心肺複蘇需要了解的藥物 / Medication needs to know for ACLS

圖來自http://www.stlukesonline.org

• Adenosine: all stable, fast rhythm, 6mg with 20 CC NS after, raise arm, can do again with 12mg
  
  
• Atropine (block vagal nerve): stable, slow rhythm, 0.5-1mg IVP, 3mg max
  
  
• Amiodarone: stable ventricular problems: V-fib, V-tach, 150mg for stable pat, 300mg for unresponsive , no pulse pt
  
  
• Aspirin: for chest pain, 325mg, or 4xASA 81mg, chew, ask pt if have allergy before giving
  
  
• Diltiazem: second line for SVT, 0.25mg/kg IV X 1
  
  
• Dopamine: check fluid 1st, increase Bp and contractility, 5mg/kg/min
  
  
• Epinephrine (1:10): increase peripheral constriction, increase sensitivity for shock, also for bradycardia, 1st given after 1st cycle of CPR, , 1mg q3-5 min
  
  
• Lidocaine: V-fib, V-tach, 1mg/kg (one box)
  
  
• Magnesium: Torsads, v-fib, low Mag serum level,
  
  
• Morphine: Chest pain
  
  
• Naloxone (Narcan): reverse narcotic overdose, 2mg once IV
  
  
• Nitroglycerine: chest pain, rule out right heart infarction, EKG first, no ED (Like Viagra) drugs for the past 2-3 days, BP at least 90mmHg, 0.4mg x3 q 3min
  
  
• Sodium Bicarb, acidosis, can use hyperventilation, 1meq/kg
  
  
• Versed (Midazolam): premed for electrotherapy
  
  
• NS: 20cc/kg bolus, 1-2 L for Hypotension
  
  Defibrillation: Defibrillator for the dead (200J)
  Cardioversion for fast heart rate (100, 200, 360J)
  Pacing for the slow heart rate
  
  
  Captography (35-45): used to
  1. ET tube in the right spot or not;
  2. >0, <10, poor CPR, >10: good CPR;
  3. Sudden >35, ROSC (return of spontaneous contraction, also Bp>90, O2 > 92 )

H's & T's

• Hypovolemia-NS
• Hypoglycemia-D50
• Hypoxia-oxygen
• Hypothermia
• Hypo/hyperkalemia
• Hypo-Magnesium
• Tension Pneumothorax
• Tamponade
• Toxins
• Thrombosis: Heart and lung

While doing CPR: O2, NS, Epi, D50, Narcan, Mg, Bicarb etc.

Stroke: Acu check plus EKG, no need BP lower meds

以上僅供本人參考