Rhythm recognition, STEMI criteria, treatment of arrhythmias, and prehospital cardiac care protocols.
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- What minimum ST-segment elevation in two or more contiguous limb leads meets STEMI criteria?
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At least 1 mm (0.1 mV)
- What minimum ST-segment elevation in two or more contiguous precordial (chest) leads meets STEMI criteria?
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At least 2 mm (0.2 mV)
- Which EKG leads show changes in an inferior wall MI?
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Leads II, III, and aVF
- Which EKG leads show changes in an anterior wall MI?
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Leads V1 through V4
- Which EKG leads show changes in a lateral wall MI?
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Leads I, aVL, V5, and V6
- In a suspected inferior MI, which extra lead should be placed to check for right ventricular involvement?
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Lead V4R (right-sided V4)
- Why is nitroglycerin withheld in a right ventricular infarction?
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The right ventricle depends on preload, so nitroglycerin can cause a severe drop in blood pressure
- What EKG finding in leads V1-V2 suggests a posterior wall MI?
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ST depression with tall, broad R waves
- What is the first-line drug for symptomatic bradycardia with a pulse?
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Atropine
- What is the adult IV dose of atropine for symptomatic bradycardia?
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1 mg, repeated every 3 to 5 minutes up to a maximum of 3 mg
- What intervention is used for symptomatic bradycardia that does not respond to atropine?
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Transcutaneous pacing
- What is the first-line drug for stable narrow-complex SVT?
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Adenosine
- What is the initial adult dose of adenosine for SVT?
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6 mg rapid IV push, followed immediately by a saline flush
- What is the second dose of adenosine if the first dose does not convert SVT?
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12 mg rapid IV push
- What bedside maneuvers can be tried before adenosine for stable SVT?
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Vagal maneuvers, such as Valsalva or carotid sinus massage