Exam (elaborations)
ESO/EKG Sharp QUESTIONS AND ANSWERS ALREADY PASSED 2024/2025
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ESO/EKG Sharp QUESTIONS AND ANSWERS ALREADY PASSED 2024/2025
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ESO/EKG SharpESO for Asystole (aka Ventricular Standstill) - ANS1. CPR 2min uninterrupted 2. 15L 02 ambu
bag 3. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q three-5 minutes. Flat line
or P wave w/ no QRS's.
ESO or bradycardia - ANS1. 02 10L NRBM 2.If pacing wires present, initiate pacing 3.Atropine
0.5mg IVP/IO can repeat three-5min up to 3mg. 4. Transcutaneous pacing asap five. If useless,
dopamine 400mg/250ml D5W@5mcg/kg/min. Titrate response up to 20 mcg/kg/min 6. Useless
supply epinephrine 2mg/250NS@2mcg/min, titrate response as much as 10mcg/min. *Assess
adequate intravascular extent/extent repute previous to vasoconstrictors.
ESO for PEA - ANS1. CPR 2 min & look for reasons H's (hypovolemia, hypoxia, hyper/o
-kalemia, hypoglycemia, hypothermia); T's (toxins, tamponade, thrombosis, trauma, anxiety
pneumothorax). 2. O2 15L ambu 3. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL),
repeat q 3-5 mins 3. If hypovolemia suspected bolus 250ml NS (LR if already infusing), repeat in
5min if no development. Four. Stat CXR
ESO for Ventricular Tachycardia (strong wide complicated) - ANS1) call health practitioner for
orders 2) O2 4L NC, titrate in line with fame 3) 12 Lead EKG four) Draw K+ & Mag++
ESO for Vtach (UNSTABLE, huge complicated) - ANS1) O2 10L NC 2) >150 biphasic:
synchronized cardioversion for dose listed on defib. If responsive, deliver Versed (midazolam)
0.Five IVP/IO previous to cardioversion. May repeat x1 to attain sedation. *Romazicon reversal
for midazolam IVP 0.2mg over 15 sec. May additionally repeat in 45sec up to zero.6mg. Three.
Draw K+ and Mag++
ESO for VFibb/Pulseless Vtach - ANSNo stacked shocks. Cont CPR until defibbing. Give meds
for the duration of CPR. Immediate defib if witnessed arrest. 1. CPR 2min or until defib arrives.
2.O2 15L ambu three.Defib (joules per permitted dose) four. Epinephrine 1mg (use 0.1mg/ml)
five. Defib 6. Amiodarone 300mg IVP/IO 7. Defib 8. Repeat Epinephrine eight. Defib nine.
Amiodarone 150mg IVP/IO 10. If rhythm persists: debib, CPR, repeat epi q3-5min.
ESO for chest pain - ANS1) aspirin 325mg if not contraindicated. 2) O2 min 4LNC titrate so sat=
or>94% 3)NTG is SBP>ninety and/or MAP>60 & HR>50, May repeat 3-5minx2. 4)morphine
2mg if SBP>90 q5min as much as 10mg. Five) if hypotension develops & no pulm congestion
suspected, bolus 250NS (or LR if jogging) & resume tx for chest ache if unrelieved. 6) Stat EKG
ESO symptomatic hypotension - ANS1) O2 10LNRBM 2) if hypovolemia suspected bolus
250NS (or LR if walking). Repeat in 5min if wanted. Three) if SBP<90 dopamine 400mg/250ml
D5W at 5mcg/kg/min. Titrate until SBP= or >90 or MAP>60 or as much as 20mcg/kg/min four) if
blood loss get stat H&H, type and go, and 2units RBC's. Five) if suspected sepsis use algorithm.
, ESO Sepsis Algorithm - ANS1) if hypovolemic infuse 250ml NS (or LR), may additionally repeat
in 5min. 2) SIRS criteria 1: 4>WBC>12 or bands>10% 2: HR>90 three: RR>20 4: temp less than
36 or >38.Three. Need to meet 2 standards 3) if meets 2 standards check for suspected/showed
infection and organ disfunction. Must meet 1 of those 1:SBP<ninety, map<65, decrease
SBP>forty, lactate>2, creatinine>2, UOP<0.5ml/kg/hr, bili>2, platelets<100,
INR.1.5/aPTT>60sec, new onset resp failure w/ bipap. 3) if one met, achieve serum lactate (if
none in final 6hrs) and repeat in 4hrs )RRT can order POC lactate). 4) order blood cultures,
seek advice from RRT, name medical doctor.
ESO for Hypoglycemia - ANSP&P #30094.99 for serum or fingerstick less than 70
ESO for expanded ITP - ANS(neuro impaired w/ dilated scholars in absence of ICP orders) 1) if
not hypotensive, put HOB>30degrees and midline. 2) if intubated hyperventilate FiO2 at one
hundred% to ought to maintain PCO2 at 30-35mmHg.Three) Mannitol 20% (100gn/500ml)
speedy infusion IVP/IO w/ filter out (if filter avail). 3) draw baseline serum K+, Na+, Cr, BUN,
glucose, and ABG. 4) insert urinary catheter.
ESO Respiratory Depression (d/t narcs or benzos) - ANS1) O2 10LNRBM. 2) for narcs give
naloxalone max 0.4mg. For Apnea supply 0.4mg IVP/IO once. For RR<10 give 0.1mg q1min up
to 3x's. 3) for benzos give Romazicon (flumazenil) 0.2mg over 15 sec. May repeat in 45sec if
needed up to 0.6mg
ESO respiratory distress - ANS(noted by RR/accessory muscles/ALC/cyanotic nailbeds) 1) O2
10LNRBM. 2) stat portable CXR. 3) if bronchospasm albuterol 0.5 in 3ml NS aerosol inhalation.
4) RRT can obtain ABG's 5) RRT may initiate non-invasive ventilation for COPD/asthma/CHF if
not contraindicated.
ESO status epilepticus - ANS(seizure 3min+, or recurrent w/out return to of conscious). 1)
protect airway, put in lateral decubitus position, protect from injury. 2) 02 10LNRBM 3) Ativan
IVP/IO 2mg over 1min 4) draw K+, Na+, Cr, BUN, glucose, and anticonvulsant levels
ESO severe anaphylaxis - ANS(stridor/wheezing/resp distress/pallor/cyanosis/signs of shock) 1)
O2 min 10LNRBM 2) epi 0.3 IM (use 1mg/ml) repeat in 5min if no improvement. 3) no
improvement give 0.1mg IVP/IO (use 0.1mg/ml) push over 5 min. Solucortef (hydrocortisone)
100mg IVP/IO. 4) diphenhydramine (Benadryl) 25mg IVP/IO 5) infuse 250 NS (LR if running) &
may repeat in 5 min.
Asystole Rhythm - ANSthe absence of ventricular activity, "flat line". Confirmed in at least two
different leads, check leads. CPR immediately for 2 min (100-120). DO NOT DEFIB
Sinus Brady (unstable) - ANS>60/pt's ordinary HR, and symptomatic. Ranges from SB to 3rd
degree block.
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