Advanced Cardiac Life Support

Question 1

What are the four cardiac arrest rhythms?

Answer 1

Ventricular fibrillation (VF)
Pulseless VTach
Pulseless electrical activity (PEA)
Asystoles

Question 2

CPR occurs in cycles lasting ____ minutes each

Answer 2

2 mins

Question 3

Which two cardiac arrest rhythms are SHOCKABLE? Which two are NOT shockable?

Answer 3

Shockable = Ventricular fibrillation & Pulseless VTach
NOT shockable = Pulseless electrical activity & Asystole

Question 4

Chest compressions in CPR are done at a rate of ____ to ____ bpm

Answer 4

100 to 120

Question 5

For SHOCKABLE cardiac arrest rhythms, what is the maximum # of rounds of CPR and AED shocks that can be done, respectively?

Answer 5

3 rounds of CPR
3 shocks

Question 6

In SHOCKABLE CA rhythms, ____(1)____ is given after the second AED shock, and ___(2)___ or ___(3)____ can be given after shock #3 if (1) doesn’t work

Answer 6

(1) epinephrine
(2) Amiodarone
(3) lidocaine

Question 7

In NON-SHOCKABLE CA rhythms, what agent is given ASAP?

Answer 7

Epinephrine ONLY

Question 8

What are 3 routes that medications can be administered to patients in cardiac arrest?

Answer 8

IV
Intraosseous (IO) - same dose as IV
Endotracheal (ET) - uncommon, usually 2-2.5x IV dose thru tube

Question 9

What is the dosing of epinephrine in cardiac arrest (all rhythms)?

Answer 9

1 mg IV or IO q3-5 mins

Question 10

What is the dosing of amiodarone in shockable rhythms of CA?

Answer 10

300 mg bolus IV + x1 bolus 150 mg in 3-5 mins
Follow bolus with NS flush

Question 11

What are some risks with amiodarone use in cardiac arrest?

Answer 11

Bradycardia, hypotension
QT prolongation

Question 12

What is the dosing of lidocaine in shockable rhythms of CA?

Answer 12

1 - 1.5 mg/kg IV or IO + boluses 0.5 - 0.75 mg/kg PRN q5-10 mins

Question 13

When would lidocaine be preferred over amiodarone as an antiarrhythmic in cardiac arrest?

Answer 13

If amiodarone caused QT prolongation

Question 14

Magnesium may be considered in cardiac arrest if there patient is in what condition?

Answer 14

Torsade de pointes
Usually 2g IV bolus, flush with NS

Question 15

The “Hs and Ts” are reversible causes of cardiac arrest. Name the “Hs” (6)

Answer 15

Hypovolemia
Hypoxia
Hydrogen excess (acidosis)
Hyperkalemia* (from renal insufficiency/dialysis)
Hypothermia
(Hypoglycemia)

Question 16

The “Hs and Ts” are reversible causes of cardiac arrest. Name the “Ts” (4)

Answer 16

Tension pneumothorax
Tamponade
Toxins
Thrombosis (pulmonary or coronary)

Question 17

If a cardiac arrest was caused by renal insufficiency hyperkalemia, what agents may be administered to stabilize the myocardial membrane?

Answer 17

Calcium chloride OR
Calcium gluconate

Question 18

If a cardiac arrest was caused by temporary intracellular shift hyperkalemia, what agents may be administered to stabilize the myocardial membrane?

Answer 18

Sodium bicarb
Insulin + dextrose
Albuterol