Pulseless Electrical Activity / Asystole Practice Test (ACLS)

Which of the following statements is true? A. There is no evidence that attempting to "defibrillate" asystole is beneficial B. The AHA recommends the use of TCP for patients with asystolic cardiac arrest C. CPR should be interrupted while establishing IV or IO access in asystole patients D. Identifying the cause of asystole is not important

A. There is no evidence that attempting to "defibrillate" asystole is beneficial There is no evidence that attempting to "defibrillate" asystole is beneficial. In one study, the group that received shocks had a trend toward worse outcomes. If it is unclear whether the rhythm is fine VF or asystole, an initial attempt at defibrillation may be warranted.

PEA and Asystole are shockable rhythms A. True B. False

B. False

What are the 2 most common causes of Pulseless Electrical Activity? A. Hypothermia and hypoxia B. Hypovolemia and hypoxia C. Hypovolemia and hyperkalemia D. Hypoxia and hyperkalemia

B. Hypovolemia and hypoxia Hypovolemia and hypoxia are the 2 most common underlying and potentially reversible causes of PEA. Be sure to look for evidence of these problems as you assess the patient.

Which of the following statements is not true? A. CPR should not be stopped to administer drugs to PEA or Asystole patients B. Treatment of PEA is limited to interventions outlined in the algorithm C. IV/IO access is a priority over advanced airway management D. Epinephrine is a common treatment for PEA and Asystole

B. Treatment of PEA is limited to interventions outlined in the algorithm Treatment of PEA is not limited to the interventions outlined in the algorithm. Healthcare providers should attempt to identify and correct an underlying cause if present. It is essential to search for and treat reversible causes for resuscitative efforts to be successful.

What is the correct dosing regimen of epinephrine to treat PEA or Asystole? A. 300 mg bolus B. 1 mg IV/IO - repeated every 8 to 10 minutes C. 1 mg IV/IO - repeated every 3 to 5 minutes D. 0.5 mg IV/IO - repeated every 8 to 10 minutes

C. 1 mg IV/IO - repeated every 3 to 5 minutes

Routine insertion of an advanced airway in asystole: A.Is contraindicated in a patient in asystole B.Should take priority over gaining IV/IO access C.Should only be performed if ventilations with a BVM are ineffective D.Is necessary so the epinephrine can be given

C.Should only be performed if ventilations with a BVM are ineffective If bag-mask ventilation is adequate providers may defer insertion of an advanced airway.

Possible causes of an isoelectric ECG (Flat line) include: A. Loose leads or leads not connected to the patient or defibrillator/monitor B. No power to the monitor C. Gain or amplitude too low D. All of the above

D. All of the above

The first dose of amiodarone for PEA treatment is: A. 150 mg B. 300 mg C. 100 mg D. Amiodarone is not used in PEA

D. Amiodarone is not used in PEA Amiodarone is used for VF/pVT

Pulseless Electrical Activity is defined as: A. No electrical activity present on an ECG B. A perfusing rhythm without spontaneous respirations C. Ventricular Fibrillation D. Any organized rhythm without a pulse

D. Any organized rhythm without a pulse Any organized rhythm without a pulse is defined as PEA. An organized rhythm consists of QRS complexes that are similar in appearance from beat to beat (ie, each has a uniform QRS configuration). Organized rhythms may have narrow or wide QRS complexes, they may occur at rapid or slow rates, they may be regular or irregular, and they may or may not produce a pulse.

Which of the following is not a reason to stop or withhold resuscitative efforts? A.Rigor mortis B.Indicators of do-not-attempt-resuscitation (DNAR) status C.Threat to safety of providers D.Resuscitation effort have been unsuccessful for 20 minutes or more

D.Resuscitation effort have been unsuccessful for 20 minutes or more The final decision to stop resuscitative efforts can never be as simple as an isolated time interval.