manning A/Prof Eillyne Seow

More information

E C C. American Heart Association. Advanced Cardiovascular Life Support. Written Precourse Self-Assessment. May 2011. 2011 American Heart Association

E C C. American Heart Association. Advanced Cardiovascular Life Support. Written Precourse Self-Assessment. May 2011. 2011 American Heart Association E C C American Heart Association Advanced Cardiovascular Life Support Written Precourse Self-Assessment May 2011 2011 American Heart Association 2011 ACLS Written Precourse Self-Assessment 1. Ten minutes

More information

New resuscitation science and American Heart Association treatment guidelines were released October 28, 2010!

New resuscitation science and American Heart Association treatment guidelines were released October 28, 2010! ACLS Study Guide 2010 Bulletin: New resuscitation science and American Heart Association treatment guidelines were released October 28, 2010! The new AHA Handbook of Emergency Cardiac Care (ECC) contains

More information

8 Peri-arrest arrhythmias

8 Peri-arrest arrhythmias 8 Peri-arrest arrhythmias Introduction Cardiac arrhythmias are relatively common in the peri-arrest period. They are common in the setting of acute myocardial infarction and may precipitate ventricular

More information

Update on Small Animal Cardiopulmonary Resuscitation (CPR)- is anything new?

Update on Small Animal Cardiopulmonary Resuscitation (CPR)- is anything new? Update on Small Animal Cardiopulmonary Resuscitation (CPR)- is anything new? DVM, DACVA Objective: Update on the new Small animal guidelines for CPR and a discussion of the 2012 Reassessment Campaign on

More information

Community Ambulance Service of Minot ALS Standing Orders Legend

Community Ambulance Service of Minot ALS Standing Orders Legend Legend Indicates General Information and Guidelines Indicates Procedures Indicates Medication Administration Indicates Referral to Other Protocol Indicates Referral to Online Medical Direction Pediatric

More information

Cardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008

Cardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Cardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Preamble In contrast to cardiac arrest in adults, cardiopulmonary arrest in pediatric

More information

E C C. American Heart Association. Advanced Cardiovascular Life Support. Written Exams. May 2011

E C C. American Heart Association. Advanced Cardiovascular Life Support. Written Exams. May 2011 E C C American Heart Association Advanced Cardiovascular Life Support Written Exams Contents: Exam Memo Student Answer Sheet Version A Exam Version A Answer Key Version A Reference Sheet Version B Exam

More information

GUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS. (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support)

GUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS. (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support) AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support) The term cardiac arrhythmia

More information

Management of Adult Cardiac Arrest

Management of Adult Cardiac Arrest 73991_CH27_page68-73.qxd 6/6/11 3:54 PM Page 68 27.68 Section 5 Medical Guidelines for Performing a 12-Lead ECG The only way to learn how to obtain a 12-lead ECG is to practice with the equipment itself.

More information

www.cprtrainingfast.com

www.cprtrainingfast.com ADVANCED CARDIAC LIFE SUPPORT (ACLS) RECERTIFICATION EXAMINATION 1. Ten minutes after an 85 year old woman collapses, paramedics arrive and start CPR for the first time. The monitor shows fine (low amplitude)

More information

Cardiac Arrest - Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008

Cardiac Arrest - Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Cardiac Arrest - Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Preamble Survival from cardiorespiratory arrest for patients who present with ventricular fibrillation

More information

ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol

ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Isoproterenol Major Indications Status Asthmaticus As a last resort for

More information

MEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES. Source: ACLS Provider Manual. American Heart Association. 2001, 2002. Updated 2003.

MEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES. Source: ACLS Provider Manual. American Heart Association. 2001, 2002. Updated 2003. MEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES Source: ACLS Provider Manual. American Heart Association. 2001, 2002. Updated 2003. 1 ET Administration Atropine o First drug for symptomatic sinus bradycardia

More information

Atrial & Junctional Dysrhythmias

Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial Premature Atrial Complex Wandering Atrial Pacemaker Atrial Tachycardia (ectopic) Multifocal Atrial Tachycardia Atrial Flutter Atrial

More information

PALS Interim Study Guide

PALS Interim Study Guide PALS Interim Study Guide 2006 Bulletin: New resuscitation science and American Heart Association treatment guidelines were released November 28, 2005! The new AHA Handbook of Emergency Cardiac Care (ECC)

More information

ROC CONTINUOUS CHEST COMPRESSIONS STUDY (CCC): MEDICAL CARDIAC ARREST MEDICAL DIRECTIVE

ROC CONTINUOUS CHEST COMPRESSIONS STUDY (CCC): MEDICAL CARDIAC ARREST MEDICAL DIRECTIVE ROC CONTINUOUS CHEST COMPRESSIONS STUDY (CCC): MEDICAL CARDIAC ARREST MEDICAL DIRECTIVE An Advanced Care Paramedic will provide the treatment based on the randomization scheme and as prescribed in this

More information

2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Presenter Name Disclosures

More information

Wilson County Emergency Management Agency Protocol Manual Protocols

Wilson County Emergency Management Agency Protocol Manual Protocols Asystole No pulse or respirations Confirm cardiac rhythm with combo pads or electrodes Record in two leads to confirm Asystole and to rule out fine V-Fib. Basic assessment and management (up to your scope

More information

Michigan Adult Cardiac Protocols CARDIAC ARREST GENERAL. Date: May 31, 2012 Page 1 of 5

Michigan Adult Cardiac Protocols CARDIAC ARREST GENERAL. Date: May 31, 2012 Page 1 of 5 Date: May 31, 2012 Page 1 of 5 Cardiac Arrest General This protocol should be followed for all adult cardiac arrests. Medical cardiac arrest patients undergoing attempted resuscitation should not be transported

More information

Alabama Medications. Christopher J. Colvin January 2010

Alabama Medications. Christopher J. Colvin January 2010 Alabama Medications Christopher J. Colvin p January 2010 Activated Charcoal Used to absorb toxins ingested before they can be absorbed in the GI system. Contraindicated in AMS patients who cannot control

More information

DEBRIEFING GUIDE. The key components of an optimal code response: 1. Early recognition that the patient is deteriorating or has become unresponsive.

DEBRIEFING GUIDE. The key components of an optimal code response: 1. Early recognition that the patient is deteriorating or has become unresponsive. DEBRIEFING GUIDE I N T R O D U C T I O N Debriefing has been shown to improve clinical behavior during cardiac resuscitation and, as such, has become a recommended procedure in the 2010 American Heart

More information

Megacode Testing Checklist 1/2 Bradycardia VF/Pulseless VT Asystole ROSC

Megacode Testing Checklist 1/2 Bradycardia VF/Pulseless VT Asystole ROSC Megacode Testing Checklist 1/2 Bradycardia VF/Pulseless VT Asystole ROSC Student Name: Test Bradycardia Management Recognizes symptomatic bradycardia Administers correct dose of atropine Prepares for second-line

More information

Team Leader. Ensures high-quality CPR at all times Assigns team member roles Ensures that team members perform well. Bradycardia Management

Team Leader. Ensures high-quality CPR at all times Assigns team member roles Ensures that team members perform well. Bradycardia Management ACLS Megacode Case 1: Sinus Bradycardia (Bradycardia VF/Pulseless VT Asystole Out-of-Hospital Scenario You are a paramedic and arrive on the scene to find a 57-year-old woman complaining of indigestion.

More information

AMERICAN HEART ASSOCIATION 2010 ACLS GUIDELINES: WHAT EVERY CLINICIAN NEEDS TO KNOW

AMERICAN HEART ASSOCIATION 2010 ACLS GUIDELINES: WHAT EVERY CLINICIAN NEEDS TO KNOW AMERICAN HEART ASSOCIATION 2010 ACLS GUIDELINES: WHAT EVERY CLINICIAN NEEDS TO KNOW Joseph Heidenreich, MD Texas A&M Health Science Center Scott & White Memorial Hospital Scott & White Memorial Hospital

More information

PEDIATRIC TREATMENT GUIDELINES

PEDIATRIC TREATMENT GUIDELINES P1 Pediatric Patient Care P2 Cardiac Arrest Initial Care and CPR P3 Neonatal Resuscitation P4 Ventricular Fibrillation / Ventricular Tachycardia P5 PEA / Asystole P6 Symptomatic Bradycardia P7 Tachycardia

More information

Current Management of Atrial Fibrillation DISCLOSURES. Heart Beat Anatomy. I have no financial conflicts to disclose

Current Management of Atrial Fibrillation DISCLOSURES. Heart Beat Anatomy. I have no financial conflicts to disclose Current Management of Atrial Fibrillation Mary Macklin, MSN, APRN Concord Hospital Cardiac Associates DISCLOSURES I have no financial conflicts to disclose Book Women: Fit at Fifty. A Guide to Living Long.

More information

Adding IV Amiodarone to the EMS Algorithm for Cardiac Arrest Due to VF/Pulseless VT

Adding IV Amiodarone to the EMS Algorithm for Cardiac Arrest Due to VF/Pulseless VT Adding IV Amiodarone to the EMS Algorithm for Cardiac Arrest Due to VF/Pulseless VT Introduction Before the year 2000, the traditional antiarrhythmic agents (lidocaine, bretylium, magnesium sulfate, procainamide,

More information

American Heart Association. Pediatric Advanced Life Support. Written Precourse Self-Assessment. Questions and Answer Key for Students.

American Heart Association. Pediatric Advanced Life Support. Written Precourse Self-Assessment. Questions and Answer Key for Students. E C C American Heart Association Pediatric Advanced Life Support Written Precourse Self-Assessment Questions and Answer Key for Students January 2012 PALS Written 2011 Precourse Self-Assessment ECG Rhythm

More information

Pediatric Advanced Life Support (PALS) Recertification Preparatory Materials

Pediatric Advanced Life Support (PALS) Recertification Preparatory Materials Pediatric Advanced Life Support (PALS) Recertification Preparatory Materials 1 PEDIATRIC ADVANCED LIFE SUPPORT (PALS) RECERTIFICATION TABLE OF CONTENTS CYCLIC APPROACH 03 PEDIATRIC ASSESSMENT FLOWCHART

More information

The Pharmacist s Role in Advanced Cardiac Life Support (ACLS) Pharmacist Objectives. Pharmacists in the ER. Background

The Pharmacist s Role in Advanced Cardiac Life Support (ACLS) Pharmacist Objectives. Pharmacists in the ER. Background The Pharmacist s Role in Advanced Cardiac Life Support (ACLS) I have no actual or potential conflict of interest in relation to this activity. it James Jensen B.S., Pharm.D., BCPS Pharmacist Objectives

More information

Practical ACLS Megacode Testing and Training Scenario Set for SimPad. Consolidated Instructor Manual. Frances Wickham Lee, DBA

Practical ACLS Megacode Testing and Training Scenario Set for SimPad. Consolidated Instructor Manual. Frances Wickham Lee, DBA Practical ACLS Megacode Testing and Training Scenario Set for SimPad Consolidated Instructor Manual Frances Wickham Lee, DBA Scenario Authors: Frances Wickham Lee, DBA John Walker, BHS John Schaefer, MD

More information

Paediatric Advanced Life Support

Paediatric Advanced Life Support Paediatric Advanced Life Support Introduction There is concern that resuscitation from cardiac arrest is not performed as well as it might because the variations in guidelines for different age groups

More information

The management of cardiac arrest

The management of cardiac arrest CHAPTER 6 The management of cardiac arrest LEARNING OBJECTIVES In this chapter you will learn: How to assess the cardiac arrest rhythm and perform advanced life support 6.1. INTRODUCTION Cardiac arrest

More information

ANZCOR Guideline 12.4 Medications and Fluids in Paediatric Advanced Life Support

ANZCOR Guideline 12.4 Medications and Fluids in Paediatric Advanced Life Support ANZCOR Guideline 12. Medications and Fluids in Paediatric Advanced Life Support Who does this guideline apply to? This guideline applies to infants and children. Summary Who is the audience for this guideline?

More information

The American Heart Association Guidelines Including Pediatric Resuscitation

The American Heart Association Guidelines Including Pediatric Resuscitation Lesson 3 The American Heart Association Guidelines Including Pediatric Resuscitation Sharon E. Mace, MD, FACEP, FAAP Objectives On completion of this lesson, you should be able to: 1. List the correct

More information

ACLS123.com 818.766.1111 2012. ACLS Study Guide. Critical Care Training Center

ACLS123.com 818.766.1111 2012. ACLS Study Guide. Critical Care Training Center ACLS123.com 818.766.1111 2012 ACLS Study Guide Critical Care Training Center 12/1/2012 Course Overview This study guide is an outline of content that will be taught in the American Heart Association Accredited

More information

Adult Cardiac Life Support (ACLS) Recertification Preparatory Materials

Adult Cardiac Life Support (ACLS) Recertification Preparatory Materials Adult Cardiac Life Support (ACLS) Recertification Preparatory Materials 1 ADULT CARDIAC LIFE SUPPORT (ACLS) RECERTIFICATION TABLE OF CONTENTS PRIMARY AND SECONDARY ABCDs I. Primary ABCD s 03 II. Secondary

More information

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor.

If you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor. This is a SAMPLE of the pretest you can access with your AHA PALS Course Manual at Heart.org/Eccstudent using your personal code that comes with your PALS Course Manual The American Heart Association strongly

More information

WE HIGHLY RECOMMEND REVIEWING THE NEW ALGORYHMS FOUND IN THE 2010 ACLS Textbook available through AHA and other retail outlets.

WE HIGHLY RECOMMEND REVIEWING THE NEW ALGORYHMS FOUND IN THE 2010 ACLS Textbook available through AHA and other retail outlets. ACLS STUDY GUIDE 2015 WE HIGHLY RECOMMEND REVIEWING THE NEW ALGORYHMS FOUND IN THE 2010 ACLS Textbook available through AHA and other retail outlets. The AHA also requests the following in preparation

More information

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES Adult Drug Reference Dopamine Drip Chart Pediatric Drug Reference Pediatric Drug Dosage Charts DRUG REFERENCES ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments ADENOSINE Paroxysmal

More information

10. An infant with a history of vomiting and diarrhea arrives by ambulance. During your primary assessment the infant responds only to painful stimula

10. An infant with a history of vomiting and diarrhea arrives by ambulance. During your primary assessment the infant responds only to painful stimula 1. You are called to help resuscitate an infant with severe symptomatic bradycardia associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation,

More information

Quiz 4 Arrhythmias summary statistics and question answers

Quiz 4 Arrhythmias summary statistics and question answers 1 Quiz 4 Arrhythmias summary statistics and question answers The correct answers to questions are indicated by *. All students were awarded 2 points for question #2 due to no appropriate responses for

More information

table of contents drug reference

table of contents drug reference table of contents drug reference ADULT DRUG REFERENCE...155 161 PEDIATRIC DRUG REFERENCE...162 164 PEDIATRIC WEIGHT-BASED DOSING CHARTS...165 180 Adenosine...165 Amiodarone...166 Atropine...167 Defibrillation...168

More information

It is recommended that the reader review each medical directive presented in this presentation along with the actual PCP Core medical directive.

It is recommended that the reader review each medical directive presented in this presentation along with the actual PCP Core medical directive. It is recommended that the reader review each medical directive presented in this presentation along with the actual PCP Core medical directive. This presentation will highlight the changes and any new

More information

Resuscitation Patient Management Tool May 2015 CPA Event

Resuscitation Patient Management Tool May 2015 CPA Event OPTIONAL: Local Event ID: Did pt. receive chest compressions and/or defibrillation during this event? criteria) (does NOT meet inclusion Date/Time the need for chest compressions ( or defibrillation when

More information

The American Heart Association released new resuscitation science and treatment guidelines on October 19, 2010.

The American Heart Association released new resuscitation science and treatment guidelines on October 19, 2010. ACLS Study Guide The American Heart Association released new resuscitation science and treatment guidelines on October 19, 2010. Please read the below information carefully This letter is to confirm your

More information

Department of Emergency and Disaster Medicine Medical University of LODZ

Department of Emergency and Disaster Medicine Medical University of LODZ Electrotherapy in emergency states Department of Emergency and Disaster Medicine Medical University of LODZ defibrillation defibrillation The purpous of defibrillation is to deliver a randomly timed high-energy

More information

PALS Study Guide. PALS Study Guide Revised August 2010, Page 1 [TCL]

PALS Study Guide. PALS Study Guide Revised August 2010, Page 1 [TCL] PALS Study Guide Course Overview This Study Guide is an extensive outline of content that will be taught in the American Heart Association Accredited Pediatric Advanced Life Support (PALS) Course. It is

More information

OBJECTIVES. When the student has finished this module, he/she will be able to:

OBJECTIVES. When the student has finished this module, he/she will be able to: Advanced Cardiac Life Support (ACLS) Review WWW.RN.ORG Reviewed September, 2015, Expires September, 2017 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited

More information

Wide-Complex Tachycardias in the ED: Myths and Pitfalls

Wide-Complex Tachycardias in the ED: Myths and Pitfalls Wide-Complex Tachycardias in the ED: Myths and Pitfalls, FACEP, FAAEM Professor and Vice Chair Director, Emergency Cardiology Fellowship Department of Emergency Medicine University of Maryland School of

More information

Purpose To guide registered nurses who may manage clients experiencing sudden or unexpected life-threatening cardiac emergencies.

Purpose To guide registered nurses who may manage clients experiencing sudden or unexpected life-threatening cardiac emergencies. Emergency Cardiac Care: Decision Support Tool #1 RN-Initiated Emergency Cardiac Care Without Cardiac Monitoring/Manual Defibrillator or Emergency Cardiac Drugs Decision support tools are evidence-based

More information

Question-and-Answer Document 2010 AHA Guidelines for CPR & ECC As of October 18, 2010

Question-and-Answer Document 2010 AHA Guidelines for CPR & ECC As of October 18, 2010 Question-and-Answer Document 2010 AHA Guidelines for CPR & ECC As of October 18, 2010 Q: What are the most significant changes in the 2010 AHA Guidelines for CPR & ECC? A: Major changes for all rescuers,

More information

Stimulates HR, BP, CO, and vasoconstriction. Stimulates renal, venous, mesenteric arterial. basic chart below) (alpha receptors) vasoconstriction

Stimulates HR, BP, CO, and vasoconstriction. Stimulates renal, venous, mesenteric arterial. basic chart below) (alpha receptors) vasoconstriction Bolus Alternate Range Drip ACLS Drugs and Drips Amiodarone / Cordarone Lidocaine Procainamide / Pronestyl Dopamine / Intropin CARDIAC ARREST PULSELESS VT/VF Arrest Kit: (300mg bolus) Amiodarone 6 Vial

More information

Bradycardia CHAPTER 12 CODE SCENARIO

Bradycardia CHAPTER 12 CODE SCENARIO Senecal-12.qxd 14/04/2005 09:44 AM Page 69 CHAPTER 12 Bradycardia CODE SCENARIO A code is called for a 78-year-old man who was admitted to the hospital for syncope of unknown etiology. He was resting comfortably

More information

Electrophysiology Daymar College. Lisa H. Young, RN, BSN, MAE 2011

Electrophysiology Daymar College. Lisa H. Young, RN, BSN, MAE 2011 Electrophysiology Daymar College Lisa H. Young, RN, BSN, MAE 2011 Electrical Conduction Pathway Chemical Basis for Impulse Formation Cardiac Action Potential Phases http://www.youtube.com/watch?v=oqpffilde0e

More information

CRNA ACLS, PALS, & BLS REFRESHER

CRNA ACLS, PALS, & BLS REFRESHER Attn: Certified Nurse Anesthetists (CRNA) CPR Consultants, Inc. 7404 G Chapel Hill Road, Raleigh, NC, 27607 CRNA ACLS, PALS, & BLS REFRESHER CRNA American Heart Association Triple Certification (BLS, ACLS,

More information

Cardiopulmonary Resuscitation

Cardiopulmonary Resuscitation Cardiopulmonary Resuscitation Jonathan E. Palmer, V.M.D. Author s address: Graham French Neonatal Section, Connelly Intensive Care Unit, New Bolton Center, University of Pennsylvania, 382 West Street Rd.,

More information

Cardiac Arrest: General Considerations

Cardiac Arrest: General Considerations Andrea Gabrielli, MD, FCCM Cardiac Arrest: General Considerations Cardiopulmonary resuscitation (CPR) is described as a series of assessments and interventions performed during a variety of acute medical

More information

THE REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEE NEW YORK CITY PREHOSPITAL TREATMENT PROTOCOLS ADVANCED LIFE SUPPORT (PARAMEDIC) PROTOCOLS

THE REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEE NEW YORK CITY PREHOSPITAL TREATMENT PROTOCOLS ADVANCED LIFE SUPPORT (PARAMEDIC) PROTOCOLS THE REGIONAL EMERGENCY MEDICAL ADVISORY COMMITTEE NEW YORK CITY PREHOSPITAL TREATMENT PROTOCOLS ADVANCED LIFE SUPPORT (PARAMEDIC) PROTOCOLS July 2012 Version 07012012 The Regional Emergency Medical Services

More information

ADVANCED LIFE SUPPORT LEARNING PACKAGE

ADVANCED LIFE SUPPORT LEARNING PACKAGE SOUTH WEST HEALTHCARE WARRNAMBOOL ADVANCED LIFE SUPPORT LEARNING PACKAGE Prepared by: J. Brown, ICU Last revised February, 2010. C. Joseph, Nursing Education. CONTENTS: Page: Objectives 3-5 Basic Life

More information

Advanced cardiovascular life support (ACLS) impacts multiple

Advanced cardiovascular life support (ACLS) impacts multiple Part 8: Adult Advanced Cardiovascular Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Robert W. Neumar, Chair; Charles W. Otto;

More information

Pediatric Pharmacotherapy A Monthly Newsletter for Health Care Professionals Children s Medical Center at the University of Virginia

Pediatric Pharmacotherapy A Monthly Newsletter for Health Care Professionals Children s Medical Center at the University of Virginia Pediatric Pharmacotherapy A Monthly Newsletter for Health Care Professionals Children s Medical Center at the University of Virginia Volume 2 Number 12 December 1996 Medications for Neonatal and Pediatric

More information

New Approaches for Prehospital Cardiac Arrest Management 2010 NCEMSF Conference

New Approaches for Prehospital Cardiac Arrest Management 2010 NCEMSF Conference New Approaches for Prehospital Cardiac Arrest Management 2010 NCEMSF Conference Mark E. Pinchalk, MS, EMT-P Paramedic Crew Chief City of Pittsburgh EMS Out of Hospital Cardiac Arrest Poor outcomes: Arizona

More information

RESPONDING TO ANESTHETIC COMPLICATIONS

RESPONDING TO ANESTHETIC COMPLICATIONS RESPONDING TO ANESTHETIC COMPLICATIONS General anesthesia poses minimal risk to most patients when performed by a capable anesthetist using appropriate protocols and proper monitoring. However, it is vitally

More information

Inotropes/Vasoactive Agents Hina N. Patel, Pharm.D., BCPS Cathy Lawson, Pharm.D., BCPS

Inotropes/Vasoactive Agents Hina N. Patel, Pharm.D., BCPS Cathy Lawson, Pharm.D., BCPS Inotropes/Vasoactive Agents Hina N. Patel, Pharm.D., BCPS Cathy Lawson, Pharm.D., BCPS 1. Definition -an agent that affects the contractility of the heart -may be positive (increases contractility) or

More information

DOI: 10.1161/CIRCULATIONAHA.110.971101

DOI: 10.1161/CIRCULATIONAHA.110.971101 Part 14: Pediatric Advanced Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Monica E. Kleinman, Leon Chameides, Stephen M. Schexnayder,

More information

Recurrent AF: Choosing the Right Medication.

Recurrent AF: Choosing the Right Medication. In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/89015.htm Recurrent AF: Choosing the Right Medication. Basamad Z. * Assistant Professor, Department

More information

JAPI VOL. 52 NOVEMBER 2004 www.japi.org 883

JAPI VOL. 52 NOVEMBER 2004 www.japi.org 883 Review Article Wide Complex Tachycardia : Recognition and Management in the Emergency Room IB Ray Abstract Cardiac arrhythmias often present as urgent medical conditions requiring immediate care. Patient

More information

Basic ECG rhythm interpretation skills (see our Six Second ECG Essentials or Mastery courses and our Six Second ECG Simulator online)

Basic ECG rhythm interpretation skills (see our Six Second ECG Essentials or Mastery courses and our Six Second ECG Simulator online) SkillStat ACLS Precourse Package Thank you for choosing SkillStat Learning Inc. for your Advanced Life Support training needs. SkillStat Learning Inc. has delivered advanced practice programs to healthcare

More information

ACLS RHYTHM TEST. 2. A 74-year-old woman with chest pain. Blood pressure 192/90 and rates her pain 9/10.

ACLS RHYTHM TEST. 2. A 74-year-old woman with chest pain. Blood pressure 192/90 and rates her pain 9/10. ACLS RHYTHM TEST Name Date Choose the best answer for each of the following questions. Each of the following strips is 6 seconds in length. 1. Identify the following rhythm a. Sinus bradycardia with 2

More information

GUIDELINE 11.5 MEDICATIONS IN ADULT CARDIAC ARREST

GUIDELINE 11.5 MEDICATIONS IN ADULT CARDIAC ARREST AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 11.5 MEDICATIONS IN ADULT CARDIAC ARREST While the listed drugs have theoretical benefits in selected situations, no medication has been shown to improve long-term

More information

2015 Interim Resources for HeartCode ACLS

2015 Interim Resources for HeartCode ACLS 2015 Interim Resources for HeartCode ACLS Original Release: November 25, 2015 Starting in 2016, new versions of American Heart Association online courses will be released to reflect the changes published

More information

ACLS Rhythms for the ACLS Algorithms

ACLS Rhythms for the ACLS Algorithms ACLS Rhythms for the ACLS Algorithms The Basics 1. Anatomy of the cardiac conduction system: relationship to the ECG cardiac cycle. A, Heart: anatomy of conduction system. B, P-QRS-T complex: lines to

More information

Arrest. What s a Nurse to do?

Arrest. What s a Nurse to do? Benzo s, Blockers, Coma & Cardiac Arrest What s a Nurse to do? Objectives Review of ACLS Algorithms for Cardiac Arrest Management Discuss the toxicology of Beta Blocker Poisoning Describe the clinical

More information

Advanced Cardiovascular Life Support Case Scenarios

Advanced Cardiovascular Life Support Case Scenarios Advanced Cardiovascular Life Support Case Scenarios ACLS Respiratory Arrest Case Out-of-Hospital Scenario You are a paramedic and respond to the scene of a possible cardiac arrest. A young man lies motionless

More information

BASIC CARDIAC ARRHYTHMIAS Revised 10/2001

BASIC CARDIAC ARRHYTHMIAS Revised 10/2001 BASIC CARDIAC ARRHYTHMIAS Revised 10/2001 A Basic Arrhythmia course is a recommended prerequisite for ACLS. A test will be given that will require you to recognize cardiac arrest rhythms and the most common

More information

ACLS PROTOCOLS. Chest Pain / Acute Coronary Syndrome... 4-2

ACLS PROTOCOLS. Chest Pain / Acute Coronary Syndrome... 4-2 ACLS PROTOCOLS CHEST PAIN / ACLS Chest Pain / Acute Coronary Syndrome... 4-2 ARRHYTHMIAS / ACLS Sinus Bradycardia... 4-4 Narrow - Complex Tachycardia... 4-6 Wide - Complex Tachycardia... 4-8 CARDIAC ARREST

More information

TO GET PAST THE 2 HARDEST STATIONS AT STATE PARAMEDIC BOARDS

TO GET PAST THE 2 HARDEST STATIONS AT STATE PARAMEDIC BOARDS A REVIEW OF THE 2 CARDIOLOGY STATIONS: WHAT TO SAY & WHAT TO DO TO GET PAST THE 2 HARDEST STATIONS AT STATE PARAMEDIC BOARDS VERSION 8 AHA ECC 2005 STANDARD---BY JAMES ROFF PARAMEDIC GRADUATE PREPARATION

More information

An Introduction to Tachyarrhythmias R. A. Seyon MN, NP, CCN(C) & Dr. R. G. Williams

An Introduction to Tachyarrhythmias R. A. Seyon MN, NP, CCN(C) & Dr. R. G. Williams Arrhythmias 1 An Introduction to Tachyarrhythmias R. A. Seyon MN, NP, CCN(C) & Dr. R. G. Williams Things to keep in mind when analyzing arrhythmias: Electrical activity recorded in 12 and 15 leads Examine

More information

Emergency Medical Services Advanced Level Competency Checklist

Emergency Medical Services Advanced Level Competency Checklist Emergency Services Advanced Level Competency Checklist EMS Service: Current License in State of Nebraska: # (Copy of license kept in file at station) Date of joining EMS Service: EMS Service Member Name:

More information

BLS: basic cardiac life support. ACLS: advanced cardiac life support. PALS: paediatric advanced life support. VF: ventricular fibrillation

BLS: basic cardiac life support. ACLS: advanced cardiac life support. PALS: paediatric advanced life support. VF: ventricular fibrillation RN-Initiated Emergency Cardiac Care: Decision Support Tool #2 Emergency Cardiac Care in Areas Using Cardiac Monitoring, Defibrillation and Emergency Cardiac Drugs Decision support tools are evidenced-based

More information

COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION

COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION Question: How should the EGBS Coverage Guidance regarding ablation for atrial fibrillation be applied to the Prioritized List? Question source: Evidence

More information

Chapter 16. Learning Objectives. Learning Objectives 9/11/2012. Shock. Explain difference between compensated and uncompensated shock

Chapter 16. Learning Objectives. Learning Objectives 9/11/2012. Shock. Explain difference between compensated and uncompensated shock Chapter 16 Shock Learning Objectives Explain difference between compensated and uncompensated shock Differentiate among 5 causes and types of shock: Hypovolemic Cardiogenic Neurogenic Septic Anaphylactic

More information

Basic Cardiac Rhythms Identification and Response

Basic Cardiac Rhythms Identification and Response Basic Cardiac Rhythms Identification and Response Module 1 ANATOMY, PHYSIOLOGY, & ELECTRICAL CONDUCTION Objectives Describe the normal cardiac anatomy and physiology and normal electrical conduction through

More information

Dysrhythmia Assessment and Management Scenarios

Dysrhythmia Assessment and Management Scenarios Dysrhythmia Assessment and Management Scenarios Authors: John Guerriero, EMT-P, Gene Iannuzzi, RN, CCRN, EMT-P, Arther Romano, EMT-P, Kevin Brown, MD, EMT-P 1 An Important Word About the Therapies Discussed

More information

Paramedic Pediatric Medical Math Test

Paramedic Pediatric Medical Math Test Paramedic Pediatric Medical Math Test Name: Date: Problem 1 Your 4 year old pediatric patient weighs 40 pounds. She is febrile. You need to administer acetaminophen (Tylenol) 15mg/kg. How many mg will

More information

PRACTICAL APPROACH TO SVT. Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia

PRACTICAL APPROACH TO SVT. Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia PRACTICAL APPROACH TO SVT Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia CONDUCTION SYSTEM OF THE HEART SA node His bundle Left bundle AV node Right

More information