ADULT BRADYCARDIA WITH A PULSE ALGORITHM

ADULT TACHYCARDIA WITH A PULSE ALGORITHM

UNSTABLE TACHYARRHYTHMIA

STABLE WIDE TACHYARRHYTHMIA

STABLE NARROW TACHYARRHYTHMIA

ADULT POST-CARDIAC ARREST CARE ALGORITHM
 TRANSCUTANEOUS PACIN

1. Set the Mod

• Demand/Synchronou
- Pacer only turns on when heart rate falls below the set rat
- Use for undifferentiated bradycardi
- Usually the mode of choic
• Fixed/Asynchronou
- Pacer is always on regardless of set rat
- Used for xed bradycardia (e.g patients with a faulty pacemaker
- Maybe used if artifacts prevent the pacer from reading the actual heart rat
2. Set the Rat
• Start at 60 bpm, then titrate to clinical stabilit
3. Set the curren
• Start at 10 mAm
4. Turn the pacer o
• Titrate the current until electrical capture is achieved (usually 1 mAmp/Kg
• Once electrical capture is achieved, con rm mechanical capture by checking the radial
pulse rate. Increase the current until radial pulse rate matches the pacing rate
• Once electrical and mechanical capture is achieved, add an extra 2-5 mAmp to the
nal pacing current to maintain adequate capture

Points to remembe
• Pacing is painful. Remember to provide adequate analgesia and sedation
• If pacing is not achieved at 100-120 mAmp, troubleshoot
- Is there hair or moisture preventing good contact with the pads
- Have you considered changing the position of the pads
- Have you tried reducing the heart rate?
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 AV BLOCKS ALGORITH

2nd Degree 2nd Degree Atrial Junctional

Sinus First Degree 3rd Degree
Type 1 Type 2 Fibrillation Bradycardia
Bradycardia AV Block AV Block
AV Block AV Block (Slow) /IVR

Rhythm Regular Regular Irregular Irregular Regular Irregular Regular

P: QRS
1:1 >1:1 0:1
Ratio

PR
Normal Prolonged Irregular Regular Irregular N/A
Interval

MECHANICAL VENTILATOR SETTINGS FOR CP

Mode: Assist-Control (AC

Tidal Volume: 6 ml/Kg/IBW (e.g Males: 50 kg + 2.3 kg for each inch over 5 feet | Females:
45.5 kg + 2.3 kg for each inch over 5 feet
Flow Trigger: Highest setting/OF
FiO2: 1.
Back-up Rate/Respiratory Rate: 1
PEEP:
0