Podcast
Questions and Answers
Which type of atrioventricular block best describes this rhythm?
Which type of atrioventricular block best describes this rhythm?
To assess CPR quality in a patient in cardiac arrest and has been intubated, which should you do?
To assess CPR quality in a patient in cardiac arrest and has been intubated, which should you do?
Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field?
Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field?
Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?
Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?
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Which type of atrioventricular block best describes this rhythm?
Which type of atrioventricular block best describes this rhythm?
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To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
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In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube?
In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube?
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You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. Which treatment is best for this patient?
You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. Which treatment is best for this patient?
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Which best describes this rhythm?
Which best describes this rhythm?
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What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest?
What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest?
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Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?
Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?
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What is the primary goal of a medical emergency team or rapid response team?
What is the primary goal of a medical emergency team or rapid response team?
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What is the recommended next step after a defibrillation attempt?
What is the recommended next step after a defibrillation attempt?
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EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient's care on arrival?
EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient's care on arrival?
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A responder is caring for a patient with a history of congestive heart failure. Which best characterizes this patient's rhythm?
A responder is caring for a patient with a history of congestive heart failure. Which best characterizes this patient's rhythm?
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Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. He is unresponsive. Which is the next step in your assessment and management?
Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. He is unresponsive. Which is the next step in your assessment and management?
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Which best describes the length of time it should take to perform a pulse check during the BLS assessment?
Which best describes the length of time it should take to perform a pulse check during the BLS assessment?
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You instruct a team member to give 1 mg Atropine IV. Which is the best example of closed-loop communication?
You instruct a team member to give 1 mg Atropine IV. Which is the best example of closed-loop communication?
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What is an effect of excessive ventilation?
What is an effect of excessive ventilation?
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If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the team leader should take?
If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the team leader should take?
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Which best describes this rhythm?
Which best describes this rhythm?
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For STEMI patients, what is the maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention?
For STEMI patients, what is the maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention?
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What is the maximum interval you should allow for an interruption in chest compressions?
What is the maximum interval you should allow for an interruption in chest compressions?
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Which is one way to minimize interruptions in chest compressions during CPR?
Which is one way to minimize interruptions in chest compressions during CPR?
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Which best describes an action taken by the team leader to avoid insufficiencies during a resuscitation attempt?
Which best describes an action taken by the team leader to avoid insufficiencies during a resuscitation attempt?
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What is an acceptable method of selecting an appropriately sized oropharyngeal airway?
What is an acceptable method of selecting an appropriately sized oropharyngeal airway?
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You are evaluating a 58-year-old man with chest discomfort. Which assessment step is most important now?
You are evaluating a 58-year-old man with chest discomfort. Which assessment step is most important now?
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A patient in respiratory distress with a blood pressure of 70/50 mmHg presents with an ECG rhythm shown. Which is the appropriate treatment?
A patient in respiratory distress with a blood pressure of 70/50 mmHg presents with an ECG rhythm shown. Which is the appropriate treatment?
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During post-cardiac arrest care, what is the recommended duration of targeted temperature management after reaching the correct temperature range?
During post-cardiac arrest care, what is the recommended duration of targeted temperature management after reaching the correct temperature range?
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Three minutes into a cardiac resuscitation attempt, one member of your team inserts an endotracheal tube. What does a PETCO2 of 8 mmHg indicate?
Three minutes into a cardiac resuscitation attempt, one member of your team inserts an endotracheal tube. What does a PETCO2 of 8 mmHg indicate?
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What is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome?
What is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome?
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If a team member is unable to perform an assigned task because it is beyond their scope of practice, what should they do?
If a team member is unable to perform an assigned task because it is beyond their scope of practice, what should they do?
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As the team leader, when do you tell the chest compressors to switch?
As the team leader, when do you tell the chest compressors to switch?
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You are performing chest compressions during an adult resuscitation attempt. What rate should you use?
You are performing chest compressions during an adult resuscitation attempt. What rate should you use?
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A patient is being resuscitated in a very noisy environment. Which is the best response if a team member thinks they heard an order for 500 mg of amiodarone IV?
A patient is being resuscitated in a very noisy environment. Which is the best response if a team member thinks they heard an order for 500 mg of amiodarone IV?
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A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next?
A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next?
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A patient has a witnessed loss of consciousness. What is the appropriate treatment if their lead II ECG reveals this rhythm?
A patient has a witnessed loss of consciousness. What is the appropriate treatment if their lead II ECG reveals this rhythm?
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Which tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival?
Which tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival?
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What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation?
What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation?
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You have completed 2 minutes of CPR. What do you do next if the ECG monitor displays a lead II rhythm and the patient has no pulse?
You have completed 2 minutes of CPR. What do you do next if the ECG monitor displays a lead II rhythm and the patient has no pulse?
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Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest?
Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest?
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In addition to defibrillation, which intervention should be performed immediately?
In addition to defibrillation, which intervention should be performed immediately?
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Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient?
Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient?
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Despite the previously administered drug and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next?
Despite the previously administered drug and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next?
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The patient has return of spontaneous circulation and cannot follow commands. Which immediate post-cardiac arrest care intervention do you choose for this patient?
The patient has return of spontaneous circulation and cannot follow commands. Which immediate post-cardiac arrest care intervention do you choose for this patient?
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Which would you have done first if the patient had not gone into ventricular fibrillation?
Which would you have done first if the patient had not gone into ventricular fibrillation?
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Based on this patient's initial assessment, which adult ACLS algorithm should you follow?
Based on this patient's initial assessment, which adult ACLS algorithm should you follow?
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What is the initial action to take if the patient's pulse oximeter shows a reading of 84% on room air?
What is the initial action to take if the patient's pulse oximeter shows a reading of 84% on room air?
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After the initial assessment of this patient, which intervention should be performed next?
After the initial assessment of this patient, which intervention should be performed next?
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If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority?
If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority?
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Study Notes
Atrioventricular Blocks
- Second-degree type II AV block is characterized by consistent PR intervals with non-conducted beats.
- Second-degree type I AV block (Wenckebach) features progressively lengthening PR intervals before a dropped beat.
- Third-degree AV block indicates a complete dissociation between atrial and ventricular activity.
Cardiac Arrest Procedures
- Monitor PETCO2 to assess CPR quality in intubated cardiac arrest patients.
- Following return of spontaneous circulation, transport patients to a coronary reperfusion-capable center for optimal care.
- In a cardiac arrest scenario, immediately resume CPR after defibrillation attempts, starting with chest compressions.
Stroke Management
- Start fibrinolytic therapy immediately if a patient presents with stroke symptoms within 3 hours and has no contraindications.
- Dispatching an alert to the hospital by EMS significantly expedites care for stroke patients.
Ventilation and Capnography
- For ventilated patients, squeeze the bag every 5 to 6 seconds during positive pressure ventilation.
- Continuous waveform capnography is the most reliable method to confirm endotracheal tube placement.
Cardiac Monitoring
- A significant decrease in PETCO2 (e.g., persistent low readings) during CPR may indicate ineffective chest compressions.
- Administer 1 mg of Atropine IV for symptomatic bradycardia or AV block.
Emergency Protocols
- Maintain target temperature management between 32-36°C for at least 24 hours post-cardiac arrest.
- Rapid response teams aim to improve patient outcomes by addressing early signs of clinical deterioration.
Drug Administration
- The initial IV dose of amiodarone for refractory ventricular fibrillation is 300 mg; subsequent doses can be 150 mg.
- Aspirin doses in suspected acute coronary syndrome should range between 160 to 325 mg.
CPR Guidelines
- Interruptions in chest compressions during CPR should not exceed 10 seconds to maintain circulation.
- Chest compressions should be performed at a rate of 100 to 120 compressions per minute.
- Change chest compressors every 2 minutes to prevent fatigue and maintain effectiveness.
Cardiovascular Interventions
- Synchronized cardioversion is appropriate for unstable narrow-complex tachycardia and can be critical for hypotensive patients.
- Administer epinephrine (1 mg) and subsequently amiodarone (300 mg) for patients who remain in ventricular fibrillation post-defibrillation.
Pulse Checks and Assessments
- Perform a pulse check within 5 to 10 seconds during Basic Life Support (BLS) assessments.
- In unstable patients, such as those with suspected acute coronary syndrome, obtaining a 12-lead ECG is crucial for diagnosis.
Post-Cardiac Arrest Care
- Monitoring systolic blood pressure above 90 mm Hg is essential in post-cardiac arrest patients receiving vasopressors.
- Noncontrast CT scans should be conducted within 25 minutes of hospital arrival for suspected stroke evaluations.
Communication in CPR
- Closed-loop communication is vital; team members should confirm understanding of assigned tasks, such as esophageal intubation and medication administration.
- Essential interventions during resuscitation must be clearly delegated to avoid confusion and ensure efficiency.
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Description
Prepare for your ACLS exam with these final test flashcards. This quiz covers critical questions about atrioventricular blocks, CPR quality, and optimal EMS destinations for cardiac patients. Test your knowledge and improve your readiness for ACLS certification.
