Pulseless ventricular adult

Cardiopulmonary arrest in adults usually results from arrhythmias. The most common arrhythmias are ventricular fibrillation (VF) and pulseless ventricular tachycardia (PVT), often in patients after myocardial infarction (MI) or pulmonary embolism (PE). In children, cardiopulmonary arrest is often the terminal event of progressive shock or respiratory failure. 

FIGURE 7-1. Advanced cardiac life support (ACLS) treatment algorithm for adult cardiopulmonary arrest. (CPR, cardiopulmonary resuscitation PEA, pulseless electrical activity PVT, pulseless ventricular tachycardia VF, ventricular fibrillation.)... 

Pulseless Ventricular Tachycardia/Ventricular Fibrillation Adult... 

Procainamide (Pronestyl, Pronestyl SR, Procanbid) [Antiarrhythmic] WARNING Only use in life-treating arrhythmias hematologic tox can be severe Uses Supraventricular/ventricular arrhythmias Action Class 1A antiarrhythmic (Table VI-7) Dose Adults. Recurrent VF/pulseless VT 20 mg/min slow IV inf to a max of 17 mg/kg or until QRS T by 50% or dysrhythmia resolves Maint inf 4 mg/min (mix 1 gm in 250 mL NS to make 4 mg/mL use 60 gtt set—60 gtt/min = 4 mg) Peds. Loading dose 15-50 mg/kg IV/IO Caution [C, +] Contra Complete heart block, 2nd- or 3rd-degree heart block w/o pacemaker, torsades de pointes, SLE Disp Tabs caps 250, 500 mg SR tabs 500, 750, 1000 mg inj 100, 500 mg/mL SE 1 BP, lupus-like synd, GI upset, taste perversion, arrhythmias, tach, heart block, angioneurotic edema, blood dyscrasias Interactions T Effects W/ acetazolamide, amiodarone, cimetidine, ranitidine, trimethoprim T effects OF anticholinergics, antihypertensives i effects W/ procaine, EtOH EMS Monitor BP and ECG use caution to prevent rapid... 

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