A PATIENT ARRIVES IN THE ED WITH ( PEA ) AT 30 BPM. CPR CONTINUES, TUBE PLACEMENT CONFIRMED, IV IN PLACE. WHAT MEDICATION IS MOST APPROPRIATE TO GIVE NEXT.
EPINEPHRIN 1MG IV
WHAT HELPS DELIVER MAXIMUM CURRENT DURING DEFIBRILLATION
CORRECT POSITION OF PADS AND CONDUCTIVE PASTE IF PADDLES USED.
WHAT ACTIONS ARE USED WHEN PERFORMING CLEAR BEFORE DEFIBRILLATIOR DISCHARGE
CHECK THE PERSON MANAGING AIRWAY
CHECK YOURSELF
CHECK THAT NO OTHERS ARE TOUCHING PATIENT
I'M CLEAR, YOUR CLEAR, EVERYONE IS CLEAR
A PATIENT WITH NARROW COMPLES PSVT IN ER. ALERT, ORINENTED, BUT PALE. HR 165 BPM ECG SHOWS SVT. BP 105/70, O2 GIVEN, IV IN PLACE. WHAT DRUG-DOSE IS MOST APPROPRIATE AS INITIAL TREATMENT?
ADENOSINE 6MG RAPID IV PUSH
THEN
12MG
12MG
TRUE OR FALSE ARTIFACDT SIGNALS DISLPLAYED ON THE MONITOR CAN LOOK LIKE VF
TRUE
ENDOTRACHEAL INTUBATION COMPLETE AND YOU HEAR GURGLING OVER THE EPIGASTRIUM. WHAT ISSA THE LIKELY EXPLANATION FOR THIS?
INTUBATION OF ESOPHAGUS
WHAT SHOULD YOU DO AFTER GIVING IV MEDICATION DURING CPR.
FOLLOW IV MEDICATION WITH A FLUID BOLUS AND RAISE ARM.
WHEN TREATING A PATIENT IN VF AND AFTER 2 SHOCKS KYOU CONSIDER USING VASOPRESSIN. WHAT IS THE GUIDELINE FOR ITS USE:
GIVE VASOPRESSIN AS AN ALTERNATIVE TO A FIRS OR SECOND DOSE OF EPINEPHRINE.
WHAT AGENTS ARE USED FREQUENTLY IN THE EARLY MANAGEMENT OF ACUTE CARDIAC ISCHEMIA?
CHEWABLE ASPRIN
SUBLIGUAL NITROGLYCERIN
IV MORPHINE
WHAT OUT OF HOSPITAL ASYSTOLE IS MOST LIKELY TO RESPOND TO TREATMENT
1 SUBMERSION IN WARM WATER
2 DRUG OVERDOSE
3 BLUNT MULTISYSTEM TRAUMA
2 DRUG OVERDOSE
WITHIN 45 MINS OF ARRIVAL IN ER, WHAT EVALUATION SEQUENCES SHOUUD BE PERFORMED ON A PATIENT WITH STROKE SYMPTOMS.
A 34 Y/O WOMAN WIHT HX OF MITRAL VALVE PROLAPSE IS IN ED COMPLAING OF PALPITATIONS. VITAL SIGNS HR165, RESP 14, BP 118/92, O2 98%, LUNGS CLEAR, NO SOB. ECG SHOWS NARROW-COMPLEX TACHYCARDIA. WHAT TERM BEST DESCRIBES HER CONDITION?
STABLE TACHYCARDIA
PATIENT IN ER WITH 1 WEEK HX OF LIGHTHEADEDNESS, PALPITATIONS, AND MILD EXERCISE INTOLERRANCE. ECG SHOWS ( atrial fibrillation ) WHAT IS THE MOST APPROPRIATE NEXT INTERVENTION?
SEEK EXPERT CONSULTATION
VASOPRESSIN CAN BE RECOMMENDED FOR WHICH ARREST RHYTHMS?
VF, ASYSTOLE, AND PEA
BAG VENTILATIONS ARE PRESENT, NOW 2 MINS AFTER 1MG EPINEPHRINE IV ( PEA ) CONTINUES AT 30BPM. WHAT IS THE NEXT ACTION?
GIVE 1MG ATROPINE IV
A 25 Y/O WOMEN IN ER HAVING ANOTHER EPISODE OF PSVT. HR IS 180, HAS PALPITATIONS, MILD SOB,. BAGAL MANEUVERS AND CAROTID MASSAGE HAVE NO EFFEDCT ON HR OR RHYTHEM. WHAT SHOULD BE NEXT INTERVENTION?
IV ADENOSINE
A PATIENT WITH HR OF 30-40 BPM COMPLAINS OF DIZZINESS, COOL AND CLAMMY, DYSPNEA. ECG SHOWS ( 3RD DEGREE HEART BLOCK ) ALL MODALITIES ARE PRESENT. WHAT SHOULD BE CONSIDERED FIRST?
BEGIN IMMEDIATE TRANSCUTANEOUS PACING, AND SEDATE IF POSSIBLE
WHAT IS THE DRUG OF CHOICE FOR MOST NARROW-QRS TACHYCARDIA
ADENOSINE
VASOPRESSIN MAY BE USED IN THE MANAGEMENT OF?
V-FIB
THE MOST COMMON SIDE EFFECT OF GIVING AMIODARONE ARE?
BRADYCARDIA AND HYPOTENSION
WHAT APPROACHE IS RECOMMENDED DURING THE " INITAL " PATIENT EVALUATION?
LEVEL OF RESPONSIVENESS
AIRWAY
BREATHING
CIRCULATION
DEFIBRILLATION IF NECESSARY
WHAT IS THE FIRST ANTIARRHYTHMIC ADMINISTERED IN PATIENTS IN PULSELESS NENTRICULAR TACHYCARDIA OR VENTRICULAR FIBRILLATION?
AMIODARONE OR LIDOCAINE
AN ORAL AIRWAY IS IN PLACE, EACH VENTILATION DELIVERED OVER 1 SECOND AT RATE OF ?
10 - 12 VENTILATIONS PER MINUTE, EACH DELIVERED OVER 1 SEC.
A PATIENT WITH POSSIBLE ACUTE CORONARY SYNDROME SHOULD RECEIVE A TARGETED HISTORY AND PHYSICAL AND A 12 LEAD ECG WITHIN _____ MINS OF CONTACT ( PRE-HOSPITAL) OR ARRIVAL IN ER.
10 MINUTES
A PATIENT WITH SYMPTOMATIC BRADYCARDIA AND PLACED ON TRANSCUTANEOUS PACEMAKERE. The RATE SHOULD BE SET AT ____________ AND SHOUD BE INCREASED SLOWLEY UNTIL CAPTURE IS ACHIEVED.
60 - 80 BPM
MOST MYOCARDIAL INFARCTONS OCCUR BECAUSE OF ?
CORONARY THROMBOSIS
IS A MONOMORPHIC VENTRICULAR TACHYCARDIA A SHOCKABLE RHYTHM
YES
HOW SHOULD IV DRUGS BE GIVEN DURING CARDIAC ARREST
GIVE IV BOLUS AND FOLLOWED WITH A 20ML OF FLUSH, RAISE ARM
IF ATTEMPTS TO ESTABLISH A PERIPHERAL IV HAVE BEEN UNSUCCESSFUL, YOU BEST COURSE OF ACTION AT THIS TIME WILL BE?
ATTEMPT INTRAOSSEOUS ACCESS
HOW IS AMIODARONE GIVEN
300MG 1ST DOSE
150MG ONE REPEAT DOSE
FOR PULSELESS V-TAC OR F-FIB
WHAT DRUG CAN BE GIVEN IN DOSES OF 1MG TO A MAX OF 3MG IN ASYSTOLE OR SLOW PEA
ATROPINE
TRUE OR FALSE BAG-VALVE-MASK VENTILATION CAN PRODUCE GASTRIC DISTENTION THAT CAN LEAD TO VOMITING AND SUBSEQUENT ASPIRATION
TRUE
DEFIBRILLATION IS INDICATED IN THE MANAGEMENT OF?
PULSELESS VENTRICULAR TACHYCARDIA
VENTRICULAR FIBRILLATION
THE MOST COMMON CAUSE OF A STROKE IS ?
A CLOT ( THROMBUS )
A 72 Y/O PATIENT HAS SEVERE CHEST PAIN. HIS CONSCIOUSNESS SUDDENLY DECREASES AS AN ALARM SOUNDS ON THE MONITOR. THE MONITOR REVEALS ( MONOMORPHIC V-TACH ). HIS SKIN IS PALE, CLAMMY, BP 68/40, R 12. PULSE IS WEAK AND FAST., WHAT IS BEST COURSE OF ACTION IN THIS SITUATION?
CONSIDER SEDATION AND PERFORM SYNCHRONIZED CARDIOVERSION
THE CORRECT DOSE OF EPINEPHRINE, WHEN GIVEN VIA ET TUBE IS
2 - 2.5 MG
A PATIENT WITH A PERMANENT PACEMAKER IN PLACE. SHOULD IT BE NECESSARY TO DEFIBRILATE THIS PATIENT, THE PADS SHOULD BE PLACED?
1 INCH FROM THE PACEMAKER GENERATOR
TRANSCUTANEOUS PACING IS NO LONGER RECOMMENDED FOR WHICH OF THE FOLLOWING RHYTHMS.
C. ASYSTOL
WHAT DYSRHYTHMIAS IS MOST EASILY CONFUSED WITH MULTIFOCAL ATRIAL TACHYCARDIA.
ATRIAL FIBRILLATION
IF ATROPINE IS GIVEN ENDOTRACHEALLY THE CORRECT DOSE IS
2-2.5MG
HOW SHOULD IV EPINEPHRIN BE GIVEN DURING CARDIAC ARREST
1 MG OF EPINEPHRINE 1:10000 SOLUTION GIVEN RAPID IV PUSH EVERY 3-5 MINS. FOLLOWED BY 10ML FLUID AND RAISE ARM.
CPR IN PROGRESS IN A CARDIAC ARREST. THIS WAS NOT WITNESSED. THE CARDIAC MONITOR SHOWES FINE V-FIB. WHAT WOULD BE THE NEXT INTERVENTION?
CONTINUE CPR FOR 2MINS OR 5 CYCLES AND THEN DEFIBRILATE
A PATIENT IS NOT RESPONSIVE, NOT BREATHING, NO PULSE. CPR IS IN PROGRESS. IV ESTABLISHED, PATIENT IS VENTILATED. ECG SHOWES ( SINUS BRADYCARDIA ) WHAT ACLS GUIDELINES SHOULD BE USED
BECAUSE THE PATIENT HAS NO PULSE YOU MUST TREAT AS A ( PEA ) ALWAYS CHECK FOR CAUSE LIKE A TENSION PNEUMOTHORAX
THE ENERGY SELECTED FOR TCP IN INDICATED IN__________________
MILLAMPERES
PROPER ORAL AIRWAY SIZE IS DETERMINED BY MEASURING FROM THE CORNEROF THE MOUTH TO THE ANGLE OF THE _____
JAW
THE MOST COMMON VASOPRESSOR USED IN CARDIAC ARREST IS _________
EPINEPHRINE
_____________ CARDIOVERSION: THE TIMED DELIVERY OF A SHOCK DURING THE QRS COMPLEX
SYNCHRONIZED
TCP IS USUALLY PERFORMED IN _____________MODE
DEMAND
EVRY OTHER BEAT COMES FROM A SITE OTHER THAN THE SA NODE IS KNOWN AS ______________
BIGEMINY
THE ENERGY SELECTED FOR DEFIBRILLATION OR CARDIOVERSION IS INDICATED IN ____________
JOULES
SYNCHRONIZED CARDIOVERSION DELIVERS A SHOCK DURING THE ____________COMPEX
QRS
DEFIBRILLATION IS INDICATED IN THE MANAGEMENT OF ____________
PULSELESS VT
VF
SECOND-DEGREE AV BLOCK, TYPE II ; BP 64/42 AND A ALTERED MENTAL STATUS _____________IS INDICATED
TCP
A COMMON CAUSE OF PEA IS ____________
HYPOVOLEMIA
FIVE CYCLES OF EPR IS EQUAL TO ABOUT __________MINS
TWO MINS
MOST WIDE QRS TACHYCARDIAS ARE ________TACHYCARDIAS
VENTRICULAR
WHAT IS THE DEFINITIVE TREATMENT FOR CARDIAC TAMPONADE
PERICARDIOCENTESIS
A TYPE OF VT IN WHICH THE QRS COMPEXES ARE OF SIMILAR SHAPE AND AMPLITUDE IS KNOWN AS ___________
MONOMORPHIC
___________ INCREASES MYOCARDIAL OXYGEN DEMAND AND DECREASES TIME FOR CORONARY ARTER PERFUSION
TACHYCARDIA
THE MAXIMUM TOTAL DOSE OF ATROPINE FOR SYMPTOMATIC BRADYCARDIA OR ASYSTOL IS ______MG
3 MG
SIGNS OF HPERKALEMIA ON THE ECG ARE USUALLY SEEN AS TALL ________
T-WAVES
DO NOT USE __________GEL FOR DEFIBRILLATION
ULTRASOUND
MORPHINE SULFATE MAY BE USED IN THE MANAGEMENT OF ACUTE PULMONARY EDEMA BECAUSE IT_______________
CAUSES VASODILATION, REDUCING PRELOAD AND AFTERLOAD
WHEN ATROPINE IS USED IN THE MANAGEMENT OF ASYSTOL, THE CORRECT DOSE IS ____
1 MG
EXAMPLES OF IRREGUILAR TACHYCARDIAS INCLUDE_____________
