28 Questions
Which of the following is the primary focus during the initial patient assessment in cardiac arrest cases?
Checking for responsiveness, breathing, and pulse
When should defibrillator pads be applied during chest compressions?
After starting chest compressions
What should be done if the patient does not have a shockable rhythm?
Start chest compressions
What should be done if a pulse returns (ROSC)?
Initiate post resuscitation care
Which medication should be administered within the first minute after resuming CPR?
Amiodarone
How often can epinephrine be repeated during the arrest?
Every 3-5 minutes
When should sodium bicarbonate be considered for administration?
After 10 minutes of CPR
In which situation should magnesium sulfate be administered?
Ventricular fibrillation
When should double sequential defibrillation be considered?
After 4 initial defibrillations
Which intervention is recommended for a patient with hypothermia?
Warm the patient
What is the recommended treatment for hyperkalemia?
Administer sodium bicarbonate
What should be administered for hypoglycemia?
Administer dextrose 50% (D50W)
What is the recommended treatment for tension pneumothorax?
Perform needle decompression
What is the recommended treatment for thrombus (coronary or pulmonary)?
Clot Buster in the ER
Which is the preferred vascular access in cardiac arrest cases?
Intraosseous (IO) access
Which medications can be given down the Advanced Airway during cardiac arrest?
Epinephrine, atropine sulfate, and naloxone (Narcan)
What should be done before pulse checks and other interventions during cardiac arrest?
Perform 2 minutes of CPR
When should a shockable rhythm be defibrillated during cardiac arrest?
Immediately after attaching defibrillator pads
When should a pulse check be performed during cardiac arrest?
Only if there is an increase in the ETCO2 level of 20 mm or more
Which of the following is true about airway management in a patient with cardiac arrest?
Continuous compressions and early defibrillation are the main focus.
When should the defibrillator be charged during chest compressions?
During the next cycle of compressions
When should endotracheal intubation be attempted in a patient with cardiac arrest?
After defibrillating and checking the rhythm
What should be done if the vocal cords are not immediately visible during endotracheal intubation attempt?
Insert a supraglottic airway without interrupting compressions
Which of the following is the correct treatment for a patient with PEA (Pulseless Electrical Activity) and a normal/fast and narrow rhythm?
Administer epinephrine 1:10,000, 1 mg IOP/IVP (10 mL)
Which of the following is the correct treatment for a patient with PEA and a slow and wide rhythm, who may have high serum levels of potassium?
Administer sodium bicarbonate, 1 mEq/kg IO/IV and calcium chloride, 1 gram IO/IV
What is the recommended treatment for a patient in asystole?
Administer epinephrine 1:10,000, 1 mg IOP/IVP (10 mL)
What is the best indicator of a viable asystole?
CO2 reading of 20 on waveform capnography
What is the recommended treatment for a patient with PEA and a slow and narrow rhythm?
Administer epinephrine 1:10,000, 1 mg IOP/IVP (10 mL)
Study Notes
Initial Patient Assessment
- Primary focus is on identifying cardiac arrest and activating emergency medical services (EMS)
Defibrillator Pads
- Apply defibrillator pads during chest compressions, as soon as possible
Non-Shockable Rhythm
- If patient does not have a shockable rhythm, continue CPR and consider other interventions
Return of Spontaneous Circulation (ROSC)
- If pulse returns, perform a rapid reassessment and consider additional interventions
Medication Administration
- Administer epinephrine within the first minute after resuming CPR
- Epinephrine can be repeated every 3-5 minutes during the arrest
- Consider sodium bicarbonate administration in certain situations (e.g., pre-arrest pH < 7.1)
- Administer magnesium sulfate for torsades de pointes
Special Situations
- For hypothermia, consider active rewarming and other interventions
- Treat hyperkalemia with calcium gluconate and insulin/glucose
- Treat hypoglycemia with glucose
- Treat tension pneumothorax with needle decompression
- Treat thrombus (coronary or pulmonary) with fibrinolytics or percutaneous coronary intervention (PCI)
Vascular Access
- Preferred vascular access is through intraosseous (IO) or central venous catheter (CVC)
Medication Administration via Advanced Airway
- Medications that can be given down the Advanced Airway include epinephrine, lidocaine, and atropine
Pulse Checks and Interventions
- Minimize interruptions in chest compressions before pulse checks and other interventions
Defibrillation
- Defibrillate shockable rhythms as soon as possible, and immediately resume chest compressions
Pulse Checks
- Perform pulse checks every 2 minutes during cardiac arrest
Airway Management
- Airway management should be prioritized during cardiac arrest, with consideration for bag-valve-mask (BVM) ventilation and endotracheal intubation
Endotracheal Intubation
- Attempt endotracheal intubation as soon as possible during cardiac arrest
- If vocal cords are not immediately visible during endotracheal intubation attempt, use alternative airway management strategies
PEA (Pulseless Electrical Activity)
- For PEA with normal/fast and narrow rhythm, consider cardiac tamponade, tension pneumothorax, and other causes
- For PEA with slow and wide rhythm and high serum potassium levels, administer calcium gluconate
- For asystole, continue CPR and consider other interventions
- For PEA with slow and narrow rhythm, consider other interventions and causes
Asystole
- Best indicator of a viable asystole is a wide complex rhythm with a pulse
This quiz tests your knowledge on the timing and actions to take during cardiac arrest, including the administration of epinephrine and checking the rhythm. Test your skills and learn the proper protocols for CPR and resuscitation.
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