1. You find an unresponsive pt. who is not breathing. Start chest com- After activating the emergency response system, you pressions of at determine
... [Show More] there is no pulse. What is your next action? 2. You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now? 3. What is the preferred method of access for epi admin- istration during cardiac arrest in most pts? 4. An AED does not promptly analyze a rythm. What is your next step? 5. You have completed 2 min of CPR. The ECG monitor least 100 per min. Obtaining a 12 lead ECG. Peripheral IV Begin chest com- pressions. Administer 1mg of displays the lead below (PEA) and the pt. has no pulse. epinepherine You partner resumes chest compressions and an IV is in place. What management step is your next priority? 6. During a pause in CPR, you see a narrow complex rythm on the monitor. The pt. has no pulse. What is the next action? 7. What is acommon but sometimes fatal mistake in car- diac arrest management? 8. Which action is a componant of high-quality chest comressions? 9. Which action increases the chance of successful con- version of ventricular fibrillation? Resume compres- sions Prolonged inter- ruptions in chest compressions. Allowing complete chest recoil Providing quality compressions im- mediately before a defibrillation at- tempt. 10. Which situation BEST describes PEA? Sinus rythm with- out a pulse 11. What is the best strategy for perfoming high-quality CPR on a pt.with an advanced airway in place? 12. 3 min after witnessing a cardiac arrest, one memeber of your team inserts an ET tube while another per- forms continuous chest comressions. During subse- quent bentilation, you notice the presence of a wave- fom on the capnogrophy screen and a PETCO2 of 8 mm Hg. What is the significance of this finding? 13. The use of quantitative capnography in intubated pt's does what? 14. For the past 25 min, EMS crews have attemptedresus- citation of a pt who originally presented with V-FIB. After the 1st shock, the ECG screen displayed asys- tole which has persisted despite 2 doses of epi, a fluid bolus, and high quality CPR. What is your next treatment? 15. Which is a safe and effective practice within the defib- rillation sequence? 16. During your assessment, your pt suddenly loses con- sciousness. After calling for help and determining that the pt. is not breathing, you are unsure whether the pt. has a pulse. What is your next action? 17. What is an advantage of using hands-free d-fib pads instead of d-fib paddles? 18. What action is recommended to help minimize inter- ruptions in chest compressions during CPR? Provide continuous chest compressionswith- out pauses and 10 ventilations per minute. Chest compres- sions may not be effective. Allowsfor monitor- ing CPR quality Consider terminat- ing resuscitive ef- forts after consult- ing medical con- trol. Be sure O2 is NOT blowing over the pt's chest during shock. Begin chest com- pressions. Hands-free allows for more rapid d-fib. Continue CPR while charging the defibrillator. 19. Which action is included in the BLS survey? Early defibrillation 20. Which drug and dose are recommended for the man- agement of a pt. in refractory V-FIB? 21. What is the appropriate intervalfor an interruption in chest compressions? Amioderone 300mg 10 seconds or less 22. Which of the following is a sign of effective CPR? PETCO2 = or > 10mm Hg 23. What is the primary purpose of a medical emergency team or rapid response team? 24. Which action improves the quality of chest compres- sions delivered during resuscitave attemepts? 25. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min? 26. A pt. presents to the ER with a new onset of dizziness and fatugue. Onexamination, the pt's heart rate is 35 beats/min, BP is 70/50, resp. rate is 22 per min, O2 sat is 95%. What is the appropriate 1st medication? 27. A pt. presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt? 28. A pt. has an onset of dizziness. The pt.s heart rate is 180, BP is 110/70, resp. rate is 18, O2 sat is 98%. This Identifying and treating early clini- cal deterioration. Shitch providers about every 2 min or every 5 com- pression cycles. 1 breath every 5-6 seconds Atropine 0.5mg 2-10mcg/kg/min Vagal manuever. is a reg narrow complex tach rythm. What is the next intervention? 29. A monitored pt. in the ICU developed a suddent onset of narrow complex tach at a rate of 220/min. The pt's BP is 128/58, the PETCO2 is 38mm Hg, and the O2 sat is 98%. There is an EJ established for vascular access. The pt. denies taking any vasodialators. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. What is the next intervention? 30. You receiving a radio report from an EMS team en- route with a pt. who may be having a stroke. The hospital CT scanner is broken. What should you do? 31. Choose an appropriate inidication to stop or withhold resuscitive efforts. 32. A 49 y/ofmaile arrives in the ER with persistant epigas- tric pain. She has been taking antacids PO for the past 6 hours because she she had heartburn. BP is 118/72, heart rate is 92/min, resp. rate is 14 non-labored and O2 sat is 96%. What is the most appropriate next ac- tion? 33. A pt. in respiratory failure becomes apneic but con- tineues to have a strong pulse. The heart rate is drop- ping paridly and now shows a sinus brady rate at 30/min. What intervention has the highest priority? 34. What is the appropriate procedure for ET suctioning after the catheter is selected? 35. While treating a stable pt for dizziness, a BP of 68/30, cool and clammy, you see a brady rythm on the ECG. How do you treat this? Adenosine 12mg IV Divert the pt. to a hospital 15 min away with CT ca- pabilities. Evidence of rigor mortis. Obtain a 12 lead ECG. Simple airway manuevers and assisted ventila- tions. Suction during withdrawl, but not for longer than 10 seconds. Atropine 0.5mg 36. A 68 y/o female pt. experienced a sudden onset of right arm weakness. BP is 140/90, pulse is 78/min, resp rate is non-labored 14/min, 02 sat is 97%. Lead 2 in the ECG shows a sinus rythm. What would be your next action? 37. You are transporting a pt. with a positive stroke as- sessment. BP is 138, pulse is 80/min, resp rate is 12/min, 02 sat is 95% room air. Glucose levels are normal and the ECG shows a sinus rythm. What is next. 38. What is the proper ventilation rate for a pt. in cardiac arrest who has an advanced airway in place? 39. A 62 y/o male pt. in the ER says his heart is beating fast. No chest pain or SOB. BP is 142/98, pulse rate is 200/min, reps rate is 14/min, O2 sats are 95 at room air. What should be the next evaluation? 40. You are evaluating a 48 y/o male with crushing sub-sternal pain. He is cool, pale, diaphretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min, resp rate is 18, and you are unable to obtain an 02 sat due to no radial pulse. The ECG shows a wide complex tach rythm. What intervention should be next? 41. What is the initial priority for an unconscious pt. with any tachycardia on the monitor? Cinncinati Stroke Scale Head CT scan 8-10 breaths per minute Obtain a 12 lead ECG. Syncronized car- dioversion. Determine if a pulse is present. 42. Which rythm requires synchronized cardioversion? Unstable SVT 43. What is the recommended dose for adenosine for pt's in refractory, but stable narrow complex tachycardia? 44. What is the usual post-cardiac arrest target range for PETCO2 who achieves return of spontaneous circula- tion (ROSC)? 12mg 35-40mm Hg 45. Which conditionis a contraindication to theraputic hy- pothermia during the post-cardiac arrest period for pt's who achieve return of spontaneous circulation (ROSC)? 46. What is the potential danger to using ties that pass circumfrentially around the pt's neck when securing an advanced airway? 47. What is the most reliable method of confirming and montioring correct placement of an ET tube? 48. What is the recommended IV fluid (NS or LR) bolus dose for a pt. who achieves ROSC but is hypotensive during the post-cardiac arrest period? 49. What is the minimum systolic BP one should attempt to achieve with fluid, Inotropic, or vasopressor ad- ministration in a hypotensive post-cardiac arrest who achieves ROSC? 50. What is the 1st treatment priority for a pt. who achieves ROSC? Responding to verbal commands Obstruction of ve- neous return from the brain Continuous wave- form capnography 1 to 2 Liters 90mm Hg Optimizing ventila- tion and oxygena- tion. [Show Less]