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Give medication after shock because chest compressions continue and help circulate the
medication
Bradycardia:
Dopamine increases contractility of the heart
o Comes in 400mg/250 mL
o Weight in pounds, drop the last number, subtract 2 (street rule for dopamine;
only works for 5 micrograms/kilogram)
Targeted temperature management effective in better outcomes in acute MI situations
Epi, Amiodarone, lidocaine = vfib and vtac
Amiodarone = with pulse given over time; 150 mg in a 100 mg bag over 10 minutes
Amiodarone = without pulse, IV push 300 mg for first dose
Lidocaine (SM relaxer) has very short half-life; Amiodarone (NOT a SM relaxer) halflife is 18-24 days
Example: Vfib/vtac no pulse
o CPR (2 min)
o Pads (vf/vt no pulse)
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Defib 200J
IV/IO
Epi 1 mg (1: 10,000)
CPR (2 min)
Check pulse, monitor
Still vf/vt
Defib 300J
Ami 300 mg IV push
Check pulse, monitor
Vf/vt, no pulse
Defib 360J
Epi 1 mg (1:10,000)
CPR (2 min)
Check pulse, monitor
Vf/vt, no pulse
Defib 360J
Ami 450 mg IV push
CPR 2 min
Check pulse, monitor
Vf/vt
Defib 360J
Epi 1mg (1:10,000)
Keep using Epi from here on out; Amiodarone maxed out and Joules
maxed out