[CK] VT Storm with Lidocaine drip.

VF or pulseless VT (after defibrillation attempts, CPR, and vasopressor administration), alternative to amiodarone: IV, intraosseous (IO): Initial: 1 to 1.5 mg/kg bolus. If refractory VF or pulseless VT, repeat 0.5 to 0.75 mg/kg bolus every 5 to 10 minutes (maximum cumulative dose: 3 mg/kg). Follow with continuous infusion (1 to 4 mg/minute) after return of perfusion (AHA/ACC/HRS [Al-Khatib 2017]). Reappearance of arrhythmia during constant infusion: 0.5 mg/kg bolus and reassessment of infusion (Zipes 2000)

Endotracheal (loading dose only): 2 to 3.75 mg/kg (2 to 2.5 times the recommended IV dose); dilute in 5 to 10 mL NS or sterile water. Note: Absorption is greater with sterile water and results in less impairment of PaO2.

Hemodynamically stable monomorphic VT: IV: 1 to 1.5 mg/kg; repeat with 0.5 to 0.75 mg/kg every 5 to 10 minutes as necessary (maximum cumulative dose: 3 mg/kg). Follow with continuous infusion of 1 to 4 mg/minute (or 14 to 57 mcg/kg/minute).

=> Sotalol stopped it (QT prolongation) Class III.

Ib = shortening action potential <-> III.

I= basically sodium channel blocker.

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[CK] STEMI_EKG learning.

892 × 548 저작권 보호를 받는 이미지일 수 있습니다. 자세히 알아보기 ECG - Common STEMI Mimics | Grays Integrative Physiology Grays Integrative Physiology Mimics will not produce reciprocal changes. If RCs in related leads, should consider it a STEMI. 방문 추가 컬렉션 공유

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[CK] LVAD parameter review. [ ] tree !!

Vital(BP): hypo, hyper. PEx(JVP): volume status -------------------------------- 1st. PI(3-7)= contractility and volume status(high volume only cause high PI) overload = high PI. low volume = low PI. (=low volume = low preload = RV failure, arrhythmia same thing) HTN = low PI low BP = low PI. (only overload cause high PI = with high preload, but otherwise, BP, volume => cause low PI) 2nd. Flow(4-6) overload, 3rd. Power(surge = only thrombus, 4-6) hypotension route (BP) => high VADFL = vasodilator, sepsis = R/O => low VADFL(most common) with high JVP => RV failure, PE/tamponade, pneumothorax , then adjust LVAD(higher) ...

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EGD, endoscopy, Colonoscopy prep.

EGD: 8hr = clear liquid diet(technically up to 2 hour, but preferred 4 hours prior to procedure) 4hr = medication with water 2hr = strict npo(nothing) Colonoscopy 8hr = no food at all but water is ok. 2hr = no liquid neither Patients typically take no food by mouth for four to eight hours prior to the procedure (sometimes longer if there is known or suspected delayed gastric emptying) and no liquids (other than sips with medications) for two hours Enteroscopy Patients should fast after midnight the evening prior to the examination to allow time for food residue to clear the small bowel. In addition, patients undergoing retrograde examinations should receive a bowel preparation to cleanse the colon. cf) ASA- sedation protocol(procedure) The American Society for Anesthesiology (ASA) guidelines state that prior to a procedure, patients should fast a minimum of two hours following clear liquid ingestion or six ...

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