ACLS Principles Flashcard 7
Rationale
A. Rationale: This is a critical concept. A gasp is not regular or normal breathing.
Question
Gasping is a sign of cardiac arrest in someone who is unresponsive.
a. True
b. False
Answer
a. True
Rationale
B. Rationale: Heat stroke can cause excessive fluid loss from sweating, which induces dehydration and hypovolemia. Hyperthermia is not a reversible cause of cardiac arrest.
Question
Heat stroke can cause cardiac arrest in older individuals, and this is due to which of the following reversible cause of cardiac arrest?
a. Hyperthermia
b. Hypovolemia
c. Hypoxia
d. Hydrogen ion
Answer
b. Hypovolemia
Rationale
C. Rationale: A palpable pulse and an organized rhythm indicate ROSC.
Question
If a palpable pulse is present in the PEA algorithm:
a. Shock with 300 J monophasic defibrillation
b. Cardioversion should be synchronized
c. Go to post-arrest care
d. Give amiodarone infusion
Answer
c. Go to post-arrest care
Rationale
A. Rationale: Lidocaine is given as a 1–1.5 mg/kg IV/IO first dose, then 0.5–0.75 mg/kg/IV/IO at 5- to 10-minute intervals to a maximum of 3 mg/kg.
Question
If amiodarone is not available, providers may consider:
a. Lidocaine
b. Dopamine
c. Procainamide
e. Adenosine
Answer
a. Lidocaine
Rationale
A. Rationale: Studies show that a majority of cardiac arrest patients are not provided with high-quality CPR, and as a consequence, the survival rate of patients with out-of-hospital cardiac arrest is only 10.4%, while it is 25.8% for those with in-hospital cardiac arrest.
Question
In 2020, the survival rate for patients with out-of-hospital cardiac arrest is:
a. 10.4%
b. 15.8%
c. 25.8%
d. 50%
Answer
a. 10.4%
Rationale
A. Rationale: In all scenarios of the adult Cardiac Arrest Algorithm, EMS personnel have been contacted and the AED or emergency equipment has been retrieved or someone is getting it before beginning CPR.
Question
In all scenarios of the adult Cardiac Arrest Algorithm, EMS has been contacted and the AED has been retrieved or someone is getting it before:
a. Beginning CPR
b. Approaching the patient
c. Checking for a pulse
d. Verifying safety of immediate environment
Answer
a. Beginning CPR
Rationale
A. Rationale: In all scenarios of the adult Cardiac Arrest Algorithm, EMS personnel should be contacted before beginning CPR. (ACLS Case: Cardiac arrest algorithm)
Question
In all scenarios of the adult Cardiac Arrest Algorithm, EMS personnel should be contacted:
a. before beginning CPR
b. before approaching the patient
c. before checking for a pulse
d. before verifying the safety of the immediate environment
Answer
a. before beginning CPR
Rationale
C. Rationale: Do not move the patient unnecessarily unless the environment is dangerous. Avoid frequent pulse checks.
Question
In an effort to minimize interruptions in chest compressions, you should:
a. Move the patient quickly to a more comfortable position.
b. Check the pulse every 20 seconds for no more than 5 seconds.
c. Avoid prolonged rhythm analysis.
d. All of the above
Answer
c. Avoid prolonged rhythm analysis.
Rationale
B. Rationale: The ECG appears to show sinus bradycardia. However, not feeling a pulse indicates the rhythm is actually pulseless electrical activity. ACLS must commence, and the first step is to call for help and activate the emergency response team. (ACLS Case: Cardiac Arrest: Algorithm)
Question
In the ICU, you are monitoring a patient that has the following ECG tracing.
You do not feel a pulse. What is the next appropriate action?
a. Administer a bolus of atropine 0.5 mg IV
b. Call for help and activate emergency response
c. Intubate the patient
d. Defibrillate at 120 J
Answer
b. Call for help and activate emergency response
Rationale
B. Rationale: Chest compressions should not be interrupted for more than 10 seconds (Systematic Approach in ACLS; BLS assessment)
Question
It is necessary to check the pulse and breathing status of a cardiac arrest patient when performing CPR, and thus interruption in chest compressions cannot be avoided. It is recommended that chest compressions should not be interrupted for more than:
a. 5 seconds
b. 10 seconds
c. 15 seconds
d. 30 seconds
Answer
b. 10 seconds