What is a common but sometimes fatal mistake in cardiac arrest management?
Prolonged interruption in chest compressions

You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now?
Obtaining a 12-lead ECG

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

An activated AED does not promptly analyze the rhythm. What is your next action?
Begin chest compressions

3 mins after witnessing a cardiac arrest, 1 member inserts an ET tube while another performs chest compress. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What does this mean?
Chest compressions may not be effective

The use of quantitative capnography in intubated patients
allows for monitoring of CPR quality

For 25 minutes, an EMS crew has attempted resuscitation of a pt who presented in V Fib. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is next?
Consider terminating resuscitative efforts after consulting medical control

Which is a safe and effective practice within the defibrillation sequence?
Be sure oxygen is not blowing over the patient’s chest during the shock

D. Commandingly announce “clear” after you deliver the defibrillation shock. What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)?
Identifying and treating early clinical deterioration

Choose an appropriate indication to stop or withhold resuscitative efforts.
Evidence of igor mortis

What is the first treatment priority for a patient who achieves ROSC?
Optimizing ventilation and oxygenating

What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC?
90mm Hg

What is the potential danger of using ties that pass circumferentially around the patient’s neck when securing an advanced airway?
Obstruction of venous return from the brain

What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube?
Continuous waveform capnoraphy

What is the recommended IV fluid (normal saline or Ringer’s lactate) bolus dose for a patient who achieves ROSC but is hypotensive during the post-cardiac arrest period?
1 to 2 L

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

Choose an appropriate indication to stop or withhold resuscitative efforts.
Evidence of rigor mortis.

What is the usual poet-cardiac target range for PETCO2 when ventilating a patient who achieves return of post arrest spontaneous circulation (ROSC)?

you find a patient who is not breathing. You activate the EMS and you determine there is no pulse. What is your next action?
Start chest compressions

You are evaluating a 58 year old man with chest pain. The BP is 92/50 and HR is 92/mi, nonlabored respiratory rate is 14 breaths/min and the pulse ox reading is 97%. What is the assessment step is most important now?
Obtaining a 12 lead ECG

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

An activated AED does not promptly analyze the rhythm. what is the next action
begin chest compressions

completed 2 minutes CPR. the ECG monitor displays PEA and the patient has no pulse. Member of the team resumes chest compressions, IV placed. What is the management step is the next priority?
Admin 1mg Epi

during pause in cpr your monitor shows Normal sinus rhythm with no pulse. What is the next action
Resume chest compressions.

common mistake in cardiac arrest management?
prolonged interuptions in chest compressions

which action is a component in high quality chest compressions
allow complete chest recoil

whisch action increases the chance for successful conversion of V FIB?
providing quality compressions immediately before defib attempts

which situation best describes PEA
Normal sinus rhythm without a pulse

What is the best stratigy for preforming High quality CPR on a PT with advanced airway?
Continous chest compressions without pauses and 10 ventilations per minute.

3 min after witnessed cardiac arrest, 1 member inserts ET TUBE another preforms continious chest compressions during ventilation you notice the presence of waveform on capnography and a PETCO2 level of 8 mm/HG. what is the significance of this finding ?
chest compressions may not be effective

Use of quantitative capnography in intubated pt’s does what?
allows for monitoring CPR quality

past 25 minutes EMS crew has attempted resesitation of VFIB after 1st shock the ECG shows Asystole, which has persisted despite 2 doses of epi and fluid bolus and High quality CPR. What is next treatment
consider termination efforts after consult with MO

Which is a safe and effective practice within the defib sequence
be sure o2 is not blowing over patient chest during shocks

during the assessment pt loses consciousness after calling for help and determining the the patient isnt breathing you are unsure if the pt has a pulse, what is next action?
begin chest compressions

what is advantage of hands free defib pads instead of paddles?
hands free pads allow for more rapid defib.

what action is recommended to help minimize chest compressions during CPR
continue CPR while charging the defibrillator

which action is included in bls survey
early defib

which drug and dose is recommended for the management of refractory v fib.
amioderone 300 mg.

what is the appropriate interval for an interuption in chest compressions?
10 seconds or less

what is a sign of effective CPR?
PETCOs > or = 10 mm hg

the primary purpose of a medical emergency team or rapid response team?
id and tx early clinical deterioration

what action improves the quality of chest compressions delivered during a resuscitation attempt?
switch providers ~ every 2 min or q 5 compression cycles

what is appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80 p/min?
one breath q 5-6 seconds

pt presents with new onset of dizzines and fatigue. on exam pt HR 35 b/p 70/50 breaths p/min 22 O2 sats 95%. what is appropriate first med.?
atropine .5 mg

what is the appropriate dose of dopamine for a pt with bradycardia when the initial dose of atropine was ineffective?
2-10 mcg/kg p/min

sudden on set dizziness with HR 180 b/p 110/70, R 18, O2 98% room air, lead II ecg sinus tachy. what is the next appropriate intervention?
vagal maneuvers

an ICU pt developed sudden onset of narrow-complex tachycardia at a rate of 220/min. b/p 128/58, PETCO2 38, O2 98%. IV in left IJ and pt has not been given any vassoactive drugs. a 12 lead ECG confirms a supraventricular tachycardia w/ no evidence of ischemia or infarction. HR not responded to vagal maneuvers. what is the next recommended intervention ?
adenosine 6 mg IV

receiving a radio report from ems team enroute, pt may be having acute stroke, the hospital CT scan not working, what should you do in this situation
divert pt to a hospital with CT scan capabilities 15 minutes away.

what is an appropriate indication to stop or withhold resuscitative efforts?
evidence of rigor mortis

49 y/o women ER w/ persistent epigastric pain, she had been taking oral antacids for past 6hrs for self diagnosed heart burn. incial b/p 118/72, P 92 reg. non-labored R 14, Os 96%. what is the most appropriate intervention to perform next?
12 lead ECG

pt in respiratory failure becomes apnic but continues have strong pulse Hr dropping rapidly now showing sinus brady at rate of 30 /min. what intervention has highest priority?
simple airway maneuvers and assisted ventilation

what is appropriate proceedure for ET suction after the appropriate cath is selected?
suction during withdrawl but no longer then 10 seconds

treating a pt with dizziness, b/p 68/30 with cool clammy skin. lead II shows second degree AV block type II (looks like a shark)? what is the most appropriate first intervention?
atropine

a 68 y/0 woman experienced a sudden onset of right arm weakness. b/p 140/90 Hr 78, R 14, O2% 97. lead II ECG: normal sinus rythum. what is the next appropriate action?
cincinnati prehospital stroke scale

EMS is transporting a pt with pos prehospital stroke assessment. upon arrival of the ER, the initial b/p 138/78, P 80, R 12, O2% 95, lead II ECG: sinus rythum, blood glucose in normal limits. what intervention you perform next?
Head CT scan

proper vent rate for a pt in cardiac arrest with advanced airway placed?
8-10 B/min

62 y.o male in ER states hear “beating fast” denies angina or SOB, b/p 142/98, P 200, R 14, O2% 95? what intervention perform next?
12 ECG

you evaluate a 48 man with crushing chest pains. is a semi-truck driver pale, diaphoretic, cool to touch, slow to respond to questions, b/p 58/32, H 190, R 18, O2% unable to obtain due to no pulse, lead II ECG displays regular wide complex tachycardia. what intervention should you perform next?
synchronized cardio-version

what is the initial priority for unconscious patient with any tachycardia on the monitor?
review patients home medications

which rhythm synchronized cardioversion?
NSR on monitor with no pulse

what is the recommended second dose of adenosine for patients in refractory but stable narrow complex tachycardia ?
12 mg

what is the usual post cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation? (ROSC)
35-40 mm Hg

Which condition is a contraindication to therapeutic hypothermia during the post cardiac arrest. For patients who achieve return of spontaneous circulation?
responding to verbal commands

What is the potential danger of using ties that pass circumferential around the patients neck when securing a patients airway?
obstruction of venous return from the brain

What is the most reliable method of confirming and monitoring correct placement of ET Tube?
continuous Wave form capnography

what is the recommended IV fluid NS or LR bolus dose for a patient who achieve ROSC but is hypotensive during the post cardiac arrest period?
1-2 liters

what is the minimum systolic BP one should attempt to achieve with fliud, intropic , or vasopressor administration i n a hypotensive post cardiac arrest patient who achieves ROSC.
90

what is the 1st treatment priority in a patient who achieves ROSC ?
Optimizing oxygenation and ventilation

What are the H’S
Hypovolemia nHypoxia nhydrogen Ion (acidosis)nhypo/hyperkalimia nHypothermia

What are the T’S
tension Pneumo ntamponade (cardiac) ntoxinsnthrombosis, pulmonary/coronary

amioderonenncardiac arrest
300mg IV Bolus nnsecond dose 150 mg

epinepherine nncardiac arrest
1mg q 3-5

vasopressin nncardiac arrest
40 u can replace 1st or second dose of epi

epinepherine IV nnpost cardiac arrest
.1-.5 mcg/kg per minute

dopamine nnpost cardiac arrest
5-10 mcg /kg

norepinepherine nnnpost cardiac
.1-.5 mcg/kg per minute

Brady with pulse Atropine?
atropine .5 mg bolus repeat every 3-5 minutes nnMAX 3 MG

Brady with pulse Dopamine
2-10 mcg/kg per minute

Brady with pulse Epi?
2-10 mcg/min

Tachy with Pulse Adenosine ?
Adenosine 6 mg rapid IV follow with NS flush nn2nd dose 12 mg if required

tachy with pulse Amioderone
1st dose 150mg over 10 minutes repeat PRN if VT recurs

Adenosine Indication: stable narrow complex SVT Precaution: posion/drug induce tachycardia or 2 or 3 degree heart block Route: IV rapid push Dosage: 6 mg follow by a 20mL of NS raise extremity, second dosage of 12 mg if needed, 1-2min …

ADENOSINE indications for use *First drug for most forms of stable narrow complex SVT. *Effective in terminating those due to reentry involving AV node or sinus node. AMIODARONE indications for use *VF/pulseless VT unresponsive to shock delivery, CPR, and a …

Adenosine – Indications – First drug for most forms of stable narrow-complex SVT – Effective in terminating reentry involving AV node/sinus node – Narrow-complex reentry tachycardia while prepping for cardioversion – Wide-complex tachycardia, thought to be reentry SVT – Doesn’t …

VF/ pulseless VT drugs Epinephrine IV/IO (1mg q3-5min) Vasopressin IV/IO (40u can replace first or second dose of EPI Amiodarone IV/IO (First dose: 300mg bolus. 2nd dose: 150mg) Asystole/PEA drugs Epinephrine IV/IO (1mg q3-5min) Vasopressin IV/IO (40u can replace first …

What are the goals of ACLS? restoration of spontaneous ventilation and circulation Cerebral perfusion and resuscitation What is Class I benefit>>> risk? procedure/treatment or diagnostic test/assessment should be performed/administered WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY …

Adenosine First drug for most forms of stable narrow-complex SVT; effective in terminating those due to reentry involving AV node or sinus node Amiodarone Because its use is associated with toxicity, it is indicated for use in patients with life-threatening …

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