question

You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action?

answer

Start chest compressions of at least 100 per min.

question

You are evaluating a 58 yo man with chest pain. The BP is 92/50 and HR is 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now?

answer

Obtaining a 12 lead ECG.

question

What is the preferred method of access for epi administration during cardiac arrest in most patients?

answer

Peripheral IV

question

What is the preferred method of access for epi administration during cardiac arrest in most patients?

answer

Peripheral IV

question

An AED does not properly analyze a rhythm. What is your next step?

answer

Begin chest compressions.

question

You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the patient has no pulse. Your partner resumes chest compressions and an IV is in place. What management step is your next priority?

answer

Administer 1mg of epi.

question

During a pause in CPR, you see a narrow complex rhythm on the monitor. The patient has no pulse. What is the next action?

answer

Resume compressions.

question

What is a common but sometimes fatal mistake in cardiac arrest management?

answer

Prolonged interruptions in chest compressions.

question

Which action is a component of high-quality chest compressions?

answer

Allowing complete chest recoil

question

Which action increases the chance of successful conversion of ventricular fibrillation?

answer

Providing quality compressions immediately before a defibrillation attempt.

question

Which situation BEST decree PEA?

answer

Sinus rhythm without a pulse.

question

What is the best strategy for performing high-quality CPR on a patient with an advanced airway in place?

answer

Provide continuous chest compressions without pauses and 10 ventilations per minute.

question

3 min after witnessing a cardiac arrest, one member of your team inserts an ET tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and PETCO2 of 8 mmHg. What is the significance of this finding?

answer

Chest compressions may not be effective.

question

The use of quantitative capnography in intubated patients does what?

answer

Allows for monitoring CPR quality

question

For the past 25 min, EMS crews have attempted resuscitation of a patient who originally presented with v-fib. After the 1st shock, the ECG screen displayed systole which has persisted despite 2 doses of epi, a flood bolus, and high quality CPR.

answer

Consider terminating resuscitative efforts after consulting medical control.

question

Which is a safe and effective practice within the defibrillation sequence?

answer

Be sure O2 is NOT blowing over the patients chest during shock.

question

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?

answer

Begin chest compressions.

question

What is an advantage of using hands-free d-fib pads instead of d-fib paddles?

answer

Hands free allows for more rapid d-fib.

question

What action is recommended to help minimize interruptions in chest compressions during CPR?

answer

Continue CPR while charging the defibrillator.

question

Which action is included in the BLS survey?

answer

Early defibrillation

question

Which drug and dose are recommended for the management of a patient in refractory v-fib?

answer

Amiodarone 300 mg

question

What is the appropriate interval for an interruption in chest compressions?

answer

10 seconds or less

question

Which of the following is a sign of effective CPR?

answer

PETCO2 = or ;10 mmHg

question

What is the primary purpose of a medical emergency team or rapid response team?

answer

Identifying and treating early clinical deterioration.

question

Which action improves the quality of chest compressions delivered during resuscitative attempts?

answer

Switch providers about every 2 min or every 5 compression cycles

question

What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min?

answer

1 breath every 5-6 seconds

question

A patient presents to the ER with a new onset of dizziness and fatigue. On examination, the patients HR is 35 beats/min, BP is 70/50, respiration rate is 22/min, O2 sat is 95%. What is the appropriate 1st medication?

answer

Atropine 0.5 mg

question

A patient presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of dopamine for this patient?

answer

2-10 mcg/kg/min

question

A patient has an onset of dizziness. The patients HR is 180, BP is 110/70, respiration rate is 18, O2 sat is 98%. This is a reg narrow complex tach rhythm. What is the next intervention?

answer

Vagal maneuver

question

A monitored patient in the ICU developed a sudden onset of narrow complex tach at a rate of 220/min. The patients BP is 128/58, the PET CO2 is 38mmHg, and the O2 sat is 98%. There is an ET established for vascular access. The patient denies taking any vasodilators. A 12 lead shows no ischemia or infarction. Vagal maneuvers are ineffective. What is the next intervention?

answer

Adenosine 12 mg IV

question

You receive a radio report from an EMS team enroute with a patient who may be having a stroke. The hospital CT scanner is broken. What should you do?

answer

Divert the patient to a hospital 15 min away with CT capabilities.

question

Choose an appropriate indication to stop or withhold resuscitative efforts.

answer

Evidence of rigor mortis

question

A 49 yo female arrives in the ER with persistent epigastric pain. She has been taking antacids PO for the past 6 hours because she had heartburn. BP is 118/72, HR is 92/min, respiration rate is 14 non-labored, and o2 sat is 96%. What is the most appropriate next action?

answer

Obtain a 12 lead ECG

question

A patient in respiratory failure becomes apneic but continues to have a strong pulse. The HR is dropping rapidly and now shows a sinus brady rate at 30/min. What intervention has the highest priority?

answer

Simple airway maneuvers and assisted ventilations

question

What is the appropriate procedure for ET suctioning after the catheter is selected?

answer

Suction during withdrawal, but not longer than 10 seconds.

question

While treating a stable patient for dizziness, a BP of 68/30, cool and clammy, you see a brady rhythm on the ECG. How do you treat this?

answer

Atropine 0.5 mg

question

A 68 yo female patient experienced a sudden onset of right arm weakness. BP is 140/90, pulse is 78/min, respiration rate is non-labored 14/min, and O2 sat is 97%. Lead 2 in the ECG shows a sinus rhythm. What would be your next action?

answer

Cincinnati stroke scale

question

You are transporting a patient with positive stroke assessment. BP is 138, pulse is 80/min, respiration rate is 12/min, O2 sat is 95% room air. Glucose levels are normal and the ECG shows a sinus rhythm. What is next?

answer

Head CT scan

question

What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place?

answer

8-10 breaths per minute

question

A 62 yo male patient in the ER says his heart is beating fast. No chest pain or SOB. BP is 142/98, pulse is 200/min, respiration rate is 14/min, and O2 sat is 95% room air. What should be the next evaluation?

answer

Obtain a 12 lead ECG

question

You are evaluating a 48 yo male with crushing substernal pain. He is cool, pale, diaphoretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min, respiration rate is 18, and you are unable to obtain an O2 sat due to no radial pulse. The ECG shows a wide complex tach rhythm. What intervention should be next?

answer

Synchronized cardioversion

question

What is the initial priority for an unconscious patient with any tachycardia on the monitor?

answer

Determine if a pulse is present

question

Which rhythm requires synchronized cardioversion?

answer

Unstable SVT

question

What is the recommended dose for adenosine for patients in refractory but stable narrow complex tachycardia?

answer

12 mg

question

What is the usual post-cardiac arrest target range for PET CO2 who achieves return of spontaneous circulation (ROSC)?

answer

35-40 mmHg

question

Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation (ROSC)?

answer

Responding to verbal commands

question

What is the potential danger to using ties that pass circumferentially around the patients neck when securing an advanced airway?

answer

Obstruction of venous return from the brain

question

What is the most reliable method of confirming and monitoring correct placement of an ET tube?

answer

Continuous waveform capnography

question

What is the recommended IV fluid (NS or LR) bolus dose for a patient who achieves ROSC but is hypotensive during the post-cardiac arrest period?

answer

1-2L

question

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?

answer

90 mmHg

question

What is the 1st treatment priority for a patient who achieves ROSC?

answer

Optimizing ventilation and oxygenation

question

What is the 1st treatment priority for a patient who achieves ROSC?

answer

Optimizing ventilation and oxygenation

question

What is the 1st treatment priority for a patient who achieves ROSC?

answer

Optimizing ventilation and oxygenation

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