Cardiac Section Protocol Test
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Questions and Answers

What is the duration of time to check for a pulse?

  • 15 seconds
  • 10 seconds (correct)
  • 5 seconds
  • 20 seconds

    • What is the medication administered after 2 minutes of CPR?

  • Atropine 1 mg IV/IO push
  • Amiodarone 300 mg IV/IO push
  • Lidocaine 1.5 mg/kg IV/IO push
  • Epinephrine 1 mg IV/IO push (correct)

    • What is the recommended interval for repeating Epinephrine administration?

  • Every 2 minutes
  • Every 10 to 15 minutes
  • Every 3 to 5 minutes (correct)
  • Every 5 to 10 minutes

    • What is the alternative medication to Amiodarone?

    <p>Lidocaine</p> Signup and view all the answers

    What is the primary therapy for Cardiac Arrest victims?

    <p>High Quality CPR</p> Signup and view all the answers

    What is the recommended method of administration for Amiodarone?

    <p>Peripheral vein or IO administration</p> Signup and view all the answers

    What may indicate ROSC according to the protocol?

    <p>An abrupt sustained increase in ETCO2</p> Signup and view all the answers

    When should the Waveform End Tidal CO2 be used according to the protocol?

    <p>Routinely in cardiac arrests</p> Signup and view all the answers

    What is the recommended dose of fluid to be used with ET administration of drugs?

    <p>10 mL NS flush</p> Signup and view all the answers

    What should happen to the body after TERMINATION OF RESUSCITATION INSIDE AN AMBULANCE?

    <p>It should be removed from the ambulance, assuming the ambulance is not the site of homicide</p> Signup and view all the answers

    What is the preferred management of the traumatic arrest patient?

    <p>Surgical intervention at an appropriate verified trauma center</p> Signup and view all the answers

    Why is traumatic arrest approached separately from primary cardiac arrest?

    <p>Due to the mechanism of injury and cause of cardiopulmonary arrest</p> Signup and view all the answers

    What may exist in the post-traumatic circulatory arrest patient?

    <p>Severe hypovolemia</p> Signup and view all the answers

    What is the current stance on the use of ACLS/PALS-type medications in traumatic arrest?

    <p>We do not recommend their use</p> Signup and view all the answers

    What is contraindicated in the traumatic arrest patient?

    <p>Post-ROSC cooling</p> Signup and view all the answers

    What should be considered in a situation where the mechanism of injury appears inconsistent with the patient’s condition?

    <p>A primary medical cause for the patient’s cardiac arrest</p> Signup and view all the answers

    What is the minimum pulse rate required for a patient to meet the inclusion criteria for narrow complex tachycardia?

    <p>150</p> Signup and view all the answers

    What is the duration of the QRS complex in narrow complex tachycardia?

    <p>Less than 0.12 seconds</p> Signup and view all the answers

    What is the next step in the post-termination body movement protocol if the cause of death is unclear?

    <p>All of the above</p> Signup and view all the answers

    What is the minimum age requirement for a patient to be considered for the narrow complex tachycardia protocol?

    <p>16 years old</p> Signup and view all the answers

    What should be considered in the post-termination body movement protocol if the cause of death is likely homicide or child abuse?

    <p>Avoid body movement unless necessary for life safety and involve law enforcement and/or the coroner’s office</p> Signup and view all the answers

    Study Notes

    Ventricular Fibrillation/Tachycardia Adult w/o Pulse

    • Patient's age is 16 years and older
    • Patient is unresponsive
    • Patient is without a pulse (checked for a maximum of 10 seconds)

    AED Findings

    • Ventricular fibrillation or ventricular tachycardia without a pulse

    Protocol

    • Continue CPR and care per SB204
    • Defibrillate immediately at 360 Joules (biphasic equivalent or manufacturer's recommendation)
    • Immediately resume CPR
    • Perform CPR for 2 minutes before another pulse or rhythm check
    • Search for possible causes as listed in SB204
    • Administer Epinephrine 1 mg (10 ml of 0.1 mg/mL) IV/IO push
    • Repeat every 3 to 5 minutes as long as arrest continues
    • Administer Amiodarone 300 mg IV/IO push
    • Repeat Amiodarone 150 mg IV/IO push in 3-5 minutes if still in VF/VTach
    • Lidocaine may be substituted as: Lidocaine 1.5 mg/kg IV/IO push
    • Repeat Lidocaine 0.5 to 0.75 mg/kg IV/IO in 3-5 minutes if still in VF/VTach

    Notes

    • High-quality CPR (SB204) is the mainstay of therapy for cardiac arrest victims
    • If a pulseless patient is found to have agonal or gasping-type respirations, apply AED or quick-look paddles immediately
    • Consider H's and T's (see SB204)

    Traumatic Cardiac Arrest (Adult & Pediatric)

    • Traumatic arrest from both blunt and penetrating trauma carries high rates of mortality
    • The preferred management of the traumatic arrest patient is surgical intervention at an appropriate verified trauma center
    • The protocol aims to delineate patients who would benefit best from resuscitative efforts
    • Do not use ACLS/PALS-type medications including epinephrine/atropine in the setting of traumatic arrest

    Narrow Complex Tachycardia w/Pulse (Unstable)

    • Patient's age is 16 years and older
    • No history of trauma or fever
    • Pulse rate greater than 150
    • Patient has signs of inadequate perfusion

    Protocol

    • Assure airway patency and administer oxygen to correct hypoxia

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