ESO

Question 1

Asystole (3)

Answer 1

1 CPR 2 min
2 O2 15 L ambu
3 epi 1mg IVP q3-5

Question 2

Brady w sympt + H Blocks
(3)

Answer 2

1 O2 10L NRB
2 PACE epicardial, transcutaneous
3 atropine 1mg Q3-5min (MAX 3)
4 PACE transcutaneous

Question 3

**Brady w sympt + H Blocks
if algorithm was ineffective + SBP<90

Answer 3

dopamine 400mg/250ml D5W

5-20mcg/kg/min until SBP>90 map>65

if ineffective, epi **4mg/250ml NS2-10mcg/min by RRT/ICU only

Question 4

PEA
assess for..

Answer 4

H+T
hypovolemia
hypoxia
hypoglycemia
hypothermia
H ions
hypo/hyperkalemia

toxin
tamponade
thrombosis
trauma
tension pneumothrx

Question 5

PEA
(5)

Answer 5

1 CPR 2 min
2 O2 15L ambu
3 epi 1mg IVP Q3-5min
4 250 NS/LR if HYPOVOLEMIA Q5min until improved
5 CXR

Question 6

stable VT (4)

Answer 6

1 call MD
2 O2 4L NC
3 EKG
4 Serum K + MG

Question 7

unstable VT (5)

Answer 7

1 O2 10L NRB
2 biphasic synchr cardioversion 200J (if HR>150) max x3
3 Versed 0.5mg IVP if awake x2
4 Serum K + Mg
5 EKG

Question 8

versed, valium ativan (benzos) reversal agent

Answer 8

romazicon 0.2mg

Question 9

V-fib + pulseless VT (7)

Answer 9

1 CPR (give meds simult)
**2 immediately defib if witnessed arrest
3 O2 15L ambu
4 defib biphasic 200j Q2min
**5 EPI 1mg Q3-5min
**6 AMIO 300mg after 2nd defib then 150mg in 5 min
**7 LIDOCAINE 1mg/kg
(DEFIB>CPR>EPI>DEFIB>CPR>AMIO>DEFIB>CPR>EPI>DEFIB>CPR>AMIO>DEFIB>CPR>LIDO

Question 10

Defibrillate for….

Answer 10

V fib + pulseless VT

Question 11

BIPHASIC SYNCH CARDIOVERSION for…

Answer 11

unstable VT

Question 12

transcutaneous pacing for….

Answer 12

Brady + HB

Question 13

Defib
Steps (6)
for vfib or pulseless vtach

Answer 13

1 defib>CPR>EPI
2 defib>CPR>AMIO 300
3 defib>CPR>EPI
4 defib> CPR>AMIO 150
5 defib>CPR>EPI
6 defib>CPR>lido 1mg/kg

Question 14

CP (6)

Answer 14

1 O2 4L NC (>94%)
2NTG 0.4 SL Q3-5min x2
3 morphine 2mg Q5 max 5
4 ASA 325
5 if hypotensive 250ml
6 EKG
***7 CBC CMP PTINR Trop

Question 15

NTG + morphine parameters for cp

Answer 15

SBP >90, MAP>60 HR>50

Question 16

contraindication for 250 ml infusion for CP

Answer 16

hypertension or pulmo congestion OR HF

Question 17

hypotension parameter

Answer 17

<90

Question 18

hypotension symptomatic (5)

Answer 18

1 O2 10L NRB
2 hypovolemic? 250ml, repeat if no change
3 dopamine 400mg.250 @ 5-20mcg/kg/min
4 H+H, T+C 2 uPRBC if blood loss
5 if suspect sepsis, follow sepsis algorithm

Question 19

hypotension post anesthesia (4)

Answer 19

1 O2 10L NRB
2 250ml + repeat if no change
3 ephedrine 10mg IVP if fluid ineffective*
4 H+H, T+C 2 uPRBC if blood loss

Question 20

hypotension. if infusion is ineffective..

Answer 20

symptomatic? dopamine 400mg/250 @5-20mcg/kg/min

post anesthesia?
ephedrine 10mg IVP

Question 21

ICP signs

Answer 21

uni/bilateral fixed + dilated pupils

decorticate or decerebrate

Question 22

ICP (3)

Answer 22

1 HOB 30 + midline
2 FiO2 100% (keep pCO2 26-30 mmHg)
3 BMP, Serum osmolality, ABG

Question 23

what happens w ICP if pCO2 is less than 25?

Answer 23

vasoconstriction> less blood in cranium + hypoxia

Question 24

resp DEPRESS <10 RR (3)

Answer 24

10L NRB if RR<10

15L AMBU if apneic

Question 25

resp DISTRESS (4)

Answer 25

1 O2 10L NRB 2 CXR 3 albuterol 0.5ml in 3ml NS if bronchospasm 4 suction if secretions 5 RRT for ABG + implement NIV

Question 26

status epilepticus (5)

Answer 26

1 protect airway 2 decubitus position 3 O2 10L NRB 4 lorazepam/Ativan 2mg 5 BMP + anticonvulsant levels

Question 27

severe anaphylaxis (10)

Answer 27

1 O2 10L NRB 2 epi 0.3mg x3 **elevate lower exremities 3 250ml infusion Q5min 4 albuterol 0.5 ml in 3ml NS if bronchospasm 5 diphenhydramine.Benadryl 25mg IVP 6 hydrocortison/Solucortef 100mg IVP 7 famotidine 20mg IVP 8 epi 4mg/250ml at 1-10mcg/min

Question 28

suspected sepsis (4)

Answer 28

1 hypovol>>250 ml 2 check for 2 SIRS criteria 3 if 2 criteria met, check for organ dysfunctn

Question 29

SIRS criteria

Answer 29

high/low WBC (>12K <4K) RR>20 HR>90 temp >38.3<36

Question 30

ORGAN DYSFUNCTION criteria

Answer 30

SBP <90 or drop by 40 MAP<65 Lac>2 Cr>2 UOP <0.5/kg/hr Bili>2 PLT <100k INR >1.5 PTT>60 sec Acute resp fail new mental change

Question 31

if organ failure for sepsis met

Answer 31

1 lactate 2 blood cx 3 ICU/RRT only norepi 4mg/250 @2-32mcg/min 4 bolus 5 RRT/MD

Question 32

Coarse vs fine VF

Answer 32

C: recent onset of VF can be corrected w defib F: more prolonged VF, approaching systole. More difficult to resuscitate

Question 33

if IV access is unavailable then epi may be given via ___ at ___ times the dose diluted in ____

Answer 33

endotracheal route 2-2.5x 10ml NS

Question 34

flush IV line with ___ after each IV med and ____

Answer 34

20ml NS elevate extremity vcc-p0ovb hgyfƒƒ

Question 35

therapeutic hypothermia

Answer 35

32-36

Question 36

compression to vent ratio

Answer 36

30:2

Question 37

compression rate

Answer 37

100-120

Question 38

vent rate

Answer 38

breath Q6sec (10/min)

Question 39

types of rep DEPRESS

Answer 39

1 rr<10 2 narcotic assoc 3 benzo assoc

Question 40

Narcotic assoc RESP BDEPRESS

Answer 40

APNEA: 15L AMBU + narcan 0.4mg/IV/IO/IM Q2min x4 max 2mg RR10: 10L NRB + narcan 0.1mg/IV/IO/IM Q2 x 4 initiate end tidal CO2

Question 41

Benzo assoc RESP DEPRESS

Answer 41

0.2 ROMAZICON over 15 sec Q45sec x 3

Question 42

contraindications for NIV

Answer 42

1 COPD, asthma CHF 2 rest arrest 3 inability to clear secretions risk for aspiration (n/v, bowel obstruction) 4 PTXor pneumomediastinum 5 epistaxis 6 facial.oral/skull sx/trauma 7 encephalopathy/AMS 8 hypotension d/t intravasc vol depletion 9 cant tol bipap