🩵Types of canula used in children :

🩵Which cannula has the fastest flow rate?

🩵Types of shock
1). 2)
3). 4)

🩵Indications of blood transfusion in shocked Pt
1)
2)

🩵Stage of shock is determined according to....... And.............


🩵Which type of shock????

❤️Pt present with massive upper Gi bleeding and confusion

❤️Pt present with tension pneumothorax

❤️Pt present with severe dyspnea confusion and hypotension after lV penicellin

❤️Severe burn

❤️Severe vomiting and diarrhea and loss of conciousness

❤️Mention the signs of shock
1)
2)
3)
4)

🩵Which type of shock require IM adrenaline injection
....................
🩵Causes of obstructive shock
1)
2)
3)

❤️Hypertensive emergencies:

Presence of end organ damage in hypertensive Pt (180/120) called....................

Managment...........

hypertensive Pt (180/120) without organ damage called....................

Managment...............

Drug of choice in managment of acute aortic dissection is.........

Ideal BP in managment of aortic dissection should be within [...... _......... ]

Drug of choice in acute MI due to hypertensive emergency
.............

Drug of choice in acute pulmonary edema due to hypertensive emergency........

Drug of choice in hypertensive encephalopathy.................

Drug of choice in subarachnoid hemorrhage due to hypertensive emergency ...............

❤️Acute coronary syndrome and arrythmias :

Wich Leads represnt the
Anterior wall?
....................
Posterior wall?
..................
Lateral wall?
..................
Septum?
..................

Stander Lead.
..................
Differential diagnosis of narrow complex tachycardia
1)
2)
3)
Differential diagnosis of Broad complex tachycardia
1)
2)
3)
Sinus arrythmias
1)
2)
3)

Atrial arrythmias
1)
2)
3)

Ventricular arrythmias
1)
2)
3)
Which type of arrythmias managed by DC cardioversion?
1)
2)

Acute coronary syndrome?
1)
2)
3)

Central Chest pain + +ve cardiac enzyme +ST segment elevation...........
Diagnosis...............
managment ..............

Central Chest pain + - ve cardiac enzyme + no ST segment elevation
Diagnosis........
managment .........

Central Chest pain + +ve cardiac enzyme + no ST segment elevation
Diagnosis ................
managment.............

❤️Sinus arrythmias :

Sinus Bradycardia:


Inherent Rate: less than 60 bpm.

• P wave is upright on lead II, look-alike and before QRS

• T wave is present after QRS.


▪︎ Interventions: (based on AHA 2016 ACLS Guidelines)

- Correct possible causes (Hypothermia, Hypoglycemia, Toxins, Hypokalemia, Hyperkalemia).

- Give Atropine 0.5 mg every 3-5 minutes maximum of 3 mg.

- Get ready or start Transcutaneous Pacer (TCP).

- If Atropine and TCP are ineffective and continues to be hypotensive, give Dopamine 2-20 mcg/kg per minute and titrate to effect.

- If profound bradycardia after Atropine and TCP, give Epinephrine 2-10 mcg/min and titrate to effect.

Sinus Tachycardia:


Inherent Rate: 100-150 beats per minute.


• P wave is visible

• QRS is narrow

• T wave is present

Sinus Tachycardia:


Inherent Rate: 100-150 beats per minute.


• P wave is visible

• QRS is narrow

• T wave is present

❤️Atrial arrythmias :

Atrial Fibrillation:

Atrial Fibrillation occurs when the atrial sites depolarize simultaneously at 400-600 bpm enabling the atrium to contract but only quiver.

The most common terms used with Afib less than 100 bpm is Controlled VR (ventricular respone) or SVR (slow ventricular response).

If the rate is greater than 100 bpm then it is called Uncontrolled VR (ventricular response) or RVR (rapid ventricular response).

If the rate goes over 150 bpm, then t'll be identified as an AVNRT (atrio-ventricular nodal reentry tachycardia) SVT (supraventricular tachycardia). It is the most common SVT diagnosed in patients.

Atrial Tachycardia:


• Rate: 150-250
• P waves: Visible
• QRS: Narrow

Atrial Tachycardia is caused by an irritated site in the Atria. It is regularly-regular with visible P waves (unlike SVT where the P waves are absent).

Interventions are focused on correcting the causes depending on the patient's stability.


Follow AHA 2016 Guidelines ACLS algorithms. Most common cause is possible Digoxin overdose.


▪︎Interventions:

• If Stable:
- Give Digibind, B-blockers, Calcium-Channel blockers, Anti-arrhythmics

- No Adenosine if caused by Digoxin overdose


• If Unstable:
- Synchronized cardioversion 10 J only