ACLS Review

26 ACLS (Advanced Cardiac Life Support) Review ...
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What is the most common cause of an accelerated junctional rhythm?
Digitalis toxicity
What is the following rhythm?
Atrial fibrillation with runs of ventricular tachycardia.
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What are the ECG findings suspected in a patient with hyperkalemia?
K 6.5–7.5 mEq/L: Prolonged P–R interval, widened QRS, decrease in P wave amplitude, tall-peaked T waves, and
ST segment depressed or elevated.
K 7.5–8.5 mEq/L: Wide QRS, further flattening of the P wave with widening, and bundle branch blocks as well as
AV blocks may occur.
K greater than 8.5 mEq/L: P wave is absent, very wide QRS, ventricular dysrhythmias including V-fib, V-tach, and
asystole.
What are the causes of cardiac dysrhythmias?
Disturbances in conductivity, such as with Wolff–Parkinson–White syndrome, or AV block and disturbances in
automaticity, such as premature atrial, junctional or ventricular complexes, atrial or ventricular tachycardia, sinus
bradycardia, and sinus tachycardia.
❍ A conduction defect above the level of the His bundle will result in .
Changes in P wave and P–R interval.
❍ Conduction defects at or below the level of the His bundle will result in .
Conduction problems involving the QRS complex with QRS widening.
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What is supraventricular tachycardia (SVT)?
It is a nonspecific dysrhythmia that cannot be individually distinguished due to its high rate. SVT is characterized
by a narrow QRS complex in which P waves often cannot be distinguished from the preceding T wave.
What are the possible causes of torsades de pointes?
Anorexia, bulimia, electrolyte abnormalities, and drug-induced; typically by tricyclic antidepressants. Also,
antidysrhythmics, including procainamide, flecainide, and quinidine, antibiotics, such as erythromycin, and
antihistamines, such as terfenadine.