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CEN-Cardiovascular Review 3

AB
Prior to cardioversion you should check these lab values if time allows...Potassium, magnesium, and digoxin levels
Prior to cardioversion, what should be done with transdermal medication and patches as well as dentures...Remove them
This is a difference between cardioversion and defibrillation...The sync is ON in cardioversion and OFF in defibrillation
Joule setting in cardioversion for narrow and regular QRS complexes50-100 Joules
Joule setting in cardioversion for narrow but irregular QRS complexes120-200 Joules (biphasic) or 200 Joules (monophasic)
Joules setting in cardioversion for wide regular QRS complexes...100 Joules
Joules in cardioversion for pediatric patients...0.5-1 Joule/kg; increased to 2 Joules/kg
Never cardiovert over these...Pacemaker or ICD (keep paddles 10 cm away)
For internal cardiac defibrillators that give continuous unneeded firing, do this...apply a bagnet
For internal cardiac defibrillators that fire during cardiac arrest do this...Allow it to fire unless it does not convert the rhythm, in which case you should apply a magnet
Wait this long after final firing of an ICD to manually defibrillate...thirty seconds
This is the best non-invasive way to decrease a narrow complex tachycardia...vagal maneuvers
This drug, used for narrow complex tachycardia, is given rapid IV push followed by 20cc saline bolus - it may cause transient heart block or asystole...Adenosine
This drug class, used for narrow complex tachycardia, is a vasodilator, negative inotrope, negative chronotrope, and negative dromotrope - they typically end in -depine...Calcium channel blockers
This drug classification, usually ending in -lol and used for narrow complex tachycardia, has a group that is cardioselective and is ideal for patients with pre-existing pulmonary conditionsBeta-blockers
Propranolol, Nadolol, Timolol, and Carteolol are examples of this type of beta-blocker...Cardioselective
Atenolol, Metoprolol, and Esmolol are examples of this type of beta-blocker...Non-cardioselective
Do this for wide complex tachycardia in which the patient is unstable...cardioversion
For stable wide complex tachycardia, this drug can be used but monitor for hypotension and widening of the QRS complex more than 50%...Procainamide IV
This drug, used for stable, wide complex tachycardia, may cause nausea, bradycardia, and hypotension...Amiodarone IV


Martinsburg, WV

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