Adjunct Techniques and Interventions Flashcard
Rationale
B. Rationale: Providing supplemental oxygen at the highest setting delivers the maximal inspired oxygen dose. (Adjuncts for ACLS: Bag-Mask Ventilation)
Question
During CPR, positive pressure ventilation via a bag-mask connected to an oxygen supply is administered at the rate of 2 ventilations for every 30 chest compressions. At the beginning of CPR, the team should give supplementary oxygen:
a. Never at the highest setting
b. At the highest setting (FiO2 100%)
c. Only if the patient has been in a drowning incident
d. At between 2 and 3 liters per minute
Answer
b. At the highest setting (FiO2 100%)
Rationale
C. Rationale: Asynchronous ventilation helps decrease interruptions in chest compressions by providing ventilation while performing chest compressions simultaneously. Give intubated patients 1 breath every 6 seconds. (Chapter 7: Adjuncts)
Question
How does one provide ventilation on an intubated patient in a multiple rescuer scenario?
a. Give 2 breaths after every 30 chest compressions
b. Give 2 breaths after every 15 chest compressions
c. Give 1 breath every 6 seconds with continuous compressions
d. There is no difference in providing ventilation in single-rescuer and team scenarios
Answer
c. Give 1 breath every 6 seconds with continuous compressions
Rationale
B. Rationale: If, after 20 minutes of resuscitation, the ETCO2 remains at 10 mm Hg or less and does not improve, it may signify an extremely poor chance of achieving ROSC and survival. (Adjuncts for Advanced Cardiovascular Life Support; Adjuncts to CPR)
Question
If, after 20 minutes of resuscitation, the end-tidal carbon dioxide remains < 10 mm Hg, the provider can assume:
a. Adequate ventilation of the patient
b. The patient has a very poor chance of survival
c. There is an upper airway obstruction
d. There is a lower airway obstruction
Answer
b. The patient has a very poor chance of survival
Rationale
C. Rationale: The preferred route of medication administration is the IV route. If the team cannot establish an IV, then IO access should be established. The endotracheal administration of medications should only be done if the team cannot establish one of the other two routes. The IV route is the quickest way for medications to reach the central circulation and heart.
Question
In the adult patient requiring medications, the preferred order for administration routes is:
a. IO, IV, endotracheal
b. IV, IM, IO
c. IV, IO, endotracheal
d. IV, IO, IM
Answer
c. IV, IO, endotracheal
Rationale
C. Rationale: Waveform capnography is the most accurate way to assess CPR and ET tube placement. The clinician should use this technology in conjunction with clinical assessment.
Question
Quantitative waveform capnography is:
a. A class II recommendation for ET tube
b. Unsuitable for supraglottic airways
c. Used in conjunction with a physical examination to determine advanced airway placement
d. Not indicated during CPR on a patient who has drowned
Answer
c. Used in conjunction with a physical examination to determine advanced airway placement
Rationale
D. Rationale: Waveform capnography is the most accurate way to monitor the adequacy of ventilation and CPR. The other interventions may be useful but are not the best way to monitor.
Question
The most accurate way to monitor the adequacy of ventilation and oxygenation in a patient with cardiac arrest is by:
a. Confirming placement of the ET tube
b. Auscultation of breath sounds
c. Monitoring oxygen saturation
d. Waveform capnography
Answer
d. Waveform capnography
Rationale
C. Rationale: Establishing a patent airway is essential when doing CPR. Sometimes, due to the loss of muscle tone in the throat, the tongue can fall back and cause an obstruction. An oropharyngeal airway can establish and maintain airway patency by pushing the tongue anteriorly and away from the pharyngeal wall. (Adjuncts for Airway Control and Ventilation)
Question
Which of the following basic airway adjuncts is most useful for an unconscious patient with an absent gag reflex in respiratory distress? The head tilt-chin lift and jaw-thrust maneuvers are unable to open the patient’s airway.
a. Nasopharyngeal airway
b. Laryngeal mask
c. Oropharyngeal airway
d. Continuous positive airway pressure (CPAP) device
Answer
c. Oropharyngeal airway
Rationale
B. Rationale: End-tidal carbon dioxide (ETCO2) measurements can be a predictor of resuscitation success. Studies have shown that if the ETCO2 remains at 10 mm Hg or less after 20 minutes of resuscitation, the patient has a reduced chance of survival. (Chapter 7: Adjuncts)
Question
Which of the following is the role of end-tidal carbon dioxide during resuscitation?
a. It measures the depth of chest compressions.
b. It is a good predictor of failed resuscitation.
c. It calculates the dosage of the next administration of epinephrine.
d. It is a good predictor of converting a shockable cardiac arrest rhythm.
Answer
b. It is a good predictor of failed resuscitation.