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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?
You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart
rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is
97%. What assessment step is most important now?
What is the preferred method of access for epi administration during cardiac arrest
in most pts?
An AED docs not promptly analyze a rythm. What is your next step?
You have completed 2 min of CPR. The ECG monitor displays the lead below
(PEA) and the pt. has no pulse. You partner resumes chest compressions and an IV
is in place. What management step is your next priority?
During a pause in CPR, you sce a narrow complex rythm on the monitor. The pt.
has no pulse. What is the next action?
What is acommon but sometimes fatal mistake in cardiac arrest management?
Which action is a componant of high-quality chest comressions?
Which action increases the chance of success{ul conversion of ventricular
fibrillation?
Providing quality compressions immediately before a defibrillation attempt.
Which situation BEST describes PEA?
Sinus rythm without a pulse
What is the best strategy for perfoming high-quality CPR on a pt.with an advanced
airway in place?
Provide continuous chest compressionswithout pauses and 10 ventilations per
minute.
3 min after witnessing a cardiac arrest, one memeber of your team inserts an ET
tube while another performs continuous chest comressions. During subsequent
bentilation, you notice the presence of a wavefom on the capnogrophy screen and a
PETCO2 of 8 mm Hg. What is the significance of this finding?
Chest compressions may not be effective.
The use of quantitative capnography in intubated pt's does what?
Allowsfor monitoring CPR quality
For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally
presented with V-FIB. After the 1st shock, the ECG screen displayed asystole
which has persisted despite 2 doses of epi, 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 cffective practice within the defibrillation sequence?
Be sure 02 is NOT blowing over the pt's chest during shock.
During your assessment, your pt suddenly loses consciousness. After calling for
help and determining that the pt. is not breathing, you are unsure whether the pt.
has a pulse. What is your next action?
Begin chest compressions.
Simple airway manuevers and assisted ventilations.
What is the appropriate procedure for ET suctioning after the catheter is selected?
Suction during withdrawl, but not for longer than 10 scconds.
While treating a stable pt for dizziness, a BP of 68/30, cool and clammy, you see a
brady rythm on the ECG. How do you treat this?
Atropine 0.5mg
A 68 y/o female pt. experienced a sudden onset of right arm weakness. BP is
140/90, pulse is 78/min, resp rate is non-labored 14/min, 02 sat is 97%. Lead 2 in
the ECG shows a sinus rythm. What would be your next action?
Cinncinati Stroke Scale
You are transporting a pt. with a posilive stroke assessment. BP is 138, pulse is
80/min, resp rate is 12/min, 02 sat is 95% room air. Glucose levels are normal and
the ECG shows a sinus rythm. What is next.
Head CT scan
What is the proper ventilation rate for a pt. in cardiac arrest who has an advanced
airway in place?
8-10 breaths per minute
A 62 y/o male pt. in the ER says his heart is beating fast. No chest pain or SOB.
BP is 142/98, pulse rate is 200/min, reps rate is 14/min, O2 sats are 95 at room air.
What should be the next evaluation?
Obtain a 12 lead ECG.
You are evaluating a 48 y/o male with crushing sub-sternal pain. He is cool, pale,
diaphretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min,
resp rate is 18, and you are unable to obtain an 02 sat due to no radial pulse. The
ECG shows a wide complex tach rythm. What intervention should be next?
Syncronized cardioversion.
What is the initial priority for an unconscious pt. with any tachycardia on the
monitor?
Determine if a pulse is present.
Which rythm requires synchronized cardioversion?
Unstable SVT
What is the recommended dose for adenosine for pt's in refractory, but stable
narrow complex tachycardia?
12mg
What is the usual post-cardiac arrest target range for PETCO2 who achieves return
of spontaneous circulation (ROSC)?
35-40mm Hg
Which conditionis a contraindication to theraputic hypothermia during the post-
cardiac arrest period for pt's who achieve return of spontaneous circulation
(ROSC)?
Responding to verbal commands
What is the potential danger to using ties that pass circumfrentially around the pt's
neck when securing an advanced airway?
Obstruction of veneous return from the brain
What is the most reliable method of confirming and montioring correct placement
ofan ET tube?
Continuous waveform capnography
What is the recommended IV fluid (NS or LR) bolus dose for a pt. who achicves
ROSC but is hypotensive during the post-cardiac arrest period?
1 to 2 Liters
What is the minimum systolic BP one should attempt to achieve with fluid,
Inotropic, or vasopressor administration in a hypotensive post-cardiac arrest who
achieves ROSC?
90mm Hg
What is the Ist treatment priority for a pt. who achieves ROSC?
Optimizing ventilation and oxygenation.
