ACLS

What is the first dose of amiodarone for treatment of VF/pVT? A: 1 mg/kg B: 300 mg C: 350 mg D: 150 mg

B: 300 mg

What is the preferred route for access of drugs when IV access is not available? A: Endotracheal B: Intraosseous C: Subcutaneous D: Sublingual

B: Intraosseous

Which of the following drugs is not used in treatment of acute stroke? A: rtPA B: Naloxone C: Enalaprilat D: Aspirin

B: Naloxone

Which of the following is not usually associated with hypoxemia? A: Cyanosis B: Rapid rate C: Changes in blood gases D: Airway problems

B: Rapid rate

Which of the following drugs are used in asystole in ACLS? A: Procainamide 20 mg IV B: Adenosine 6 mg IV push C: Epinephrine 1 mg IV every 3-5 minutes D: Amiodarone 300 mg bolus

C: Epinephrine 1 mg IV every 3-5 minutes

Which of the following is not one of the H's and T's? A: Hypovolemia B: Tension pneumothorax C: Trauma D: All of the above are correct Spaced repetition C: Traum

C: Trauma

Scenario 3. Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor:asystole What ACLS algorithm are you going to begin this scenario with? Cardiac Arrest (VT/VF branch) Bradycardia (unstable branch) Cardiac Arrest (Asystole/PEA branch) Unstable Tachycardia

Cardiac Arrest (Asystole/PEA branch)

Hyperventilation increases interthoracic pressure which causes decrease in

Cardiac output

Agonal gasp according to the ACLS is an indication of

Cardial Arrest

What action is recommended to help minimize interruptions in chest compressions during CPR? 1.Identifying And treating early clinical deterioration. 2.Continue CPR while charging the defibrillator. 3.Simple Airway manuevers and assisted ventilations. 4.Chest Compressions may not be effective.

Continue CPR while charging the defibrillator.

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor: rhythm strip asystole Vasopressin 40 U IV can replace the 1st or 2nd dose of epinephrine in the cardiac arrest algorithm. True False

False

For PEA a rhythm and pulse check should be performed after________cycles of CPR.

Five

You perform defibrillation with 120 J. What is your next intervention? Deliver a second shock (120-200 J) Give 1mg Epinephrine IV push (repeat the epinephrine every 3-5 minutes) Give 5 cycles of CPR Check the rhythm and the pulse

Give 5 cycles of CPR

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor: asystole As an EMS provider in the out of hospital setting, your first step is to: Give epinephrine 1mg IV/IO Give CPR for 5 cycles Give atropine 1mg IV/IO Give 1 unsynchronized shock (120-200 J)

Give CPR for 5 cycles

For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally presented with V-FIB. After the 1st shock, the ECG screen displayed asystole which has persisted despite 2 doses of epi, a fluid bolus, and high quality CPR. What is your next treatment? 1.Providing quality compressions immediately before a defibrillation attempt. 2.Consider terminating resuscitive efforts after consulting medical control. 3.Provide continuous chest compressionswithout pauses and 10 ventilations per minute. 4.Continue CPR while charging the defibrillator.

2.Consider terminating resuscitive efforts after consulting medical control.

What is an advantage of using hands-free d-fib pads instead of d-fib paddles? 1.Optimizing ventilation and oxygenation. 2.Hands-free allows for more rapid d-fib. 3.Simple airway manuevers and assisted ventilations. 4.Syncronized cardioversion.

2.Hands-free allows for more rapid d-fib.

What is the best strategy for perfoming high-quality CPR on a pt.with an advanced airway in place? 1.Providing quality compressions immediately before a defibrillation attempt. 2.Provide continuous chest compressionswithout pauses and 10 ventilations per minute. 3.Identifying and treating early clinical deterioration. 4.Suction during withdrawl, but not for longer than 10 seconds. .

2.Provide continuous chest compressionswithout pauses and 10 ventilations per minute.

Which action improves the quality of chest compressions delivered during resuscitave attempts? 1.Suction during withdrawl, but not for longer than 10 seconds. 2.Switch providers about every 2 min or every 5 compression cycles. 3.Providing quality compressions immediately before a defibrillation attempt. 4.Be sure O2 is NOT blowing over the pt's chest during shock.

2.Switch providers about every 2 min or every 5 compression cycles.

Which of the following is a sign of effective CPR? 1. 90mm hg 2. Amioderone 300mg 3. PETCO2 = or > 10mm Hg 4. 35-40mm hg.

3. PETCO2 = or > 10mm Hg

A monitored pt. in the ICU developed a suddent onset of narrow complex tach at a rate of 220/min. The pt's BP is 128/58, the PETCO2 is 38mm Hg, and the O2 sat is 98%. There is an EJ established for vascular access. The pt. denies taking any vasodialators. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. What is the next intervention? 1.Amioderone 300mg 2.Adenosine 12mg IV 3.Adenosine 6mg Iv 4.Adenosine 7mg Iv

3.Adenosine 12mg Iv

The use of quantitative capnography in intubated pt's does what? 1.Allowing complete Chest recoil 2.Peripheral iv 3.Allows for monitoring CPR quality 4.Responding to Verbal commands

3.Allows for monitoring CPR quality

Which drug and dose are recommended for the management of a pt. in refractory V-FIB? 1. Epinephrenine 12mg 2.Adenosine 12mg iv 3.Amioderone 300mg 4.Amioderone 299mg

3.Amioderone 300mg

A pt. presents to the ER with a new onset of dizziness and fatigue. On examination, the pt's heart rate is 35 beats/min, BP is 70/50, resp. rate is 22 per min, O2 sat is 95%. What is the appropriate 1st medication? 1. Vagal manuever. 2. amionorone 12mg 3.Atropine 0.5mg 4.Adenosine 12mg iv

3.Atropine 0.5mg

What is the primary purpose of a medical emergency team or rapid response team? 1.Continue cpr while charging the defibrillator. 2.Syncronized cardioversion. 3.Identifying and treating early clinical deterioration. 4.Optimizing ventilation and oxygenation.

3.Identifying and treating early clinical deterioration

Scenario 2. Scenario 2 data: You are caring for a 50-year-old female. She is 2 days post-op. from a total hip replacement. 6L/min by nasal cannula. When you enter the patient's room, she appears to be unconscious and you note that her nasal cannula is laying beside her bed. Your initial assessment reveals: SKIN: ashen, diaphoretic, warm CVS: Carotid pulse only, HR 25, unable to obtain blood pressure RESP: sporadic and shallow CNS: Unresponsive Monitor: asystole You have called for help. Being an in-hospital setting emergency, your first priority is to: 1. give epinephrine 2.begin chest compressions 3.secure the airway and ventilate with BVM (bag valve mask) 4.establish IV access

3.secure the airway and ventilate with BVM (bag valve mask)

You have given the epinephrine and completed the 5 cycles of CPR. A rhythm check reveals no change. You attempt a third defibrillation. What will be your defibrillator setting?(In all scenarios, assume that the biphasic defibrillator shock setting can be from 50-360 Joules. The shock selection on many biphasic defibrillators can vary.) 300 Joules 150 Joules 120 Joules 50 Joules

300 Joules

What is the correct dosing for amiodarone in the Cardiac Arrest Algorithm? 150mg IV once. If this in not effective give 300mg IV once. 200mg IV once. 300mg IV once. Then consider an additional 150mg IV once. give IV infusion of 300mg per hour

300mg IV once. Then consider an additional 150mg IV once.

During CPR with no advanced airway in place the compression-to-ventilation ratio is: 5:1 30:2 10:1 20:2

30:2

Normal PETCO2 level?

35-40 mmHg

What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min? 1. 1 breath every 15-20 seconds 2. 1 to 2 liters 3. 4 breath every 5-6 seconds 4. 1 breath every 5-6 seconds

4. 1 breath every 5-6 seconds

Which action increases the chance of successful conversion of ventricular fibrillation? 1.Allowing complete chest recoil 2.Identifying and treating early clinical deterioration. 3.Provide continuous chest compressions without pauses and 10 ventilations per minute. 4.Providing quality compressions immediately before a defibrillation attempt.

4.Providing quality compressions immediately before a defibrillation attempt

As you begin CPR, you recall the number of CPR cycles that are to be delivered between other interventions is ________ and you also recall that the correct compression-to-ventilation ratio is __________. 5, 30:2 10, 10:2 2, 30:2 15, 10:1

5, 30:2

After completing 5 cycles of CPR, the rhythm is unchanged. You shock a second time with 200 J and resume CPR. While completing the cycle of CPR what else should be done? Give Epinephrine 1 mg IV push (repeat every 3-5 minutes) Vasopressin 40 U IV push to replace the 1st or 2nd dose of epinephrine Give Epinephrine 0.5mg IV push (repeat every 3-5 minutes) Either 1 or 2 is correct

Give Epinephrine 1 mg IV push (repeat every 3-5 minutes)

After synchronized cardioversion is unsuccessful, the pt. continues to deteriorate. The patient is now unconscious with pulseless ventricular tachycardia. Below is what you see on the monitor: What is the first and most important intervention? Begin CPR and give 5 cycles before shocking Give Epinephrine 1mg IV push (repeat every 3-5 minutes) Give one unsynchronized shock (120-200 J) Place an advanced airway

Give one unsynchronized shock (120-200 J)

You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now?

Obtain a 12 lead EKG

During CPR after an advanced airway is in place, which of the following is true: The breaths should be synchronized with the chest compressions. The goal is 20 or greater breaths per minute Chest compressions should be stopped while giving breaths. One breath every 6 seconds should be given

One breath every 6 seconds should be given

What is the preferred method of access for epi administration during cardiac arrest in most pts? a. Resume Compressions b. Early Defibrillation c. Adenosine 12mg Iv d. Peripheral IV

Peripheral IV

Which situation BEST describes PEA?

Sinus rythm without a pulse

After providing a shock with an AED you should: Start CPR, beginning with chest compressions check a pulse give a rescue breath let the AED reanalyze the rhythm

Start CPR, beginning with chest compressions

What is this rhythm?

Third degree AV block

You recognize this rhythm because there is no apparent relationship between the P-waves and the QRS complexes. What is the rhythm?

Third degree AV block

As you finish up with the first cycle of CPR and give the first dose of epinephrine (1mg IVP), the rhythm changes. The rhythm below is what you now see on the monitor. The patient remains unresponsive. What is this rhythm? artifact ventricular tachycardia atrial fibrillation ventricular fibrillation

V-Fib

Within the VT/VF pulseless arrest algorithm, the amiodarone dosing is as follows:

a) 300mg IV/IO push → (if no conversion) b) 150 mg IV/IO push → (after conversion) c) Infusion #1 360 mg IV over 6 hours (1mg/min) → d) Infusion #2 540 mg IV over 18 hours (0.5mg/min)

The goal of BLS interventions for a patient in respiratory or cardiac arrest is to: restore effective oxygenation restore effective ventilation restore or support effective circulation

all of above the above

After you initiate TCP the patient continues to stabilize. VS are: HR 70; BP 105/75; RR 5; You continue to support ventilation with the bag valve mask, and TCP continues. If transcutaneous pacing was not available, what medication can be considered as an alternative? atropine dopamine epinephrine vasopressin either 2 or 3 none of the above

either 2or 3 dopamine epinephrine

You give a second shock and perform 5 cycles of CPR. What medication should you give after the second shock during CPR? epinephrine amiodarone atropine lidocaine

epinephrine

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor: asystole After your IV is secure, your next step involves giving a medication. What medication should be used? epinephrine 0.5mg IV atropine 1mg IV vasopressin 40 U IV epinephrine 1mg IV

epinephrine 1mg IV

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor strip: asystole Epinephrine should be repeated at what frequency for the treatment of Asystole? every 3-6 minutes every 3-5 minutes only 3 times after each cycle of CPR

every 3-5 minutes

A second shock is delivered at 200 J, and CPR is continued. Your next intervention is to: seek expert consultation consider giving antiarrhythmics check a pulse for no more than 10 seconds give 1 mg epinephrine while continuing CPR

give 1 mg epinephrine while continuing CPR

You shock the patient with 120 J and continue CPR immediately. After 5 cycles of CPR, your rhythm check reveals continued ventricular fibrillation. What is your next step? give epinephrine 1mg IV/IO check to see that your leads are still connected give 1 shock give atropine 0.5mg IV/IO

give 1 shock

You determine that this rhythm is ventricular fibrillation, and you begin the VF cardiac arrest algorithm (left branch). What is your first intervention? give 1 shock (120-200 J) give 3 stacked shocks continue CPR (5 cycles) give epinephrine 1mg IV/IO

give 1 shock (120-200 J)

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor strip: asystole You give epinephrine 1 mg IV and finish the cycle of CPR. What is your next intervention? give amiodarone 300 mg IV give epinephrine 1 mg IV shock 120-200 J rhythm check

rhythm check

You give the amiodarone 300 mg IV and after completing the 5 cycles of CPR you check the rhythm. What is your next step? give amiodarone 150 mg IV consider giving atropine 0.5mg IV shock (360 J) check a pulse

shock (360 J)

Typically, suctioning attempts in ACLS situations should be: ten seconds or less 20 seconds or less 5 seconds or less no more than 30 seconds

ten seconds or less

What is the H's in ACLS H&Ts

*Hypovolemia *Hypoxia *Hydrogen ion (acidosis) *Hyper-/hypokalemia *Hypothermia.

What is the T's in ACLS H&Ts

*Toxins * Tamponade(cardiac) *Tension pneumothorax * Thrombosis (coronary and pulmonary)

Your rhythm check reveals continued pulseless VT. What are your next 2 steps? 1 shock, check rhythm 1 shock 200 Joules, epinephrine 1mg IV 5 cycles CPR, epinephrine 1mg IV 1 shock 200 Joules, 5 cycles CPR

1 shock 200 Joules, 5 cycles CPR

Lidocaine can be used instead of amiodarone as an antiarrhythmic during cardiac arrest. What is the proper dosing of lidocaine? 1.5 mg IV first dose, then 0.75 mg IV 3 mg/kg rapid IV push 0.5 to 0.75 mg/kg IV, if no affect 1 to 1.5 mg/kg IV 1 to 1.5 mg/kg first dose, then 0.5 to 0.75 mg/kg IV

1 to 1.5 mg/kg first dose, then 0.5 to 0.75 mg/kg IV

What is the appropriate interval for an interruption in chest compressions? 1. 10 seconds or less 2. 8-10 breaths per minute 3. 1 breath every 5-6 seconds 4. 90mm hg

1. 10 seconds or less

ou have performed vagal maneuvers. This is what you see on the monitor: What is your next step? 1. Give adenosine 6mg rapid IV push. If no conversion, give 12mg rapid IV push 2. Give adenosine 12mg rapid IV push. If no conversion, give another 12mg rapid IV push. 3. Give Amiodarone 150mg over 10 minutes. May repeat as needed 4. Continue to attempt vagal manuvers until the patient converts to a regular sinus rhythm

1. Give adenosine 6mg rapid IV push. If no conversion, give 12mg rapid IV push

You are caring for a 50-year-old female. She is 2 days post-op. from a total hip replacement. 6L/min by nasal cannula. When you enter the patient's room, she appears to be unconscious and you note that her nasal cannula is laying beside her bed. Your initial assessment reveals: SKIN: ashen, diaphoretic, warm CVS: Carotid pulse only, HR 25, unable to obtain blood pressure RESP: sporadic and shallow CNS: Unresponsive Monitor: asystole Which is the correct order for treatment in this scenario? 1. assist breathing and give oxygen, monitor ECG & VS, establish IV access 2. give oxygen, monitor ECG & VS, establish IV access, assist breathing 3. monitor ECG & VS, assist breathing and give oxygen, establish IV access 4. establish IV access, Give oxygen, monitor ECG & VS, assist breathing

1. assist breathing and give oxygen, monitor ECG & VS, establish IV access

Which action is included in the BLS survey? 1.Early defibrillation 2.Continuous waveform capnography 3.Peripheral iv 4.Resume compressions

1.Early defibrillation

What is acommon but sometimes fatal mistake in cardiac arrest management? Choose matching definition 1.Prolonged interruptions in chest compressions. 2.Simple airway manuevers and assisted ventilations. 3.Hands-free allows for more rapid d-fib. 4.Identifying and treating early clinical deterioration.

1.Prolonged interruptions in chest compressions.

You give amiodarone 300 mg (first dose) and finish the cycle of CPR. Upon a rhythm check, you see, the patient has converted to a normal sinus rhythm and has a pulse (ROSC). As you begin the post-arrest phase, the patient has a short run of VT. In light of the continued arrhythmia, you are instructed to start an amiodarone drip for post-resuscitation maintenance therapy. What is dose for amiodarone drip

150 mg over 10 mins 1mg/min for the 1st 6 hrs

A pt. presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt? 1-2-10 mcg/kg/min 2. 7-17mcg/kg/min 3. 22-42mcg/kg/min 4. 1-11mcg/kg/min

2-10 mcg/kg/min

Which is the correct dosing for an epinephrine infusion in the bradycardia algorithm? 1 mg/min 2-10 mcg/kg/min 2-10 mcg/min 0.5mg/min

2-10 mcg/min

A pt. presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt?

2-10mcg/kg/min

You give amiodarone 300 mg (first dose) and finish the cycle of CPR. Upon a rhythm check, you see, the patient has converted to a normal sinus rhythm and has a pulse (ROSC). As you begin the post-arrest phase, the patient has a short run of VT. In light of the continued arrhythmia, you are instructed to start an amiodarone drip for post-resuscitation maintenance therapy. What is maximum cumulative dose for amiodarone in a 24 hour period? 2.2 grams 3.2 grams 1.5 grams 5.6 grams

2.2 grams

You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the pt. has no pulse. You partner resumes chest compressions and an IV is in place. What management step is your next priority? Choose matching definition 1.Adenosine 12mg iv 2.Administer 1mg of epinepherine 3.Administer 0mg of epinepherine 4.Administer 9mg of epinepherine

2.Administer 1mg of epinepherine

Which action is a componant of high-quality chest comressions? 1.Allows for monitoring cpr quality 2.Allowing complete chest recoil 3.Resume compressions 4.Peripheral iv

2.Allowing complete chest recoil

Scenario 1. Scenario 1 data:A 40-year-old man arrives at the ER accompanied by his family. He is complaining of palpitations after working outside for several hours. The assessment is as follows: SKIN: Hydrated, pale, warm and dry CVS: Strong peripheral pulses and a BP of 125/80 CNS: Fully intact RESP: RR is 22, no resp. difficulties, lungs CTA You start an IV on the patient. The monitor shows a narrow complex SVT (160). What is your next intervention? 1. Give adenosine 6mg rapid IV push 2.Attempt vagal maneuvers 3.Perform immediate synchronized cardioversion 4.Give epinephrine 1mg IV push

2.Attempt vagal maneuvers

Which is a safe and effective practice within the defibrillation sequence? 1.Prolonged interruptions in chest compressions. 2.Be sure O2 is NOT blowing over the pt's chest during shock. 3.Hands-free allows for more rapid d-fib. 4.Identifying and treating early clinical deterioration.

2.Be sure O2 is NOT blowing over the pt's chest during shock.

During your assessment, your pt suddenly loses consciousness. After calling for help and determining that the pt. is not breathing, you are unsure whether the pt. has a pulse. What is your next action? 1.Cinncinati Stroke Scale 2.Begin chest compressions. 3.Syncronized cardioversion. 4.Resume compressions

2.Begin chest compressions

3 min after witnessing a cardiac arrest, one memeber of your team inserts an ET tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a wavefom on the capnogrophy screen and a PETCO2 of 8 mm Hg. What is the significance of this finding? 1.Resume compressions 2.Chest compressions may not be effective. 3.Begin chest compressions. 4.Continue cpr while charging the defibrillator.

2.Chest compressions may not be effective.

You give 6mg Adenosine rapid IV push with no effect. 12mg Adenosine rapid IV push is then given. The patient develops severe chest pain, his rhythm is the same, and his vital signs are: HR 220, BP (not obtainable), and weak pulse. The patient also has LOC changes. Your next step should be? perform immediate defibrillation give 2nd dose of 12mg adenosine rapid IV push perform immediate synchronized cardioversion perform precordial thump

perform immediate synchronized cardioversion

You deliver 1 shock of 120J fot a pVT patient .After the shock what is the your next step? deliver a second shock check a pulse resume CPR (5 cycles) give epinephrine 1mg IV

resume CPR (5 cycles)

The most important intervention with witnessed sudden cardiac arrest is: early defibrillation effective chest compressions early activation of EMS rapid use of resuscitation drugs

early defibrillation

You have resumed CPR. Your next intervention after 5 cycles of CPR is to: perform a rhythm check assess breathing shock before any other intervention give epinephrine

perform a rhythm check

Which of the following is an initial treatment for PEA? A: CPR B: 360 J shock (monophasic) C: Amiodarone D: Advanced airway placement

A: CPR

What is the next action in the ACLS acute stroke algorithm if a patient with acute ischemic stroke remains a candidate for thrombolytic therapy after passing the relative exclusion criteria? A: Discuss relative risks or benefits with the patient or family members B: Proceed with rtPA if patient onset of symptoms was within 6 hours C: Begin anticoagulant therapy D: All of the above

A: Discuss relative risks or benefits with the patient or family members

Tachycardia in an adult is generally classified as a heart rhythm with a rate that is: A: Greater than 100 B: Greater than 150 C: Less than 100 D: Greater than 300

A: Greater than 100

The third shock is delivered and you restart CPR (5 cycles). What medication should be given after the 3rd shock during CPR? Amiodarone 300 mg Lopressor 50 mg Atropine 1mg Dopamine 5-20 mcg/min

Amiodarone 300 mg

Scenario 3. Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor:see image As you prepare for an epinephrine infusion and consider transvenous pacing, the patient's rhythm suddenly changes. This is what you see on the monitor. What should be checked to ensure that this is true asystole? 1. loose leads or leads not connected to the patient 2. signal gain 3. ensure that the patient is pulseless 4. all of the above

all of the above

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor: asystole While the EMS team is providing 5 cycles of CPR what other activities can be completed? secure the airway start an IV provide the patient with oxygen all of the above.

all of the above.

You shock the patient and complete 5 cycles of CPR. After the CPR, you see the following rhythm on the monitor. You perform a pulse check. The patient now has a palpable pulse. VS are: HR 60; BP 105/65; RR 5-8 You have corrected the ventricular fibrillation and the patient is stabilizing but has had several short runs of ventricular tachycardia post-arrest. You now consider maintenance antiarrhythmic therapy that can be started if any arrhythmias persist in the post-arrest phase. Which is the best drug of choice in this scenario? amiodarone lidocaine epinephrine magnesium sulfate

amiodarone

The epinephrine is given and the round of CPR completed. A rhythm check reveals no change in the rhythm and pulseless VT continues. You shock with 300 J and start another cycle of CPR. What medication are you going to give at this time? give lidocaine 1-1.5 mg IV epinephrine 1 mg IV amiodarone 300 mg IV vasopressin 40 U IV

amiodarone 300 mg IV

You are caring for a 50-year-old female. She is 2 days post-op. from a total hip replacement. 6L/min by nasal cannula. When you enter the patient's room, she appears to be unconscious and you note that her nasal cannula is laying beside her bed. Your initial assessment reveals: SKIN: ashen, diaphoretic, warm CVS: Carotid pulse only, HR 25, unable to obtain blood pressure RESP: sporadic and shallow CNS: Unresponsive Monitor: see image You give atropine 1 mg IV push. There is no change in the patients rhythm/rate. What will be your next intervention? attempt transcutaneous pacing increase atropine to 1mg IVP adenosine 1mg IVP norepinephrine 1mg IVP

attempt transcutaneous pacing

You confirm that this is true asystole and that the patient has no pulse. You begin the cardiac arrest algorithm. Your first step is to: give 1 shock (120-200 J) give epinephrine 1 mg begin CPR immediately continue transcutaneous pacing

begin CPR immediately

Scenario 3. Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor:see image Transcutaneous pacing is attempted. You set the pacing rate for 60/min and attempt capture. After trying for about 30-40 seconds, you are unable to achieve capture. What other medication may now be considered for use in the bradycardia algorithm? epinephrine dopamine amiodarone both epinephrine or dopamine both dopamine or amiodarone

both epinephrine or dopamine

An AED does not promptly analyze a rythm. What is your next step? a. Simple airway maneuvers and assisted ventilation b. Vagal maneuvers c. Begin chest compressions d. Evidence of rigor mortis

c. Begin chest compressions

You give amiodarone 300 mg IV and finish the cycle of CPR, your rhythm check reveals continued pulseless VT, continuing on, you shock the patient with 360 J. What is your intervention at this time. complete 5 cycles of CPR check a pulse start amiodarone drip give epinephrine 1 mg IV

complete 5 cycles of CPR

What is the preferred method of access for epi administration during cardiac arrest in most pts? a. Resume compressions b. Adenosine 12 mg IV c. Early Defribilation d. Peripheral IV

d.Peripheral IV

After giving the first dose of epinephrine you finish the cycle of CPR. A rhythm check shows that the patient's rhythm changed from asystole to the rhythm below. He also remains pulseless. Your first action is to: give 5 cycles of CPR give another dose of epinephrine 1mg IV give 1 unsynchronized shock (120-200 J) give amiodarone 300mg IV x 1

give 1 unsynchronized shock (120-200 J)

The epinephrine is given, and after the cycle of CPR is completed a rhythm check reveals continued ventricular fibrillation. You give a third shock (300 J) and resume CPR. What is your next intervention during CPR? give lidocaine 2 to 2.5 mg/kg IV/IO give magnesium 2 to 4 grams IV/IO give atropine 1mg IV/IO give amiodarone 300mg IV/IO

give amiodarone 300mg IV/IO

Scenario data: A 65-year-old male collapses as he is out for his morning walk. A bystander witnessed the collapse, activates EMS, and begins CPR. The EMS team arrives 6 minutes later. The monitor is attached and the assessment is as follows: Skin: cold/clammy/cyanotic Cardiovascular: no pulse Respiratory: no respirations CNS: no response Monitor strip: V-Tach After giving the first dose of epinephrine you finish the cycle of CPR. A rhythm check shows that the patient's rhythm changed from asystole to V-tach. He also remains pulseless. Your first action is to: give 5 cycles of CPR give another dose of epinephrine 1mg IV give 1 unsynchronized shock (120-200 J) give amiodarone 300mg IV x 1

give another dose of epinephrine 1mg IV

You are caring for a 50-year-old female. She is 2 days post-op. from a total hip replacement. 6L/min by nasal cannula. When you enter the patient's room, she appears to be unconscious and you note that her nasal cannula is laying beside her bed. Your initial assessment reveals: SKIN: ashen, diaphoretic, warm CVS: Carotid pulse only, HR 25, unable to obtain blood pressure RESP: sporadic and shallow CNS: Unresponsive Monitor: see image An IV has been established. The patient is showing clear signs of poor perfusion with the following rhythm. observe and monitor give adenosine 6mg rapid IV push give atropine 1 mg IV begin CPR

give atropine 1 mg IV

After you begin CPR what is your next step? give atropine 1 mg IV/IO continue CPR, nothing else can be done give 1 shock give epinephrine 1 mg IV/IO

give epinephrine 1 mg IV/IO

Great Job! You saved the patient He has been stabilized and intubated, but does not respond to verbal commands. He is transported to the hospital's ICU. Since the patient is not responsive what would be the most important intervention in the post-cardiac arrest phase. monitor waveform capnography obtain an arterial blood gas induce therapeutic hypothermia monitor oxygen saturation

induce therapeutic hypothermia

After completing 5 cycles of CPR a rhythm check reveals the following: Your pulse check reveals a faint palpable pulse. VS are: HR 30; BP 78/58; and the patient does not have spontaneous breathing. What is the next step? continue CPR give atropine 1 mg IV perform synchronized cardioversion initiate transcutaneous pacing

initiate transcutaneous pacing The defibrillator/pacer is attached and the rhythm is 3rd degree block.. The patient's perfusion status is unstable (low BP, low HR). In this case, administration of atropine could delay pacing. The most important intervention would be to implement transcutaneous pacing. Now may also be a good time to perform intubation as well.