what should be done to minimize interruptions in chest compressions during CPR?
continue CPR while the defibrillator is charging
what condition is an indication to stop of withhold resuscitative efforts?
safety to threat providers?
After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead II ECG appears below. What is your next action?
IV or IO access
After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action?
check for a pulse
what is the recommendation on the use of cricoid pressure to prevent aspiration during cardiac arrest?
not recommended for routine use?
What survival advantages does CPR provide to a patient in ventricular fibrillation?
produces a small amount of blood flow to the heart
what is the recommended compression rate for performing CPR?
at least 100 per minute
EMS personnel arrive to find a patient in cardiac arrest. Bystanders are performing CPR. After attaching a cardiac monitor, the responder observes the following rhythm strip. What is the most important early intervention?
defibrillation
a patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. the next intervention is to:
administer a second shock
what is the recommended next step after a defibrillation attempt?
begin CPR, starting with chest compressions
which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest?
antecubital vein
what is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?
300 mg
IV/IO drug administration during CPR should be
given rapidly during compressions
how often should the team leader switch chest compressors during a resuscitation attempt?
every 2 minutes
which finding is a sign of ineffective CPR?
PETCO2 <10 mm Hg
A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent?
closed-loop communication
how long should it take to perform a pulse check during the BLS survey?
1 to 5 seconds
Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient?
apply the AED
Which treatment or medication is appropriate for the treatment of a patient in asystole?
atropine
An AED advises a shock for a pulseless patient lying in snow. What is the next action?
administer the shock immediately and continue as directed by the AED
what is the minimum depth of chest compressions for an adult in cardiac arrest?
2 inches
a patient with pulseless ventricular tachycardia is defibrillated. what is the next action?
start chest compressions at a rate of at least 100/min.
You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action?
have a team member attempt to palpate a carotid pulse
emergency medical responders are unable to obtain a peripheral IV for a patient in cardiac arrest. what is the next most preferred route for drug administration?
Intraosseous (IO)
what is the appropriate rate of chest compressions for an adult in cardiac arrest?
at least 100/min
You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation?
divert the pt. to a hospital 15 minutes away with CT capabilities
a 53-year-old man has shortness of breath, chest discomfort, and weakness. the patient’s blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and pulse oximetry reading is 96%. The lead II ECG is displayed below. a patent peripheral IV is in place. what is the next action?
vagal maneuvers
a 49-year-old man has retrosternal pain radiating into the left arm. the patient is diaphoretic, with associated shortness of breath. the blood pressure is 130/88mm hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. the patients 12-lead ECG shows ST-segment elevation in the anterior leads. first responders administered 160mg of aspirin, and there is a patent peripheral IV. the pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. what is the next action?
administer 2 to 4 mg of morphine by slow IV bolus.
a 56-year-old man reports that he has palpations but not chest pain or difficulty breathing. the blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. the lead II ECG displays a wide-complex tachycardia. what is the next action after establishing an IV and obtaining a 12-lead ECG?
seeking expert consultation
a postoperative patient in the ICU reports new chest pain. what actions have the highest priority?
obtain a 12-lead ECG and administer aspirin if not contraindicated.
an 80-year-old woman presents to the emergency department with dizziness. she now states she is asymptomatic after walking around. her blood pressure is 102/72 mm Hg. She is alert and oriented. he lead II ECG is below. after you start an IV, what is the next action?
conduct a problem-focused history and physical examination.
what is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes?
160 to 325 mg
a responder is caring for a patient with a history of congestive heart failure. the patient is experiencing shortness of breath, a blood pressure of 68/50 mm hg, and a heart rate of 190/min. the patient’s lead II ECG is displayed below
unstable supraventricular tachycardia
what is the most appropriate intervention for a rapidly deteriorating patient who has this lead II ECG?
synchronized cardioversion
what is the purpose of a medical emergency team (MET) or rapid response team (RRT)?
improving patient outcomes by identifying and treating early clinical deterioration
what is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rythm?
10 to 12 breaths per minute
You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now?
obtaining a 12-lead ECG
family members found a 45-year-old woman unresponsive in bed. the patient is unconscious and in respiratory arrest. what is the recommended initial airway management technique?
performing a head tilt-chin lift maneuver
a patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm:
what is the appropriate intervention?
synchronized cardioversion
a patient has a witnessed loss of consciousness. the lead II ECG reveals this rhythm:
what is the appropriate intervention?
defibrillation
what is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation?
120 to 200 j
which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)?
measure from the corner of the mouth to the angle of the mandible.
which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes?
heart rate greater than 80/min
what is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)?
atropine Bolus
Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation?
initiate antiarrhythmic infusion
what is the immediate danger of excessive ventilation during the post-cardiac arrest period for patients who achieve ROSC?
decreased cerebral blood flow
what is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest?
32 degrees C to 34 degrees C.
what is the recommended duration of therapeutic hypothermia after reaching the target temperature?
12 to 24 hours
what is the danger of routinely administering high concentrations of oxygen during the post-cardiac arrest period for patients who achieve ROSC?
potential oxygen toxicity
what is the recommended dose of epinephrine for the treatment of hypotension in a post-cardiac arrest patient who achieves ROSC?
o.1 to 0.5 mcg/kg per minute IV infusion