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ACLS COMPLETE 2021
In which situation does bradycardia require treatment? ✔✔Hypotension Which intervention is most appropriate for the treatment of a patient in asystole? ✔✔Epinephrine You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previousy advised "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next? ✔✔Establish IV or IO access A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and the pulse oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. what is your next action? ✔✔Administer adenosine 6mg IV push A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a toal does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mm Hg. Which therapy is now indicated? ✔✔Epinephrine 2 to 10 mcg/min A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first? ✔✔Epinephrine 1 mg IV/IO A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? ✔✔Hold aspirin for at least 24 hours if rtPA is administered A patient is in refractory ventricular fibrillation and has received multiple appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg IV. The patient is intubated. Which best describe the recommended second does of amiodarone for this patient? ✔✔150 mg IV push A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of atropine? ✔✔0.5mg A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. Which drug should be administered? ✔✔Adenosine 6mg
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred? ✔✔IV or IO What is the indication for the use of magnesium in cardiac arrest? ✔✔Pulseless ventricular tachycardia-associated torsades de pointes A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action is recommended next? ✔✔Seeking expert consultation A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to administer? ✔✔Epinephrine 1mg IV/IO A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you order next. ✔✔Epinephrine 1 mg A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration? ✔✔Use of a phosphodiestrase inhibitor within the previous 24 hours A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/ mm HG/ Which action do you take next? ✔✔Perform electrical cordioversion A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 units per hour are being administered. The patient did not take aspirin because he has a history of gastritis, with was treated 5 years ago. What is your next action? ✔✔Give aspirin 160-325 mg to chew You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His blood pressure is 180/100mm Hg. Which drug do you anticipate giving to this patient? ✔✔Aspirin A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be given next? ✔✔Amiodarone 300mg What is the maximum interval for pausing chest compressions? ✔✔10 seconds
You arrive on the scene to find CPR in progress. Nursing staff report the patient was recovering from a pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been initiated. What do you administer now? ✔✔Epinephrine 1 mg IV You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check, you see the rhythm shown here. Team members tell you that the patient was well but reported chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, and IV access has been established, Which intervention would be your next action? ✔✔Epinephrine 1mg What is recommended depth of chest compressions for an adult victim? ✔✔At least 2 inches How does complete chest recoil contribute to effective CPR? ✔✔Allows maximum blood return to the heart What is the recommended compression rate for high-quality CPR? ✔✔ 100 - 120 compressions per minute A patient becomes unresponsive. You are uncertain if a faint pulse is present. They rhythm shown here is seen on the cardiac monitor. An IV is in pace. Which action do you take next? ✔✔Start high-quality CPR A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm shown here. Which action is indicated next? ✔✔Give an immediate unsynchronized high-energy shock (defibrillation dose) How often should you switch chest compressors to avoid fatigue? ✔✔About every 2 minutes You find an unresponsive pt. who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action? ✔✔Start chest compressions of at least 100 per min. 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.
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. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is your next treatment? ✔✔Consider terminating resuscitive efforts after consulting medical control. Which is a safe and effective practice within the defibrillation sequence? ✔✔Be sure oxygen is not blowing over the patient's chest during the shock. During your assessment, your patient suddenly loses consciousness. After calling for help and determining that the patient is not breathing, you are unsure whether the patient has a pulse. What is your next action? ✔✔Begin chest compressions.
tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. What is the next recommended intervention? ✔✔Adenosine 6mg IV push You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? ✔✔Divert the patient to a hospital 15 minutes away with CT capabilities. Choose an appropriate indication to stop or withhold resuscitative efforts. ✔✔Evidence of rigor mortis. A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to perform next? ✔✔Obtain a 12 lead ECG. A patient in respiratory failure becomes apneic but continues to have a strong pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min. What intervention has the highest priority? ✔✔Simple airway manuevers and assisted ventilations. 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/ 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. Which rhythm requires synchronized cardioversion? ✔✔Unstable supraventricular tachycardia What is the recommended second dose of adenosine for patients in refractory but stable narrow- complex tachycardia? ✔✔12mg What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? ✔✔ 35 - 40mm Hg Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? ✔✔Responding to verbal commands 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.
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. You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action? ✔✔Have a team member attempt to palpate a carotid pulse. Emergency medical responders are unable to obtain a peripheral IV for a patient in cardiac arrest. What is the next most preferred route for drug administration? ✔✔Intraosseous (IO) What is the appropriate rate of chest compressions for an adult in cardiac arrest? ✔✔At least 10 0/min You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? ✔✔Divert the patient to a hospital 15 minutes away with CT capabilities. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next action? ✔✔Vagal maneuvers 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 102/72 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)? ✔✔Improving patient outcomes by identifying and treating early clinical deterioration What is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rhythm? ✔✔10 to 12 breaths per minute Family members found a 45-year-old woman unresponsive in bed. The patient is unconscious and in respiratory arrest. What is the recommended initial airway management technique? ✔✔Performing a head tilt-chin lift maneuver A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm: What is the appropriate next intervention? ✔✔Synchronized cardioversion
A patient is in refractory ventricular fibrillation. High CPR is in progress and shocks have been given. One dose of epinephrine was given after the second shock. An anti arrhythmic drug was given immediately after the the third shock. What drug should the team leader request to be prepared for administration next? ✔✔second dose of epinephrine 1 mg A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine has been given. Which is the next drug to anticipate to administer? ✔✔amiodarone 300 mg You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action? ✔✔Give a single shock what do you do after return of spontaneous circulation ✔✔maintain O2 sat at 94% treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion what are the 5 h's and 5 t's ✔✔The Hs and Ts is a mnemonic used to aid in remembering the possible reversible causes of cardiac arrest.[1] A variety of disease processes can lead to a cardiac arrest; however, they usually boil down to one or more of the "Hs and Ts". hypovolemia hypoxia hydrogen ion (acidosis) hypo/hyperkalemia hypothermia tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary (PE) thrombosis, coronary Bradycardia require treatment when? ✔✔chest pain or shortness of breath is present how do you treat non-symptomatic bradycardia ✔✔monitor and observe what constitutes symptomatic bradycardia ✔✔hypotension altered mental status signs of shock chest pain
acute heart failure A patient with sinus bradycardia and a heart rate of 42 has diaphoresis and blood pressure of 80/60. What is the initial dose of atropine? ✔✔0.5 mg how do you treat symptomatic bradycardia ✔✔give 0.5mg atropine every 3-5 mins to max of 3mg if that doesn't work try one of the following: transcutaneous pacing 2 - 10mcg/kg / minute dopamine infusion 2 - 10mcg per minute epinephrine infusion what is considered a tachycardia requiring treatment ✔✔over 150 per minute when do you consider cardioversion ✔✔if persistent tachycardia is causing: hypotension altered mental status signs of shock chest pain acute heart failure if persistent tachycardia does not present with symptoms what do you need to consider ✔✔wide QRS? greater than 0.12 seconds Your patient has been intubated. IV/IVO access is not available. Which combination of drugs can be administered by endotracheal route? ✔✔Lidocaine, epinephrine, vasopressin reentry supraventricular tachycardia ✔✔ polymorphic ventricular tachycardia - aka torsades ✔✔ atrial fibrilation ✔✔ sinus tachycardia ✔✔ coarse ventricular fibrillation ✔✔ atrial flutter ✔✔ reentry supraventricular tachycardia ✔✔
A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. ASA was not taken by the patient because he had a history of gastritis treated 5 years ago. What is the next action? ✔✔ASA 160-325 mg chew A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What should you do? ✔✔seek expert consultation A 35 year old woman has palpitations, light headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. What drug should be administered? ✔✔adenosine 6 mg A 57 year old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180 bpm. She becomes diaphoretic and her blood pressure is 80/60 mm Hg. What is the next action? ✔✔cardioversion when does bradycardia require treatment? ✔✔hypotension You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated". A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to what? ✔✔establish IV or IO access you are caring for a 66 year old man with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. the ct scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving? ✔✔aspirin A 62 year old man suddenly experienced difficulty speaking and left-sided weakness. He was brought into the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy? ✔✔hold aspirin for at least 24 hours if rtPA is administered a 45 year old woman has a history of palpitations develops lightheadedness and palpitations. She has received adenosine 6 mg IV for SVT without conversion. BP 128/70. next step? ✔✔adenosine 12 mg STEMI intervention is most important in reducing patients in hospital and 30 day mortality? ✔✔reperfusion therapy
a patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm VT. What tx is indicated ✔✔unsynchronized high energy shock which action should you take immediately after providing an AED shock ✔✔resume chest compressions which action causes air to enter victim's stomach (gastric inflation) during bag-mask ventilation ✔✔ventilation too quickly, A patient becomes unresponsive. You are uncertain if a faint pulse is present with the rhythm below. What is your next action? ✔✔CPR you are the code team leader and arrive to find a patient with CPR in progress. On next rhythm check NSR. Pt reported chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise and IO access has been established. Intervention? ✔✔EPI 1 mg refractory ventricular fibrillation. 3rd shock just administered. what is next action ✔✔resume high-quality chest compression 2nd degree mobitz ✔✔ 2nd degree wenckebach ✔✔ coarse V fib ✔✔ PEA ✔✔ fine V Fib ✔✔ A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. Your immediate next order is? ✔✔resume high quality chest compressions A patient with sinus bradycardia and a heart rate of 42 bpm has diaphoresis and a BP of 80/ mm Hg. What is the initial dose of atropine? ✔✔0.5 mg When can you use magnesium in cardiac arrest? ✔✔VF/pulseless VT associated with torsades de pointes
A patient is in cardiac arrest. High quality chest compressions are being given. The patient is intubated and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer? ✔✔Epinephrine 1 mg or vasopressin 40 units IV or IO A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. ASA was not taken by the patient because he had a history of gastritis treated 5 years ago. What is the next action? ✔✔Give ASA 160-325 chewed immediately What is the dose of vasopressin and how is it administered (in cardiac arrest)? ✔✔40 units administered IV or IO A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the recommended route for drug administration during CPR? ✔✔IV or IO A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 100/60 mm HG. What is now indicated? ✔✔Epinephrine 2 to 10 mcg/min You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated". A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to what? ✔✔Gain IV or IO access A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 SL NTG tablets. There are no contraindications, and 4 mg of morphine sulfate was administered. Shortly afterward, blood pressure falls to 88/60 mm Hg, and the patient has increased chest discomfort. What should you do? ✔✔Give normal saline 250 mL to 500 mL fluid bolus Supraventricular Tachycardia ✔✔ Atrial fibrillation ✔✔ Second deg AV block: Mobitz 1 ✔✔ Second deg AV block: Mobitz 2 ✔✔Intermittent non-conducted P waves without progressive prolongation of the PR interval (compare this to Mobitz I). Ventricular fibrillation ✔✔ Third deg AV block ✔✔
Sinus bradycardia ✔✔ Ventricular fibrillation ✔✔ Atrial flutter ✔✔ Pulseless electrical activity ✔✔Push Epi Always Second deg AV block: Mobitz 2 ✔✔ Supraventricular tachycardia ✔✔ Polymorphic ventricular tachycardia ✔✔ Sinus bradycardia ✔✔ Sinus tachycardia ✔✔ Ventricular fibrillation ✔✔ Agonal rhythm into asystole ✔✔ If patient is in cardiac arrest and the rhythm is asystole and CPR is beign given. What is the first drug you should give? (a) Atropine 0.5 mg IV/IO (b) Atropine 1 mg IV/IO (c) Dopamine 2 to 20 mcg/kg per min IV/IO (d) Epinephrine 1 mg IV/IO ✔✔(d) Epinephrine 1 mg IV/IO A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138 bpm. He is asymptomatic, with a blood pressure of 110/70. He has a history of angina. What action is recommended next? (a) Giving adenosine 6 mg IV bolus (b) Giving lidocaine 1 to 1.5 mg IV bolus (c) Performing synchroniczed cardioversion (d) Seeking expert consultation ✔✔(d) Seeking expert consultation A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first? (a) Atropine 1 mg IV/IO (b) Epinephrine 1 mg IV/IO (c) Lidocaine 1 mg/kg IV/IO
