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ACLS

ACLS. Team Kerigan Rounds CTU Medicine, HGH June 20, 2007. ACLS. EKGs. antidotes. Stroke!. Drugs. Pot- pourri. ACLS. EKGs. antidotes. Stroke!. Drugs. Pot- pourri. $100. $100. $100. $100. $100. $200. $200. $200. $200. $200. $300. $300. $300. $300. $300. $400. $400.

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ACLS

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  1. ACLS Team Kerigan Rounds CTU Medicine, HGH June 20, 2007

  2. ACLS EKGs antidotes Stroke! Drugs Pot- pourri

  3. ACLS EKGs antidotes Stroke! Drugs Pot- pourri $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500 $500 $500 $500

  4. EKGs $100

  5. EKGs $100 • WHAT IS HYPERKALEMIA? • Marked widenening of the QRS duration combined with tall, peaked T waves are suggestive of advanced hyperkalemia. Note the absence of P waves, suggesting a junctional rhythm, but in hyperkalemia the atrial muscle may be paralyzed while still in sinus rhythm. The sinus impulse conducts to the AV node through internodal tracts without activating the atrial muscle.

  6. EKGs $200

  7. EKGs $200 WHAT IS WPW TYPE PREEXCITATION?

  8. EKGs $300

  9. EKGs $300 WHAT ARE J-WAVES OR OSBORNE WAVES?

  10. EKGs $400

  11. EKGs $400 WHAT IS EARLY REPOLARIZATION, NORMAL VARIANT?

  12. EKGs $500

  13. EKGs $500 WHAT IS RBBB PLUS MOBITZ II 2ND DEGREE AV BLOCK? THE CLASSIC RSR' IN V1 IS RBBB. MOBITZ II 2ND DEGREE AV BLOCK IS PRESENT BECAUSE THE PR INTERVALS ARE CONSTANT.

  14. ANDTIDOTES $100 OPIATES

  15. ANDTIDOTES $100 NALOXONE

  16. ANDTIDOTES $200 DIGOXIN

  17. ANDTIDOTES $200 DIGIBIND

  18. ANDTIDOTES $300 BETA-BLOCKERS

  19. ANDTIDOTES $300 GLUCAGON

  20. ANDTIDOTES $400 BENZOS

  21. ANDTIDOTES $400 FLUMAZENIL

  22. ANDTIDOTES $500 TCAs

  23. ANDTIDOTES $500 Sodium Bicarbonate

  24. STROKE $100 LIST THE INCLUSION CRITERIA (4) FOR tPA ADMINISTRATION FOR ACUTE ISCHEMIC STROKE

  25. STROKE $100 • WHAT ARE: • Age 18 years or older • Clinical diagnosis of ischemic stroke with a measurable neurologic deficit • No evidence of intracranial hemorrhage on pretreatment non-contrast CT head • Time of symptom onset (when patient was last seen normal) well established as < 180 minutes (3 hours) before treatment would begin?

  26. STROKE $200 INDICATIONS TO LOWER BP IN AN ACUTE ISCHEMIC STROKE

  27. STROKE $200 • IF SYSTOLIC >220 OR DIASTOLIC >120 • 2. END-ORGAN INVOLVEMENT (AORTIC DISSECTION, ACUTE MYOCARDIAL INFARCTION, PULMONARY EDEMA, HYPERTENSIVE ENCEPHALOPATHY)

  28. STROKE $300 ELEVATED BODY TEMPERATURE IN THE SETTING OF ACUTE CEREBRAL ISCHEMIA IS ASSOCIATED WITH INCREASED MORBIDITY AND MORTALITY. THIS IS WHEN YOU SHOULD TREAT A FEVER

  29. STROKE $300 WHAT IS T>37.5?

  30. STROKE $400 IDENTIFY THE LESION

  31. STROKE $400 WHAT IS A PCA STROKE? HYPODENSE AREAS IN THE RIGHT OCCIPITAL LOBE, CONSISTENT WITH RECENT PCA

  32. STROKE $500 3 OF THE 6 RELATIVE CONTRAINDICATIONS FOR tPA ADMINISTRATION FOR ACUTE ISCHEMIC STROKE

  33. STROKE $500 • WHAT ARE: • 1.Only minor or rapidly improving stroke symptoms (clearing spontaneously) • 2.Within 14 days of major surgery or serious trauma • 3.Recent gastrointestinal or urinary tract hemorrhage (within previous 21 days) • 4.Recent acute myocardial infarction (within previous 3 months) • 5.Post-myocardial infarction pericarditis • 6.Abnormal blood glucose level (<2.8 or >22.2 mmol/L]) ?

  34. DRUGS $100 4 FIBRINOLYTIC AGENTS

  35. DRUGS $100 • WHAT ARE: • ALTEPLASE (tPA) • RETEPLASE (RETAVASE) • TENECTEPLASE (TNK) • STREPTOKINASE (STREPTASE) ?

  36. DRUGS $200 CONSIDER GIVING THIS DRUG IF YOU SEE THIS EKG

  37. DRUGS $200 WHAT IS MAGNESIUM, LOADING DOSE 1-2 G IV?

  38. DRUGS $300 THIS IS THE NNT WITH ASA THERAPY IN SETTING OF ACS TO SAVE ONE LIFE AT 30 DAYS.

  39. DRUGS $300 WHAT IS NNT OF 19?

  40. DRUGS $400 AMIODARONE BELONGS TO THIS CLASS OF ANTIARRYTHMICS

  41. DRUGS $400 WHAT IS CLASS III?

  42. Daily Double!!

  43. DRUGS $500 IN THE SETTING OF VENTRICULAR FIBRILLATION/PULSELESS VT, THESE TWO ANTI-ARRYTHMICS SHOULD BE CONSIDERED (INCLUDE DOSES)

  44. DRUGS $500 WHAT ARE: AMIODARONE 300MG IV/ ONCE, THEN CONSIDER ADDITIONAL 150MG IV ONCE OR LIDOCAINE 1-1.5MG/KG FIRST DOSE THEN 0.5-0.75 MG/KG IV, MAXIMUM 3 DOSES OR 3MG/KG ?

  45. POTPOURRI $100 THIS IS THE TIME RANGE THAT CARDIAC TROPONINS ARE DETECTABLE IN THE BLOOD AFTER INFARCTION

  46. POTPOURRI $100 WHAT IS 3-12 HOURS?

  47. POTPOURRI $200 MAX. SETTING FOR MONOPHASIC DEFIBRILLATION

  48. POTPOURRI $200 WHAT IS 360 J?

  49. POTPOURRI $300 3 METHODS TO SHIFT K+ INTO CELLS

  50. POTPOURRI $300 • WHAT ARE: • SODIUM BICARBONATE • INSULIN PLUS GLUCOSE (2 U PER 5 G) • VENTOLIN?

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