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Questions and Answers
What is identified by the ECG strip: Atrial Flutter?
What is identified by the ECG strip: Atrial Flutter?
Atrial Flutter
What is identified by the ECG strip: Second-degree atrioventricular block (Mobitz I Wenckebach)?
What is identified by the ECG strip: Second-degree atrioventricular block (Mobitz I Wenckebach)?
Second-degree atrioventricular block (Mobitz I Wenckebach)
What is identified by the ECG strip: Ventricular fibrillation?
What is identified by the ECG strip: Ventricular fibrillation?
Ventricular fibrillation
What is identified by the ECG strip: Monomorphic ventricular tachycardia?
What is identified by the ECG strip: Monomorphic ventricular tachycardia?
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What is identified by the ECG strip: Second-degree atrioventricular block (Mobitz II block)?
What is identified by the ECG strip: Second-degree atrioventricular block (Mobitz II block)?
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What is identified by the ECG strip: Atrial fibrillation?
What is identified by the ECG strip: Atrial fibrillation?
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What is identified by the ECG strip: Pulseless electrical activity?
What is identified by the ECG strip: Pulseless electrical activity?
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What is identified by the ECG strip: Sinus Bradycardia?
What is identified by the ECG strip: Sinus Bradycardia?
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What is identified by the ECG strip: Supraventricular Tachycardia?
What is identified by the ECG strip: Supraventricular Tachycardia?
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What is identified by the ECG strip: Normal Sinus Rhythm?
What is identified by the ECG strip: Normal Sinus Rhythm?
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What is identified by the ECG strip: Polymorphic Ventricular Tachycardia?
What is identified by the ECG strip: Polymorphic Ventricular Tachycardia?
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What is identified by the ECG strip: Agonal Rhythm/Asystole?
What is identified by the ECG strip: Agonal Rhythm/Asystole?
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What is your next action for a monitored patient in the ICU with a sudden onset of narrow-complex tachycardia at a rate of 220/min?
What is your next action for a monitored patient in the ICU with a sudden onset of narrow-complex tachycardia at a rate of 220/min?
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Which drug do you anticipate giving to a patient with a history of large intracerebral hemorrhage and a blood pressure of 180/100 mm Hg?
Which drug do you anticipate giving to a patient with a history of large intracerebral hemorrhage and a blood pressure of 180/100 mm Hg?
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What drug should be given next for a patient in pulseless ventricular tachycardia after two shocks and one dose of epinephrine?
What drug should be given next for a patient in pulseless ventricular tachycardia after two shocks and one dose of epinephrine?
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What is a contraindication to nitrate administration for a patient with ongoing chest discomfort?
What is a contraindication to nitrate administration for a patient with ongoing chest discomfort?
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What is the first drug/dose to administer when a patient is in cardiac arrest with asystole?
What is the first drug/dose to administer when a patient is in cardiac arrest with asystole?
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What is the appropriate medication order after one dose of epinephrine for a patient in refractory ventricular fibrillation?
What is the appropriate medication order after one dose of epinephrine for a patient in refractory ventricular fibrillation?
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Which intervention is most appropriate for the treatment of a patient in asystole?
Which intervention is most appropriate for the treatment of a patient in asystole?
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What is the initial dose of atropine for a patient with sinus bradycardia and a heart rate of 42/min?
What is the initial dose of atropine for a patient with sinus bradycardia and a heart rate of 42/min?
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What is the next action for a patient with STEMI and ongoing chest discomfort who has a history of gastritis?
What is the next action for a patient with STEMI and ongoing chest discomfort who has a history of gastritis?
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What action do you take next for a patient with palpitations, chest discomfort, and tachycardia consistent with the rhythm shown?
What action do you take next for a patient with palpitations, chest discomfort, and tachycardia consistent with the rhythm shown?
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What is the recommended second dose of amiodarone for a patient who is in refractory ventricular fibrillation?
What is the recommended second dose of amiodarone for a patient who is in refractory ventricular fibrillation?
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What therapy is indicated for a patient with sinus bradycardia, a heart rate of 36/min, and failed pacing?
What therapy is indicated for a patient with sinus bradycardia, a heart rate of 36/min, and failed pacing?
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In a cardiac arrest scenario, which method is preferred for medication administration if no pathway is in place?
In a cardiac arrest scenario, which method is preferred for medication administration if no pathway is in place?
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Which drug should be administered first after a patient is in cardiac arrest with refractory ventricular fibrillation?
Which drug should be administered first after a patient is in cardiac arrest with refractory ventricular fibrillation?
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What action is recommended next for a patient with a rapid irregular wide-complex tachycardia and a history of angina?
What action is recommended next for a patient with a rapid irregular wide-complex tachycardia and a history of angina?
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In which situation does bradycardia require treatment?
In which situation does bradycardia require treatment?
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What is the indication for the use of magnesium in cardiac arrest?
What is the indication for the use of magnesium in cardiac arrest?
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After finding asystole, which action do you take next?
After finding asystole, which action do you take next?
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What is the first action for a patient with unresponsive status and faint pulse presence?
What is the first action for a patient with unresponsive status and faint pulse presence?
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What is the maximum interval for pausing chest compressions?
What is the maximum interval for pausing chest compressions?
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What should you do immediately after providing an AED shock?
What should you do immediately after providing an AED shock?
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What is the recommended compression rate for high-quality CPR?
What is the recommended compression rate for high-quality CPR?
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Study Notes
ECG Identifications
- Atrial Flutter: Characterized by rapid, organized atrial contractions.
- Second-degree AV Block (Mobitz I - Wenckebach): Progressive lengthening of the PR interval leading to dropped beats.
- Ventricular Fibrillation: Chaotic electrical activity with no effective heartbeat.
- Monomorphic Ventricular Tachycardia: Consistent, regular QRS complexes indicating a rapid heart rate.
- Second-degree AV Block (Mobitz II): Intermittent dropped beats without progressive lengthening of the PR interval.
- Atrial Fibrillation: Irregularly irregular rhythm with no discernible P waves.
- Pulseless Electrical Activity (PEA): Organized electrical activity without a palpable pulse.
- Sinus Bradycardia: Heart rate less than 60 bpm with normal sinus rhythm.
- Supraventricular Tachycardia (SVT): Rapid heart rate originating above the ventricles.
Emergency Treatment Protocols
- Administer Adenosine (6 mg IV Push): Indicated for stable SVT unresponsive to vagal maneuvers.
- Aspirin for Stroke Assessment: Administer to patients with a history of intracerebral hemorrhage under appropriate conditions.
- Amiodarone (300 mg IV): Used during pulseless VT, especially after unsuccessful defibrillation.
- Use of Nitrates: Contraindicated in patients who have taken phosphodiesterase inhibitors within 24 hours.
- Epinephrine (1 mg IV/IO): First drug to give in cases of asystole and during cardiac arrest scenarios.
- Synchronized Cardioversion: Recommended for unstable tachycardia cases presenting with low blood pressure or symptoms.
Advanced Cardiac Life Support (ACLS) Details
- Magnesium Use: Indicated in cases of pulseless VT associated with torsades de pointes.
- High-quality CPR: Maintains a compression rate of 100 to 120 compressions per minute; pause for no longer than 10 seconds.
- Rescue Breathing: Administered every 6 seconds in patients with respiratory arrest.
- Compression Depth: At least 2 inches is recommended for adult victims during CPR.
- Cardiac Arrest Response: Resume compressions immediately following any AED shock.
Patient Management and Drug Administration
- Initial Dose of Atropine: 1 mg IV recommended for symptomatic bradycardia.
- Epinephrine Dosing in Resuscitation: Continue to administer 1 mg doses for patients in refractory cardiac fibrillation.
- Aspirin Administration: Should be provided to patients in STEMI with appropriate history, while avoiding in certain GI conditions.
Special Situations and Considerations
- Wide-complex Tachycardia: Seek expert consultation for asymptomatic patients with adequate blood pressure.
- Rescue Breathing After Carotid Pulse: Initiate if patient is unresponsive but has a detectable pulse.
- Ventilation Techniques: Ensure proper seal and minimize air entering the stomach during bag-mask ventilation by delivering enough volume to achieve chest rise.
Follow-up Actions
- Compressions Switch: Team members should alternate every 2 minutes to prevent fatigue.
- Recovery Procedures: In case of ventricular fibrillation, continue CPR and prepare for medication administration or further shocks.
- Anticipate Patient Needs: Always establish IV or IO access for rapid medication delivery in emergencies.
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Description
Test your knowledge of key ECG strips relevant for ACLS certification. This self-assessment includes various cardiac arrhythmias such as Atrial Flutter and different degrees of atrioventricular blocks. Perfect for reinforcing your understanding of critical heart rhythms.
