Acute LVF: management
LMNOP:
- Lasex (frusemide)
- Morphine (diamorphine)
- Nitrates
- Oxygen (sit patient up)
- Pulmonary ventilation (if doing badly)
Asystole: treatment
"Have some asystole "TEA":
- Transcutaneous pacing
- Epi
- Atropine
Atrial fibrillation: causes of new onset
THE ATRIAL FIBS:
- Thyroid
- Hypothermia
- Embolism (P.E.)
- Alcohol
- Trauma (cardiac contusion)
- Recent surgery (post CABG)
- Ischemia
- Atrial enlargement
- Lone or idiopathic
- Fever, anemia, high-output states
- Infarct
- Bad valves (mitral stenosis)
- Stimulants (cocaine, theo, amphet, caffeine)
JVP: raised JVP differential
PQRST (EKG waves):
- Pericardial effusion
- Quantity of fluid raised (fluid over load)
- Right heart failure
- Superior vena caval obstruction
- Tricuspid stenosis/ Tricuspid regurgitation/ Tamponade (cardiac)
JVP: raised JVP extra-cardiac causes
FAT PEA:
- Fever
- Anaemia
- Thyrotoxicosis
- Pregnancy
- Exercise
- A-V fistula
*These are in addition to all the cardiac ones (pericardial effusion, RHF, tricuspid stenosis, SVC obstruction, etc).
MI: immediate treatment
DOGASH:
- Diamorphine
- Oxygen
- GTN spray
- Asprin 300mg
- Streptokinase
- Heparin
PEA/Asystole (ACLS): etiology
ITCHPAD:
- Infarction
- Tension pneumothorax
- Cardiac tamponade
- Hypovolemia/ Hypothermia/ Hypo-, Hyperkalemia/ Hypomagnesmia/ Hypoxemia
- Pulmonary embolism
- Acidosis
- Drug overdose
Pulseless Electrical Activity (PEA): checklist
PEA:
- Pulses check
- Epinepherine
- Atropine
Shock: general features
CHORD ITEM:
- Cold, clammy skin
- Hypotension
- Oliguria
- Rapid, shallow breathing
- Drowsiness, confusion
- Irritability
- Tachycardia
- Elevated or reduced central venous pressure
- Multi-organ damage
Shock: signs and symptoms
TV SPARC CUBE:
- Thirst
- Vomiting
- Sweating
- Pulse weak
- Anxious
- Respirations shallow/rapid
- Cool
- Cyanotic
- Unconscious
- BP low
- Eyes blank
Shock: types
RN CHAMPS:
- Respiratory
- Neurogenic
- Cardiogenic
- Hemorrhagic
- Anaphylactic
- Metabolic
- Psychogenic
- Septic
*Alternatively: "MR. C.H. SNAP", or "NH CRAMPS".
Resuscitation: basic steps
ABCDE:
- Airway
- Breathing
- Circulation
- Drugs
- Environment
Syncope: Cardiovascular Causes
HEART VESSELS:
*Cardiac causes are HEART:
- Heart attack
- Embolism (PE)
- Aortic obstruction (IHSS, AS or myxoma)
- Rhythm disturbance, ventricular
- Tachycardia
*Vascular causes are VESSELS:
- Vasovagal
- Ectopic (reminds one of hypovolemia)
- Situational
- Subclavian steal
- ENT (glossopharyngeal neuralgia)
- Low systemic vascular resistance (Addison's, diabetic vascular neuropathy)
- Sensitive carotid sinus
Ventricular fibrillation: treatment
"Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock":
- Shock= Defibrillate
- Everybody= Epinephine
- Little= Lidocaine
- Big= Bretylium
- Momma= MgSO4
- Poppa= Pocainamide
V-fib/pulseless v-tach (new ACLS as of 2001)
"EVAL My Pumper":
- Epinephrine
- Vasopressin
- Amiodarone (class IIb--better for heart failure)
- Lidocaine (indeterminate - better for young, healthy or persistent)
- MgSO4 (IIb for hypomagnesemic state or torsades)
- Procainamide (IIb for intermittent/recurrent VF/VT)
Vfib/Vtach: drugs used according to ACLS
"Every Little Boy Must Pray":
- Epinephrine
- Lidocaine
- Bretylium
- Magsulfate
- Procainamide
