Podcast
Questions and Answers
Which of the following is the primary focus during the initial patient assessment in cardiac arrest cases?
Which of the following is the primary focus during the initial patient assessment in cardiac arrest cases?
- Determining the presence or absence of a pulse
- Checking for responsiveness, breathing, and pulse (correct)
- Starting chest compressions
- Applying defibrillator pads
When should defibrillator pads be applied during chest compressions?
When should defibrillator pads be applied during chest compressions?
- After defibrillation
- After starting chest compressions (correct)
- Before starting chest compressions
- After determining the presence or absence of a pulse
What should be done if the patient does not have a shockable rhythm?
What should be done if the patient does not have a shockable rhythm?
- Resume compressions after defibrillation
- Initiate post resuscitation care
- Apply defibrillator pads
- Start chest compressions (correct)
What should be done if a pulse returns (ROSC)?
What should be done if a pulse returns (ROSC)?
Which medication should be administered within the first minute after resuming CPR?
Which medication should be administered within the first minute after resuming CPR?
How often can epinephrine be repeated during the arrest?
How often can epinephrine be repeated during the arrest?
When should sodium bicarbonate be considered for administration?
When should sodium bicarbonate be considered for administration?
In which situation should magnesium sulfate be administered?
In which situation should magnesium sulfate be administered?
When should double sequential defibrillation be considered?
When should double sequential defibrillation be considered?
Which intervention is recommended for a patient with hypothermia?
Which intervention is recommended for a patient with hypothermia?
What is the recommended treatment for hyperkalemia?
What is the recommended treatment for hyperkalemia?
What should be administered for hypoglycemia?
What should be administered for hypoglycemia?
What is the recommended treatment for tension pneumothorax?
What is the recommended treatment for tension pneumothorax?
What is the recommended treatment for thrombus (coronary or pulmonary)?
What is the recommended treatment for thrombus (coronary or pulmonary)?
Which is the preferred vascular access in cardiac arrest cases?
Which is the preferred vascular access in cardiac arrest cases?
Which medications can be given down the Advanced Airway during cardiac arrest?
Which medications can be given down the Advanced Airway during cardiac arrest?
What should be done before pulse checks and other interventions during cardiac arrest?
What should be done before pulse checks and other interventions during cardiac arrest?
When should a shockable rhythm be defibrillated during cardiac arrest?
When should a shockable rhythm be defibrillated during cardiac arrest?
When should a pulse check be performed during cardiac arrest?
When should a pulse check be performed during cardiac arrest?
Which of the following is true about airway management in a patient with cardiac arrest?
Which of the following is true about airway management in a patient with cardiac arrest?
When should the defibrillator be charged during chest compressions?
When should the defibrillator be charged during chest compressions?
When should endotracheal intubation be attempted in a patient with cardiac arrest?
When should endotracheal intubation be attempted in a patient with cardiac arrest?
What should be done if the vocal cords are not immediately visible during endotracheal intubation attempt?
What should be done if the vocal cords are not immediately visible during endotracheal intubation attempt?
Which of the following is the correct treatment for a patient with PEA (Pulseless Electrical Activity) and a normal/fast and narrow rhythm?
Which of the following is the correct treatment for a patient with PEA (Pulseless Electrical Activity) and a normal/fast and narrow rhythm?
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?
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?
What is the recommended treatment for a patient in asystole?
What is the recommended treatment for a patient in asystole?
What is the best indicator of a viable asystole?
What is the best indicator of a viable asystole?
What is the recommended treatment for a patient with PEA and a slow and narrow rhythm?
What is the recommended treatment for a patient with PEA and a slow and narrow rhythm?
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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
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