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You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority? Administer 1mg of epinephrine During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient has no pulse. What is the next action? Resume compressions What is a common but sometimes fatal mistake in cardiac arrest management? Prolonged interruptions in chest compressions.
Which action is a componant of high-quality chest comressions? Allowing complete chest recoil Which action increases the chance of successful conversion of ventricular fibrillation? Providing quality compressions immediately before a defibrillation attempt. Which situation BEST describes pulseless electrical activity? Sinus rythm without a pulse What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? Provide continuous chest compressions without pauses and 10 ventilations per minute. Three minutes after witnessing a cardiac arrest, one member of your team inserts an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? Chest compressions may not be effective. The use of quantitative capnography in intubated patients allows for monitoring of CPR quality.
Which action is included in the BLS survey? Early defibrillation Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? Amioderone 300mg What is the appropriate interval for an interruption in chest compressions? 10 seconds or less Which of the following is a sign of effective CPR? PETCO2 ≥10 mm Hg What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? Identifying and treating early clinical deterioration. Which action improves the quality of chest compressions delivered during a resuscitation attempt? Switch providers about every 2 minutes or every 5 compression cycles. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min?
1 breath every 5-6 seconds A patient presents to the emergency department with new onset of dizziness and fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/ mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication? Atropine 0.5mg A patient with dizziness and shortness of breath with a sinus bradycardia of 40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? 2 to 10 mcg/kg per minute A patient has sudden onset of dizziness. The patient's heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown below: Vagal manuever.
What is the appropriate procedure for endotracheal tube suctioning after the appropriate catheter is selected? Suction during withdrawal but for no longer than 10 seconds. While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and cool, clammy skin, you see this lead II ECG rhythm:What is the first intervention? Atropine 0.5mg A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory rate of 14 breaths/min, and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most appropriate action for the EMS team to perform next? Cincinnati Prehospital Stroke Scale assessment EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival in the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG displays sinus rhythm. The blood glucose level is within normal limits. What intervention should you perform next?
Head CT scan What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place? 8 - 10 breaths per minute A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you perform next? Obtain a 12 lead ECG. You are evaluating a 48-year-old man with crushing substernal chest pain. The patient is pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the heart rate is 190/min, the respiratory rate is 18 breaths/min, and the pulse oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG displays a regular wide-complex tachycardia. What intervention should you perform next? Synchronized cardioversion What is the initial priority for an unconscious patient with any tachycardia on the monitor? Determine whether pulses are present.
You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now? Obtaining a 12 lead ECG. What is the preferred method of access for epi administration during cardiac arrest in most pts? Peripheral IV An AED does not promptly analyze a rythm. What is your next step? Begin chest compressions. What is the potential danger of using ties that pass circumferentially around the patient's neck when securing an advanced airway? Obstruction of venous return from the brain What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube? Continuous waveform capnography hat is the recommended IV fluid (normal saline or Ringer's lactate) bolus dose for a patient who achieves ROSC but is hypotensive during the post-cardiac arrest period? 1 to 2 Liters What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC?
90mm Hg What is the first treatment priority for a patient who achieves ROSC? Optimizing ventilation and oxygenation. What should be done to minimize interruptions in chest compressions during CPR? Continue CPR while the defibrillator is charging. Which condition is an indication to stop or withhold resuscitative efforts? Safety threat to providers After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient's lead II ECG appears below. What is your next action? IV or IO access After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? Check for a pulse.
What is the recommended next step after a defibrillation attempt? Begin CPR, starting with chest compressions. Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest? Antecubital vein Which finding is a sign of ineffective CPR? PETCO2 <10 mm Hg How often should the team leader switch chest compressors during a resuscitation attempt?
. Every 2 minutes IV/IO drug administration during CPR should be given rapidly during compressions What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? 300 mg A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? Closed-loop communication
How long should it take to perform a pulse check during the BLS Survey? 5 to 10 seconds Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient? Check the patient's pulse. An AED advises a shock for a pulseless patient lying in snow. What is the next action? Administer the shock immediately and continue as directed by the AED. Which treatment or medication is appropriate for the treatment of a patient in asystole? Epinephrine What is the minimum depth of chest compressions for an adult in cardiac arrest? 2 inches A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? Start chest compressions at a rate of at least 100/min.
A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? Administer 2 to 4 mg of morphine by slow IV bolus. A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG? Seeking expert consultation A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? Obtain a 12-lead ECG and administer aspirin if not contraindicated. An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/ mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
Conduct a problem-focused history and physical examination. What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? 160 to 325 mg A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient's lead II ECG is displayed below. stable supraventricular tachycardia What is the most appropriate intervention for a rapidly deteriorating patient who has this lead II ECG? Synchronized cardioversion What is the purpose of a medical emergency team (MET) or rapid response team (RRT)?
Defibrillation What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? 120to200J Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? Measure from the corner of the mouth to the angle of the mandible. Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes? Right ventricular infarction and dysfunction What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)? Administration of IV or IO fluid bolus
Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation? Transport the patient to a facility capable of performing PCI. What is the immediate danger of excessive ventilation during the post-cardiac arrest period for patients who achieve ROSC? Decreased cerebral blood flow What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? 32°C to 34°C What is the recommended duration of therapeutic hypothermia after reaching the target temperature? 12 to 24 hours What is the danger of routinely administering high concentrations of oxygen during the post- cardiac arrest period for patients who achieve ROSC?
