ACLS Principles Flashcard 12
Rationale
D. Rationale: The use of antiarrhythmics is not supported by evidence. If the patient has a body temperature < 30°C (which is 86°F), it is reasonable to defibrillate once.
Question
When considering the treatment of VF/VT in the patient with hypothermia:
a. Do not treat when the patient has a body temperature < 30°C.
b. If the patient has a body temperature < 86°F, do not defibrillate.
c. Evidence suggests that antiarrhythmic drugs are helpful for the hypothermic patient in cardiac arrest.
d. Therapy should be aimed at rapid core rewarming.
Answer
d. Therapy should be aimed at rapid core rewarming.
Rationale
B. Rationale: Once vascular access has been achieved in a cardiac arrest patient, epinephrine may be given as soon as it is feasible.
Question
When is epinephrine given during cardiac resuscitation?
a. After an advanced airway has been placed
b. Once vascular access has been achieved
c. Only after an initial shock from a defibrillator has been delivered
d. If stacked shocks from a defibrillator have resulted in no return of spontaneous circulation
Answer
b. Once vascular access has been achieved
Rationale
A. Rationale: Studies have shown that epinephrine given as soon as possible after the onset of cardiac arrest improves survival through hospital discharge with good neurologic outcomes when compared to giving it later. (Case: Adult Cardiac Arrest)
Question
When is the best time to give epinephrine to increase the chances of survival of a patient in a nonshockable cardiac arrest?
a. As soon as epinephrine becomes available
b. 5 minutes after cardiac arrest
c. 10 minutes after cardiac arrest
d. 15 minutes after cardiac arrest
Answer
a. As soon as epinephrine becomes available
Rationale
B. Rationale: Fetal monitoring should not be implemented during cardiac arrest in the pregnant patient. If fetal monitoring is in place, it should be discontinued during the resuscitation.
Question
When resuscitating a pregnant woman in cardiac arrest, the action that is contraindicated is:
a. Lateral displacement of the uterus
b. Fetal monitoring
c. Maternal airway management
d. Discontinue magnesium infusion
Answer
b. Fetal monitoring
Rationale
B. Rationale: Treating cardiac arrest with pulseless electrical activity relies on high-quality CPR and prompt delivery of epinephrine every 3 to 5 minutes via IV bolus injection.
Question
When resuscitating patients with cardiac arrest in pulseless electrical activity, how often is epinephrine given?
a. Intravenous infusion of epinephrine titrated to 1 mg every minute
b. Inject epinephrine every 3 to 5 minutes
c. Give epinephrine every 2 minutes while performing rhythm checks
d. Epinephrine is administered 1 mg every 120 chest compressions
Answer
b. Inject epinephrine every 3 to 5 minutes
Rationale
A. Rationale: Automated external defibrillators can determine if a patient has a shockable or nonshockable rhythm. When a nonshockable rhythm is identified, the rescuer should continue with chest compressions (30 compressions to 2 ventilations for a single rescuer or two-rescuers).
Question
When the AED assesses that the patient’s cardiac arrest rhythm is nonshockable, the rescuer should:
a. Provide chest compressions
b. Perform a precordial thump
c. Provide 2 rescue breaths
d. Use a manual defibrillator
Answer
a. Provide chest compressions
Rationale
A. Rationale: Asystole often represents the final rhythm.⁷
Question
Which cardiac rhythm often represents the “final” rhythm?
a. Asystole
b. Pulseless electrical activity
c. Pulseless ventricular tachycardia
d. Ventricular fibrillation
Answer
a. Asystole
Rationale
C. Rationale: The prerequisites for the ACLS course are a BLS course, basic ECG interpretation, and a basic understanding of common ACLS drugs.
Question
Which is a prerequisite for the ACLS course?
a. Being a board-certified professional health provider
b. Medical school diploma
c. Basic knowledge of ECG interpretation
d. Previous PALS certification
Answer
c. Basic knowledge of ECG interpretation
Rationale
B. Rationale: Waveform capnography in intubated cardiac arrest patients measures end-tidal CO2 pressure, which is indicative of pulmonary perfusion and ventilation. Studies have shown that it can be used to prognosticate outcomes for cardiac arrest patients. After 20 minutes of CPR, if the patient exhibits an end-tidal CO2 of 10 mm Hg or less, there is a very low likelihood of ROSC.
Question
Which of the following clinical data can be used to decide when to terminate resuscitative efforts when resuscitating a cardiac arrest patient in asystole?
a. End-tidal CO2 of 8 mm Hg after 20 minutes
b. Oxygen saturation of 93%
c. Anisocoria
d. All of the above
Answer
b. Oxygen saturation of 93%
Rationale
D. Rationale: Hypoxia can be caused by medical conditions that disrupt oxygenation and ventilation. It is recommended to provide oxygen supplementation to all patients with hypoxia, especially those in cardiac arrest. Packed RBCs, surfactant, and inhaled corticosteroids and beta-agonists are definitive treatments for different causes of hypoxia.
Question
Which of the following interventions is recommended to treat hypoxia in all cases to reverse cardiac arrest?
a. Packed RBCs
b. Surfactant
c. Inhaled corticosteroids and beta-agonists
d. Oxygen supplementation
Answer
d. Oxygen supplementation