Cardiac Arrest

________________ is the cessation of cardiac mechanical activity, confirmed by the absence of a detectable pulse, unresponsiveness, and apnea or agonal, gasping respiration

I said PEA

Sudden death is an unexpected death of cardiac etiology occurring either immediately or within __________ of onset of symptoms. a. 1 hour b. 4 hours c. 12 hours d. 24 hours

a. 1 hour

Which of the following is appropriate for a patient with an implanted cardioverter-defibrillator who is in ventricular fibrillation? a. Avoid placing the pads or paddles directly over the device, and defibrillate as usual. b. Use anterior-posterior pad or paddle placement, and do not exceed 100 joules. c. Reverse the pads or paddles so that the sternum pad is at the apex and the apex pad is at the sternum. d. Perform CPR, administer antidysrythmics, and do not perform external defibrillation.

a. Avoid placing the pads or paddles directly over the device, and defibrillate as usual.

At doses recommended for use in cardiac arrest, epinephrine and vasopressin: a. Cause significant peripheral vasocontriction. b. Neutralize acid accumulated during cardiac arrest. c. Slow conduction through the AV node. d. Cause profound peripheral vasodilation.

a. Cause significant peripheral vasocontriction.

A 77-year-old female has suffered a cardiac arrest. When performing a quick-look, you are unsure if the rhythm shown on the cardiac monitor is asystole or fine ventricular fibrillation. How should you proceed? a. Confirm the rhythm in another lead. If you are still unsure if the rhythm is asystole or VF, treat the rhythm as VF. b. Don't waste time confirming a second lead early defibrillation is to important c. It is not important to confirm the rhythm because epinephrine is the first line drug for either one. d. Continue with BLS interventions only until an identifiable rhythm is apparent.

a. Confirm the rhythm in another lead. If you are still unsure if the rhythm is asystole or VF, treat the rhythm as VF.

Which of the following is the LEAST likely cause of PEA a. Hypertension b. Hypovolemia c. Cardiac tamponade d. Tension pneumothorax

a. Hypertension

The MOST common cause of cardiac arrest in adult patients is: a. acute myocardial infarction. b. electrocution. c. an arrhythmia. d. respiratory failure.

a. acute myocardial infarction.

The farther removed the conduction tissue is from the sinatrial node: a. the slower its intrinsic rate of firing. b. the longer the P-R interval will be. c. the faster its intrinsic rate of firing. d. the narrower the QRS complex will be.

a. the slower its intrinsic rate of firing

The first antiarrhythmic administered in the management of the patient in pulseless ventricular tachycardia or ventricular fibrillation is: a. Epinephrine or vasopressin. b. Amiodarone or lidocaine. c. Vasopressin or amiodarone. d. Epinephrine or lidocaine.

b. Amiodarone or lidocaine

A 65-year-old female has experienced a cardiopulmonary arrest. Which of the following is NOT one of the four critical tasks that should be assigned at the start of the resuscitation effort? a. Airway management b. Crowd control c. IV access and medication administration d. Monitoring and defibrillation

b. Crowd control

A 65-year-old female is found unresponsive, apneic, and pulseless. CPR is in progress. Your next course of action should be to: a. Initiate Transcutaneous Pacing at 80 beats per minute and 100mA. b. Defibrillate with 360 joules (or equivalent biphasic energy) as needed. c. Perform synchronized cardioversion with 100 joules. d. Establish an IV line and prepare for endotracheal intubation.

b. Defibrillate with 360 joules (or equivalent biphasic energy) as needed.

Which of the following is NOT one of the links in the chain of survival? a. Rapid activation of EMS b. Early warning c. Provision of advanced care d. Hospital care

b. Early warning

The first medication used in the management of pulseless electrical activity (PEA) is: a. Atropine. b. Epinephrine. c. Amiodarone. d. Lidocaine.

b. Epinephrine.

What is the most common cause of pulseless electrical activity? a. Hypothermia b. Hypovolemia c. Tension pneumothorax d. Myocardial rupture

b. Hypovolemia

Your patient is a 54-year-old male who is unresponsive and cyanotic and has agonal respirations. A "quick look" shows ventricular tachycardia. Which of the following is most important when determining the immediate treatment of this patient? a. How long he has been "down" b. Whether he has a pulse c. Whether he is allergic to lidocaine d. Whether he has an implanted cardioverter-defibrillator

b. Whether he has a pulse

Establishing peripheral intravenous access is part of: a. "A" in the primary ABCD survey. b. "B" in the secondary ABCD survey. c. "C" in the secondary ABCD survey. d. "D" in the primary ABCD survey.

c. "C" in the secondary ABCD survey

When the adhesive pads of the automated external defibrillator (AED) have been attached: a. Assessment of the rhythm takes approximately 60 to 90 seconds, depending on the brand of AED. b. The device will announce that a shock is indicated if asystole is present by a written message, visual alarm, or voice-synthesized statement. c. All contact with the patient must cease when the device is placed in "analyze" mode. d. CPR should be continued while the "analyze" control is pressed.

c. All contact with the patient must cease when the device is placed in "analyze" mode.

A 66-year-old male is supine on the waiting room floor in a dentist's office. He is pulseless and apneic. Bystanders state he seemed excessively anxious, then collapsed about 5 minutes before your arrival. The monitor shows asystole in three leads. Which of the following is the most appropriate first action? a. Start an IV, and administer 1.0 mg epinephrine 1:10,000. b. Defibrillate once at 360 joules or the biphasic equivalent. c. Begin chest compressions and bag-valve-mask ventilations. d. Do not begin resuscitation.

c. Begin chest compressions and bag-valve-mask ventilations.

A 65-year-old female is found unresponsive, apneic, and pulseless. CPR is in progress. CPR has resumed. You are able to palpate pulses with chest compressions and observe rise and fall of the chest with bag-valve-mask ventilation. An IV has been established in the patient's left antecubital fossa. The first medication that should be administered in this situation is: a. Magnesium Sulfate 2g IVP b. Lidocaine 1.5mg/kg IVP c. Epinephrine 1mg IVP d. Dopamine 2ug/kg/min

c. Epinephrine 1mg IVP

During a resuscitation effort, what information should be provided by the resuscitation team members to the team leader? 1. State vital signs every 3 to 5 minutes or with any change in the ABCDs of resuscitation. 2. State when procedures and medications are completed. 3. Clarify orders as needed. 4. Provide primary and secondary ABCD information. a. 1 and 2 only b. 2 and 3 only c. 1, 3, and 4 only d. 1, 2, 3, and 4

d. 1, 2, 3, and 4

Modifiable cardiac risk factors include: a. Heredity. b. Race. c. Gender. d. Alcohol intake.

d. Alcohol intake.

A 65-year-old female is found unresponsive, apneic, and pulseless. CPR is in progress. To speed delivery of the medication administered to the patient's central circulation, you should: a. Follow the medication with a 100-mL fluid flush and continue CPR. b. Follow the medication with a 20-mL fluid flush, elevate the extremity, and continue CPR. c. Increase the rate of chest compressions and ventilations to twice the usual rate. d. Attempt insertion of a central venous catheter.

d. Attempt insertion of a central venous catheter.

A therapeutic intervention that is "of no documented benefit; may be harmful" is categorized as: a. Class I. b. Class IIa. c. Class IIb. d. Class III.

d. Class III

EMT-Basics responded to a 73-year-old male in cardiac arrest. The patient was unresponsive, apneic, and pulseless. An automated external defibrillator (AED) was applied. The AED defibrillated without conversion of the rhythm. The patient has now arrived in the emergency department. The AED has delivered a second and third shock without conversion of the rhythm. CPR has been resumed. As an ACLS rescuer, how should you proceed? a. Immediately remove the AED, attach monitoring electrodes and leads, resume CPR, and then place an endotracheal tube. b. Establish an IV, place an endotracheal tube, and then resume CPR for 3 to 5 minutes before attempting any other intervention. c. Continue CPR, place an endotracheal tube, establish an IV, and administer amiodarone or lidocaine. d. Continue CPR, place an endotracheal tube, establish an IV, and administer epinephrine or vasopressin IV.

d. Continue CPR, place an endotracheal tube, establish an IV, and administer epinephrine or vasopressin IV.