Field Skills Lab, Static Cardiology

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Normal Sinus Rhythm
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Normal Sinus Rhythm
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
38 y/o female complaining of N/V. BP 98, Respirations 16, SaO2 = 94%, ETCO2=38
ECG from Google Images

V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
76 y/o male, unresponsive, no respirations, no pulse

ECG from Google Images

Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
76 y/o female c/o weakness and being lightheaded. BP=128/66, R=16, SaO2=92%, ETCO2=38

ECG from Google Images

Atrial Fibrillation
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Atrial Fibrillation
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
86 y/o male presents to clinic with fluttering in his chest. Denies pain or SOB. Physician called 911 for transport to ED.
ECG from Google Images

Paced Rhythm
ABC, O2, IV, Monitor (3 & No12 Lead -why)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced Rhythm
ABC, O2, IV, Monitor (3 & No12 Lead -why)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
75 y/o male with N/V
ECG from Google Images

Multifocal PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Multifocal PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
53 y/o female with SOB with activity and general weakness
BP=98/48, R=24
ECG from Google Images

Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
88 y/o female with 7/10 chest pain
ECG from Google Images

Non-conducted PACABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consider 0.5 Atropine if symptomatic with slow rate
Non-conducted PACABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consider 0.5 Atropine if symptomatic with slow rate
54 y/o male with dizzyness
ECG from Google Images

Premature Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Premature Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
75 y/o female with palpatations
ECG from Google Images

Sinus Arrest
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Sinus Arrest
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
32 y/o female with dizzyness
ECG from Google Images

Sinus Bradycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
If symptomatic and slow, consider 0.5 Atropine
Sinus Bradycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
If symptomatic and slow, consider 0.5 Atropine
43 y/o with weakness
ECG from Google Images

Sinus Tachycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Symptomatic and stable:
Sinus Tachycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Symptomatic and stable:
ECG from Google Images

Sinus to V-tach
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Sinus to V-tach
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
48 y/o male 8/10 chest pain to unresponsive
ECG from Google Images

Third Degree Block
Third Degree Block
69 y/o male with post syncope
ECG from Google Images

Coupling PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Coupling PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
55 y/o female weakness
ECG from Google Images

Ventricular Quadgemeny
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Ventricular Quadgemeny
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
ECG from Google Images

V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
ECG from Google Images

V-tach
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
V-tach
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1mg or 40 U Vasopressin
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
no pulse

ECG from Google Images

First Degree Block with ST elevation
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
First Degree Block with ST elevation
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

First Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
First Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

Second Degree 4:1 or Third Degree?
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace
Second Degree 4:1 or Third Degree?
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace

Second Degree Type 2
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace
Second Degree Type 2
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace

Third Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
Third Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced

Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Accelerated Junctional
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
A-Fib
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

A-Flutter with Unifocal PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Contact Medical Control if symptomatic and 150 amiodarone is needed.

Paced With Spikes Upward
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced With Spikes Upward
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

Hypothermia with Osborn Wave
http://en.wikipedia.org/wiki/Osborn_wave
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Passive and active warming as appropriate

PEA
ABC, Advanced Airway, ResQpod, Mechanical CPR
@2 min, change compressor, CPR
O2-IV-Monitor, H’s and T’s
Epinephrine 1 mg every 4 min
@2 min, change compressor, CPR
Epinephrine Drip, 2-10 mcg/min
Dopamine Drip, 2-20 mcg/kg/min

Paced
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

Multifocal PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Multifocal PVCs
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Frank Yanowitz M.D.

PAC
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consider 0.5 Atropine if symptomatic and slow
PAC
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consider 0.5 Atropine if symptomatic and slow

NSR
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
NSR
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Google Images

NSR
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
NSR
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint

Paced
ABC, O2, IV, Monitor (3 & no12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
ABC, O2, IV, Monitor (3 & no12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Google Images

NSR with High T-wave
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
NSR with High T-wave
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
56 y/o dialysis patient C/O SOB due to missed dialysis

Paced
ABC, O2, IV, Monitor (3 & no12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
ABC, O2, IV, Monitor (3 & no12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
79 y/o female with weakness, internal defib went off 30 minutes ago, BP=144/86
Google Images

Paced with PVC
ABC, Advanced Airway, ResQpod, Mechanical CPR
@2 min, change compressor, CPR
O2-IV-Monitor, H's and T's
Epinephrine 1 mg every 4 min
@2 min, change compressor, CPR
Epinephrine Drip, 2-10 mcg/min
Dopamine Drip, 2-20 mcg/kg/min
Paced with PVC
ABC, Advanced Airway, ResQpod, Mechanical CPR
@2 min, change compressor, CPR
O2-IV-Monitor, H’s and T’s
Epinephrine 1 mg every 4 min
@2 min, change compressor, CPR
Epinephrine Drip, 2-10 mcg/min
Dopamine Drip, 2-20 mcg/kg/min
99 y/o female, unresponsive, no respiration, no pulse

Paced
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
68 y/o male who cut his finger on a table saw

Paced
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Paced
ABC, O2, IV, Monitor (3 & no 12 Lead, why?)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
78 y/o female C/O SOB, cough, temp

Sinus with PJC
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Sinus with PJC
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
42 y/o male working in office, palpitations, BP=142/96
Frank Yanowitz M.D.

Sinus Arrest
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Sinus Arrest
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
26 y/o female mild SOB
Google Images

Sinus Bradycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Atropine 0.5 mg
Sinus Bradycardia
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Atropine 0.5 mg
49 y/o female c/o dizziness, BP=116/72, R=20
Google Images

Sinus Tachycardia-Unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Adenosine, 6 mg with 20cc flush, 12 mg with 20 cc flush
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
Sinus Tachycardia-Unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Adenosine, 6 mg with 20cc flush, 12 mg with 20 cc flush
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
56 y/o female, shopping, sudden onset of chest pain, BP=78/32
Google Images

Sinus to V-tach without a pulse
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg 
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
Sinus to V-tach without a pulse
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
52 y/o manager, chest pain, SOB to unconscious
Google Images

Sinus with Bigeminy
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
66 y/o female with syncope getting up from the kitchen table

Sinus with Bigeminy
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Sinus with Bigeminy
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
24 y/o male, been doing cocaine for 2 days, chest pain and SOB. BP=184/126

Third Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace
Third Degree Block
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Pace
88 y/o female in nursing home, responds to pain, BP 60/30, R=6

Ventricular Coupling
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Ventricular Coupling
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
70 y/o male, SOB after working in the yard, BP 92/54, R=28
Frank Yanowitz M.D.

Ventricular Quadgeminy
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
 Antiarrhythmic if fast
 Atropine if slow
Ventricular Quadgeminy
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Maintain appropriate vital signs and perfusion
Treat life threats and chief complaint
Consult with MD to consider:
Antiarrhythmic if fast
Atropine if slow
92 y/o female, no complaints
Frank Yanowitz M.D.

V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg 
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
42 y/o construction worker collapsed, unresponsive, no breath, no pulse
Google Images

V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H's and T's 
Epinephrine 1mg 
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
V-Fib
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
Fire fighter at working fire. Collapsed, no response, no breath, no pulse

V-Tach with a pulse-unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
V-Tach with a pulse-unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
78 y/o male with chest pain, 8/10, BP 88/52
Google Images

V-Tach pulseless
Shock or 2-min of CPR
ABC, Advanced Airway, ResQpod, H’s and T’s
Epinephrine 1mg
@2 min, shock, change compressor, CPR
Amiodarone 300mg
@2 min, shock, change compressor, CPR
Epinephrine, 1 mg
@2 min, shock, change compressor, CPR
Amiodarone 150 mg
Consider bicarb, Mag. Sulfate (torsade de points)
66 y/o male in nursing home, unresponsive, no pulse

V-Tach with a pulse-unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
V-Tach with a pulse-unstable
ABC, O2, IV, Monitor (3 & 12 Lead)
SAMPLE, OPQRST, Vital Signs
Consider Sedation
Synchronized cardioversion: dosage per monitor
Synchronized cardioversion: Increase joules per monitor
56 y/o male with syncope, BP 78/40

WPW with Delta Wave

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