Ch 21 EMT: Resuscitation
You are transporting a 50-year-old male patient whom you successfully defibrillated at the scene. You are 5 minutes away from the hospital when the patient goes back into cardiac arrest. Which of the following is the BEST course of action? A. Tell the driver to stop, analyze the cardiac rhythm, and deliver a shock as necessary. B. Tell the driver to stop and assist you with CPR, and request another unit for assistance. C. Initiate CPR and continue transporting. D. Analyze the cardiac rhythm and deliver shocks as necessary.
A. Tell the driver to stop, analyze the cardiac rhythm, and deliver a shock as necessary.
Which of the following statements about the AED is correct? A. The AED can encounter difficulty in analyzing a rhythm in a moving vehicle. B. Biphasic AEDs can analyze the rhythm in a moving vehicle. C. AEDs can analyze in a moving vehicle but cannot shock. D. The AED can always analyze the rhythm in a moving vehicle.
A. The AED can encounter difficulty in analyzing a rhythm in a moving vehicle.
If you are in doubt as to when or whether to terminate resuscitation efforts, seek the advice of: A. another EMT. B. a family member of the patient. C. an ALS provider. D. a physician.
D. a physician.
Blunt and penetrating injuries can damage chambers of the heart or cause conditions like: A. asphyxial cardiac arrest. B. ventricular tachycardia. C. ventricular fibrillation. D. pericardial tamponade.
D. pericardial tamponade.
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED advises shock. After defibrillating the patient, what is your next intervention? A. Continue CPR. B. Check for a pulse. C. Insert a Combitube. D. Place in the recovery position.
A. Continue CPR.
Delivery of an electrical shock to restore a normal heart rhythm most directly affects which of the following? A. Electrical function in the heart B. Peripheral pulses C. Blood circulation D. Blood pressure
A. Electrical function in the heart
Your patient is a 44-year-old female who has collapsed while jogging. She has been unresponsive for 4 to 5 minutes by the time you arrive. Her husband appears to be performing high-quality CPR. Which of the following should be your FIRST action? A. Load the patient into the ambulance for further assessment. B. Apply the AED. C. Insert an oropharyngeal airway and begin ventilations. D. Stop CPR and check for a pulse.
B. Apply the AED.
Which of the following types of defibrillators sends the shock first in one direction and then the other? A. Triphasic defibrillator B. Biphasic AED C. Monophasic AED D. Implanted defibrillator
B. Biphasic AED
Which of the following is not one of the links in the chain of survival? A. Immediate high-quality CPR B. Rehabilitation C. Rapid defibrillation D. Immediate recognition and activation of the emergency response system
B. Rehabilitation
As you arrive for a patient in cardiac arrest, bystanders are analyzing the patient with an AED. You should: A. turn off the AED and check for a pulse. B. allow the AED to shock before you take over care. C. stay back until bystanders transfer care to you. D. remove the AED and apply your own.
B. allow the AED to shock before you take over care.
Mechanical CPR devices are used by EMS agencies in order to provide: A. a faster response time to the scene. B. high-quality compressions. C. a 100% success rate. D. better quality of care with less training.
B. high-quality compressions.
If there are ALS providers on the scene, they may receive a termination order from their medical direction if: A. bystanders have already attempted to use an AED on the patient. B. the patient has failed to respond to BLS and ALS interventions. C. EMTs improperly positioned an advanced airway before the arrival of ALS. D. EMTs have arrived on scene and are ready to take over.
B. the patient has failed to respond to BLS and ALS interventions.
EMTs arrive at the scene of a cardiac arrest to see a police officer beginning to defibrillate the patient. At what point should the EMTs take over? A. Only if the EMTs feel the police office is incompetent to administer the AED correctly B. After a "no shock indicated" message is received but otherwise not until the patient is resuscitated C. After the shock is delivered or a "no shock indicated" message is received D. Immediately, even if interrupting the police office in the middle of shocking the patient
C. After the shock is delivered or a "no shock indicated" message is received
Which of the following issues is considered a mechanical failure of the heart that may lead to cardiac arrest? A. Asystole B. Ventricular tachycardia C. Aortic valve stenosis D. Agonal breathing
C. Aortic valve stenosis
You have just used an AED to deliver a shock to your cardiac arrest patient. You should immediately: A. begin artificial ventilations. B. reanalyze with the AED. C. resume chest compressions. D. check a carotid pulse.
C. resume chest compressions.
Which of the following describes the EMT's MOST important role in the ideal provision of emergency cardiac care? A. Recognition and activation of emergency response system B. Postarrest care following advanced life support C. Early advanced cardiac life support D. Immediate high-quality CPR and rapid defibrillation
D. Immediate high-quality CPR and rapid defibrillation
Which of the following people is allowed to continue providing patient care when the patient is to be "cleared" for delivery of a shock via the defibrillator? A. Anyone in contact with the patient below the level of the patient's knees B. The EMT performing bag-valve mask ventilations C. The provider who is ventilating the patient, so long as the patient has been intubated by a paramedic so that the provider does not directly touch the patient D. None of the above
D. None of the above
Your patient was pulseless but had a return of spontaneous pulses after one shock from the AED. Before transport, you notice that the patient is again unresponsive. You should next: A. assess the blood pressure. B. transport the patient. C. continue ventilations. D. check the pulse.
D. check the pulse.
The Lucas CPR device involves: A. closing the Lifeband chest band over the patient's chest. B. providing bag-mask ventilation at a rate of 2 ventilations for every 30 compressions. C. removing the stabilization strap, if the patient must be moved. D. stopping CPR just long enough to put a base plate under the patient.
D. stopping CPR just long enough to put a base plate under the patient.
When caring for a patient who has a ventricular assist device, you should remember that even if the device is working properly: A. the patient will have a higher-than-normal blood pressure. B. the patient will have a lower-than-normal respiratory rate. C. the patient will not have radial pulses but will have carotid pulses. D. the patient will not have a pulse or blood pressure.
D. the patient will not have a pulse or blood pressure.
The Zoll AutoPulse device is designed: A. to be started automatically. B. to start only if bag-valve-mask ventilation is applied. C. to start only if an advanced airway is in place. D. to be started manually.
D. to be started manually.
You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes. He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain. Your nearest facility is 5 minutes away, a Level III Trauma Center is 10 minutes away, and a hospital with cardiac catheterization capabilities is 20 minutes away. The patient is requesting to be transported to his cardiologist's hospital, which is 30 minutes away. Which hospital is the best destination? A. The nearest hospital with cardiac catheterization B. The trauma center C. The hospital the patient requests D. The nearest facility
A. The nearest hospital with cardiac catheterization
Which of the following is a contraindication for use of the AED? A. The patient is in contact with metal. B. The patient has been down for over 10 minutes. C. The patient is under 8 years of age. D. The patient is hypothermic.
A. The patient is in contact with metal.
If you turn resuscitation efforts for a patient over to another rescuer, this person must be trained to which level of proficiency? A. The same level as or a greater level than you B. The level of an ALS provider C. The level of a physician D. The highest possible level
A. The same level as or a greater level than you
Your patient is a 66-year-old female who has regained a pulse after a shock with an AED; however, she remains unresponsive and is not breathing adequately. Which of the following should be done next? A. Ventilate the patient with high-concentration oxygen and transport immediately. B. Deliver a fourth shock to improve the patient's respiratory status. C. Apply a nonrebreather mask with high-concentration oxygen and keep reassessing the pulse. D. Remove the AED, assist the patient's ventilations with a bag-valve mask and supplemental oxygen, and keep reassessing the pulse.
A. Ventilate the patient with high-concentration oxygen and transport immediately.
You are treating your cardiac arrest patient when a "No Shock Indicated" message appears. You should next: A. continue CPR for 2 minutes. B. insert an oral airway. C. reanalyze. D. ventilate 20 times per minute.
A. continue CPR for 2 minutes.
ALS personnel have just placed an advanced airway in an adult cardiac arrest patient. You should: A. deliver positive pressure ventilations at 10-12 breaths per minute. B. deliver two breaths after every 30 compressions. C. ventilate the patient twice after every 15 compressions. D. ventilate the patient at 12-20 breaths per minute.
A. deliver positive pressure ventilations at 10-12 breaths per minute.
A 54-year-old male is found pulseless and apneic on the sofa. The scene is safe. You should first: A. start CPR and retrieve an AED. B. apply oxygen. C. call medical control. D. call for ALS.
A. start CPR and retrieve an AED.
You are the first on the scene of a 72-year-old patient in cardiac arrest. You have your medical supply kit, oxygen, and an AED. At least 4 to 5 minutes of high-quality CPR has been provided by the police officer who arrived before you. You have confirmed an open airway, apnea, and pulselessness. Which of the following should you do next? A. Perform bag-valve mask ventilations with supplemental oxygen for 30 seconds before applying the defibrillator pads. B. Perform one-rescuer CPR until additional personnel arrive. C. Apply the defibrillator pads and shock as indicated. D. Contact medical direction before taking any action.
C. Apply the defibrillator pads and shock as indicated.
Which of the following would not be corrected by defibrillation? A. Ventricular fibrillation B. Ventricular tachycardia C. Asystole D. Dysrhythmia
C. Asystole
Which of the following patients should have an automated external defibrillator applied? A. A 6-month-old in severe respiratory distress B. A 67-year-old man with severe, crushing chest pain that is not relieved by nitroglycerin C. A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic D. A 40-year-old female in cardiac arrest due to chest injuries sustained in a motor vehicle crash
C. A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED does not advise shock. What is your next intervention? A. Replace the malfunctioning AED. B. Stop CPR and place the patient in the recovery position. C. Continue CPR. D. Insert a Combitube.
C. Continue CPR.
When using an AED, which of the following people is responsible for calling to "clear" the patient before delivering a shock? A. EMT managing the airway B. EMT supervising bystanders C. EMT operating the defibrillator D. EMT doing chest compressions
C. EMT operating the defibrillator
What of the following is the single most important factor in determining survival from cardiac arrest? A. Rapid transport B. Immediate recognition C. Early CPR D. Effective ALS
C. Early CPR
Which of the following will provide a cardiac arrest patient the greatest chance of survival? A. Advanced airway management B. Early advanced cardiac life support C. Early defibrillation D. Rapid transport
C. Early defibrillation
Which of the following would not be considered an element of post-arrest care? A. Ensuring proper airway positioning B. Obtaining a 12-lead ECG C. Early defibrillation D. Maintaining adequate oxygenation
C. Early defibrillation
What determines which authorities may issue a valid "cease resuscitation" order? A. Medical direction B. Your standard of care C. Local protocols D. Federal law
C. Local protocols
Which of the following BEST describes the continued need for prehospital advanced cardiac life support, even when EMTs in the community carry AEDs? A. The patient may need medications to support his cardiac rhythm and blood pressure prior to attempting defibrillation. B. Before attempting defibrillation, it may be necessary to obtain a 12-lead ECG on the patient. C. Not all cardiac arrests are due to problems that respond to defibrillation. D. All of the above
C. Not all cardiac arrests are due to problems that respond to defibrillation.
What does ventricular fibrillation do? A. Forces the heartbeat to become quite rapid B. Initiates commotio cordis C. Prevents the heart muscle from contracting normally D. Causes asphyxial cardiac arrest
C. Prevents the heart muscle from contracting normally
Which of the following BEST describes an appropriate shock sequence for the patient in ventricular tachycardia? A. Shock, shock, shock, shock B. Shock, pulse check, shock, pulse check, shock, pulse check C. Shock, 2 minutes of CPR, reanalyze, shock again if indicated D. Shock, shock, shock, pulse check, 2 minutes of CPR, shock, shock, shock
C. Shock, 2 minutes of CPR, reanalyze, shock again if indicated
Once an EMT has begun resuscitative efforts, when may the EMT cease those efforts? A. The EMT's partner gives the order to cease. B. No other rescuer is available to relieve the EMT. C. Spontaneous circulation and breathing occur. D. The patient has no pulse after 1 minute.
C. Spontaneous circulation and breathing occur.
Which of the following is NOT a reason that an AED may indicate that there is "no shock advised"? A. The patient's heart has no electrical activity; he is "flat line," or in asystole. B. The patient's heart rhythm is normal. C. The patient is in ventricular fibrillation or ventricular tachycardia. D. The patient has organized electrical activity in the heart but no pulse.
C. The patient is in ventricular fibrillation or ventricular tachycardia.
In which of the following dysrhythmias would it be most important to apply and engage an automatic external defibrillator? A. Pulseless electrical activity B. Asystole C. Ventricular tachycardia D. Atrial tachycardia
C. Ventricular tachycardia
You are preparing a patient in cardiac arrest for an AED when you palpate a small lump below the patient's right clavicle. How should this modify your placement of the AED? A. Place the AED pads over the patient's abdomen. B. Place the AED as you would for any patient. C. While placing the pads in the general area you need them, keep them several inches away from the lump. D. Do not place the AED but transport the patient immediately.
C. While placing the pads in the general area you need them, keep them several inches away from the lump.
All of the following are elements of adult high-performance CPR, EXCEPT: A. maintaining a 2:30 ratio of ventilations to compressions. B. placing the heel of one hand on the center of the victim's chest. C. compressing the patient's chest to no more than 1 inch in depth before allowing full relaxation. D. compression rate of at least 100 per minute.
C. compressing the patient's chest to no more than 1 inch in depth before allowing full relaxation.
For both the Lucas and Zoll AutoPulse CPR devices, you would take Standard Precautions and: A. close the Lifeband over the patient's chest. B. apply the stabilization strap. C. ensure CPR is in progress and effective. D. position the pressure pad so that it touches the chest.
C. ensure CPR is in progress and effective.
If a shock is not indicated, how many cycles of CPR will you give before analyzing again? A. 10 B. 15 C. 2 D. 5
D. 5
You are caring for a cardiac arrest patient who has a body temperature of 84 deg F. You attempt defibrillation once with no success. At what core body temperature should you attempt defibrillation again? A. 90 deg F B. 88 deg F C. 85 deg F D. 86 deg F
D. 86 deg F
If an EMT is tasked with managing the family of a patient who is deceased after termination of resuscitation, what is an effective care strategy? A. Minimize the family's time with the deceased patient. B. Tell the family the EMT knows how they feel. C. Prevent the family from seeing the deceased patient. D. Be straightforward and use direct language.
D. Be straightforward and use direct language.
In which of the following ways does cardiac arrest in children differ from cardiac arrest in adults? A. Ventricular fibrillation is common in children. B. Ventricular fibrillation is not common in adults. C. Cardiac arrest in adults is more likely to be due to respiratory failure. D. Cardiac arrest in children is more likely to be due to respiratory failure.
D. Cardiac arrest in children is more likely to be due to respiratory failure.
Which of the following should NOT be done during defibrillation? A. Pressing the defibrillation pads firmly to the chest to ensure good contact B. Shaving the chest before placing the defibrillation pads to improve contact C. Performing CPR while the AED is being attached D. Continued ventilation during the analysis phase to prevent hypoxia
D. Continued ventilation during the analysis phase to prevent hypoxia