Arrhythmias Flashcard 2

C. Rationale: Atropine is given at a dose of 1 mg IV every 3 to 5 minutes until a total dose of 3 mg has been administered.

D. Rationale: Compressions are not needed until all other options are exhausted, including TCP, epinephrine, and dopamine.

A. Rationale: The most common arrhythmia following lightning injury is asystole. Ventricular fibrillation is commonly seen following manmade electro current shocks. The other arrhythmias can occur but are less likely to be immediately fatal.

C. Rationale: Bradyarrhythmia’s are heart rates that are < 60 beats per minute, but when symptoms arise, the rate usually falls to < 50 beats per minute, and this is the working definition of bradycardia

D. Rationale: Transcutaneous pacing (TCP) is a temporizing therapy for symptomatic bradycardia that has failed traditional therapy (atropine). However, TCP should be used earlier in patients with infranodal AV block as atropine works at the AV node and is unlikely to manage these types of bradycardic rhythms. As pacing can lead to contraction of the skeletal muscles, it can be quite painful for alert patients, and analgesics should be given. Hypothermia-induced bradycardia is physiological and is one of the cases in which bradycardia should not be treated.

C. Rationale: Asystole, ventricular fibrillation, and pulseless ventricular tachycardia are cardiac arrest rhythm. The rhythm in image C is ventricular tachycardia and in the absence of a pulse is considered a cardiac arrest rhythm.

D. Rationale: The following are cardiac arrest rhythms: asystole, pulseless electrical activity, pulseless ventricular tachycardia, and ventricular fibrillation.

A. Rationale: Adenosine is not a treatment for bradycardia. Emergency cardiovascular care guidelines suggest that atropine remains the first-line drug treatment for acute symptomatic bradycardia. Transcutaneous pacing and dopamine may be used if atropine is not effective.

A. Rationale: Synchronized cardioversion is NOT used in stable asymptomatic patients with SVT. However, it remains the mainstay of treatment for unstable patients that have tachyarrhythmias with a pulse.

A. Rationale: This patient is in an unstable tachycardia (low blood pressure, high respiratory rate, skin cool and clammy). According to the tachycardia algorithm, the treatment for this patient is immediate cardioversion.