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no more a loser
Forum Guru Topics: 140 Posts: 580 |
significant electrical activity on EKG with no signs of organized pattern Management sequence of Ventricular fibrillation?
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Anticoagulation therapy.
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defibrilate with 200J --> see the rhythm again. If asystole --> Epinephrine and if sinus rhythm--> anti-arrhythmic (xylocaine iv or amiodarone iv)
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no more a loser
| Forum Guru Topics: 140 Posts: 580
Tx for Vfib : DRUGS: ALMPB: All Lets Make Pt Better A:amiodarone 300mg IV L: lidocaine 1mg/kg M: Mg sulfate 1-2g IV P:Procainamide 50mg IV bolus B: bicarbonate 1mEq/kg Shock(200 J)->Shock(300 J)->Shock(360 J)->Epi 1mg ->Shock(360 J)->Epi 1mg ->Shock(360 J)->Epi 1mg ->Shock(360 J)->DRUGS: (ALMPB alternating with shock) amiodarone ->Shock (360 J)->lidocaine->Shock (360 J)->Mg sulfate->Shock (360 J)->procainamide->Shock (360 J)->bicarbonate
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Carefull... Epi must be administrated in 3 to 5 minutes intervals throughout all the reanimation process. You can start antiarrythmic drugs while giving epi shots every 3 to 5 minutes. Also, you can use vasopresin 40 U IV only 1 dose, instead of epi. After failure of vasopresin at 10-20 minutes post injection, you can go back to epi, 1 mg IV bolus every 3 to 5 minutes Routine administration of Mg sulf is not recomended in the 2000 guidelines from AHA. It´s a class IIa recomendation for pts at risk for or with reasons to think of hypomagnesemia, such as: alcoholics or malnutrition. Mg sulf is still recomended for torsade de pointes. Procainamide is specially useful for recurrent V fib. That is, vfib, successful reanimation, Vfib again. Then you use procainamide. :?: I don´t know about bicarbonate. Does it have any special indication? should it be given routinely? Remember to keep applying chest compressions if there´s no palpable pulse.
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