ACLS Megacode Scenario 4: In Hospital Cardiac Arrest

[Music] a 52 year old woman with a history of hypertension and type 2 diabetes presents to the er complaining of chest pain for the past hour radiating into her jaw she complains of shortness of breath the patient is placed on a cardiac monitor evaluation skin clammy and diaphoretic cv regular rate and rhythm without audible murmurs rub or gallop respiratory lungs are clear bilaterally with equal breath sounds rr is 16 with breathing slightly labored cns alert and oriented times four but appears uncomfortable and anxious identify the rhythm b nsr with pvcs pvcs are early with wide bizarre qrs and no discernible p waves your immediate intervention is a obtain a 12-lead ekg to determine if there is underlying ischemia while you are starting the iv the patient vomits and loses consciousness the monitor reveals this rhythm you should d begin cpr as soon as you recognize cardiac arrest you should begin high quality cpr you identify that this is a shockable rhythm so a team member should prepare to defibrillate although immediate defibrillation is the priority cpr should not be delayed while preparations are made to shock after shocking the patient with 120 joules utilizing a biphasic monitor you should next b continue cpr after any defibrillation the next step is to resume high quality cpr after cpr the monitor continues to show v-fib what is your next intervention [Music] d defibrillate ventricular fibrillation is a shockable rhythm so the next appropriate intervention is to defibrillate your next consideration after cpr in light of the continuing v-fib on the monitor should now be [Music] c epinephrine one milligram ivp if a shockable rhythm continues after high quality cpr and two defibrillations the team should administer epinephrine you give one milligram epinephrine ivp how often can you repeat this dose [Music] a every three to five minutes there is no dosing limit for epinephrine after giving the epinephrine you see this rhythm on the monitor what is your next intervention a continue cpr after administration of a medication high quality cpr is necessary to circulate the medication after completing administration of epinephrine and the five cycles of cpr the patient remains pulseless but now has the following rhythm what is your next intervention [Music] c defibrillate you should recognize this rhythm as postless ventricular tachycardia another of the shockable rhythms you defibrillate and begin high quality cpr the next intervention should be [Music] c consider amiodarone or lidocaine at this point you should consider a dose of amiodarone or a lidocaine iv or io you have given one dose of amiodarone you are ready to give another dose what is the correct dosage b 150 milligrams the appropriate second dose of amiodarone is 150 milligram iv or io after repeating meodurone and completing five cycles of cpr you see the following rhythm your next intervention is [Music] c resume high quality cpr assistely is not a shockable rhythm instead the team must resume high quality cpr the patient has a return of spontaneous circulation with a blood pressure of 90 over 60 and no spontaneous breathing the patient is hooked to the ventilator the rhythm strip reveals what is your next intervention b amiodarone infusion after rosc the team should begin an immediate amiodarone infusion and prepare for transport to the icu you

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Keywords: How to manage In-Hospital Cardiac Arrest, cardiac arrest management in hospital, Tutorial In-hospital cardiac arrest management, In-hospital cardiac arrest simulation, How to manage IHCA, acls scenarios, acls megacode, ACLS megacode simulation, IHCA, How to treat cardiac arrest, acls megacode examples, in hospital cardiac chain of survival, cardiac arrest in hospital, Health Ed Solutions, megacode, acls, acls certification, advanced cardiac life support, Acls simulator

Id: unhX10kO160

Length: 6min 57sec (417 seconds)

Published: Wed Jan 27 2021