ACLS Principles Flashcard 11
Rationale
D. Rationale: During CPR, oxygen supplementation must be given at 100% when providing positive pressure ventilation.
Question
What is the best oxygen supplementation setting when providing ventilation in cardiac arrest patients?
a. 20%
b. 33%
c. 75%
d. 100%
Answer
d. 100%
Rationale
A. Rationale: Ventricular fibrillation will present with coarse waves or higher amplitude early in its course. If left untreated, the rhythm will progress to finer waves until a flat line is observed if no intervention is received.
Question
What is the distinguishing characteristic of the ECG tracing in a patient with cardiac arrest secondary to ventricular fibrillation early in its course?
a. Coarse waves
b. Fine waves
c. Faster rate
d. Slower rate
Answer
a. Coarse waves
Rationale
A. Rationale: Epinephrine to treat cardiac arrest is recommended to be given IV or IO with a solution of 1:10,000 dilution, 1 mg every 3 to 5 minutes. (ACLS Case: Cardiac Arrest)
Question
What is the dosage of epinephrine given in the treatment of cardiac arrest?
a. 1 mg every 3 to 5 minutes
b. 2 mg every 3 to 5 minutes
c. 1 mg before every pulse recheck
d. 2 mg single dose before every defibrillator shock
Answer
a. 1 mg every 3 to 5 minutes
Rationale
B. Rationale: Amiodarone is the first-line antiarrhythmic drug given during cardiac arrest because it can improve ROSC in patients with refractory ventricular fibrillation or pulseless ventricular tachycardia. When amiodarone is unavailable, lidocaine can be used. Magnesium sulfate can be used to treat torsades de pointes. Sotalol is an antiarrhythmic drug used to treat tachyarrhythmias with a pulse.
Question
What is the first-line antiarrhythmic drug given to cardiac arrest patients with persistent ventricular fibrillation that is unresponsive to defibrillation?
a. Atropine 1 mg IV bolus injection
b. Amiodarone 300 mg IV bolus
c. Sotalol 100 mg slow IV push
d. Magnesium sulfate 1 gram IV infusion over 5 to 20 minutes
Answer
b. Amiodarone 300 mg IV bolus
Rationale
D. Rationale: Rescuers must always ensure that the scene is safe for them to conduct the rescue. Otherwise, they must await the arrival of other professionals to ensure scene safety. These professionals may be firemen, police, or even a bomb squad.
Question
What is the foremost action that a rescuer must perform when entering a scene and intending to deliver first aid to a patient with a gunshot wound from a mass shooting event?
a. Check for response.
b. Shout for help.
c. Check for pulse.
d. Ensure scene safety.
Answer
d. Ensure scene safety.
Rationale
A. Rationale: ECC guidelines recommend administration of epinephrine every 3 to 5 minutes during resuscitation.
Question
What is the timing for giving epinephrine 1 mg IV bolus during resuscitation in cardiac arrest?
a. Every 3 to 5 minutes
b. Every 2 minutes
c. Just once
d. After 5 minutes
Answer
a. Every 3 to 5 minutes
Rationale
A. Rationale: “Asystole is a cardiac rhythm associated with no discernible electrical activity on the ECG.” This is represented by a flat line.
Question
What is your interpretation of an ECG tracing representing a cardiac arrest rhythm with absent electrical activity?
a. Asystole
b. Pulseless electrical activity
c. Ventricular tachycardia
d. Ventricular fibrillation
Answer
a. Asystole
Rationale
C. Rationale: The untrained bystander should provide compression-only CPR to adult patients with cardiac arrest. The responder may be guided by the dispatcher or not at all and should continue CPR until an AED or a trained rescuer arrives on the scene.
Question
What should an untrained bystander do in an adult cardiac arrest situation?
a. Contact EMS and stay away from the patient’s immediate vicinity
b. Help with crowd control
c. Compression-only CPR
d. Rescue breathing only
Answer
c. Compression-only CPR
Rationale
C. Rationale: When an advanced airway is in place, providing ventilations is made much easier and provides minimal interruptions in chest compressions. Chest compressions should be given continuously at a rate of 100–120 per minute. To prevent over-ventilation, the rescuers give one breath every 6 seconds with visible chest rise.
Question
What ventilation technique must be performed by multiple EMS responders to a patient in cardiac arrest with an advanced airway?
a. 2 breaths every 30 chest compressions
b. 2 breaths every 15 chest compressions
c. Asynchronous ventilation at 10 breaths per minute
d. Chest compression-only CPR
Answer
c. Asynchronous ventilation at 10 breaths per minute
Rationale
B. Rationale: When bystanders provide CPR, the chance of survival decreases only 3–4% per minute.
Question
When bystanders provide CPR, the chance of survival decreases 7–10% each minute.
a. True
b. False
Answer
b. False