Pre-course MCQ

Question 1

What are the ECG features of a posterior STEMI?
What vessel is implicated?

Answer 1

• ST-depression in leads V1–3
• Dominant R waves V1-2
• Left circumflex or right coronary artery

Question 2

When using transcutaneous pacing, when does electrical capture typically occur?

Answer 2

• With a current of 50–100mA

Question 3

What should you check for when there is electrical capture and QRS complexes and why?

Answer 3

• Pulse
• QRS complex does not guarentee myocardial contractility –absence of pulse in presence of good electrical capture = PEA

Question 4

What happens initially during drowning?

Answer 4

• Laryngospasm and breath holding preventing entry of water into the patient’s lung

Question 5

In relation to submersion durations, what is the prognosis?

Answer 5

• <10m = very high chance of good outcome
• > 25m = low chance of good outcome

Question 6

How are PaO2 and inspired concentration linked?

Answer 6

• PaO2 should be numerically around 10 less than the inspired concentration

Question 7

If a DNACPR decision is made with a person who has an ICD, how is this managed?

Answer 7

• Keep shock function of ICD as although may not want CPR they may choose to have treatment from ICD which could restore their current clinical situation

Question 8

What is the pharmacology of adrenaline?

Answer 8

• Alpha and beta-adrenergic effects
• No long-term benefits when given in cardiac arrest
• Increases systemic vasoconstriction
• Improves coronary and cerebral perfusion pressures during CPR

Question 9

In patients with asthma in cardiac arrest, what needs to be considered during defibrillation?

Answer 9

• Higher defibrillation energies after first failed shock as hyperinflation increases thoracic impedance

Question 10

What is the management of ventricular standstill?

Answer 10

• External pacing more likely to achieve cardiac output than most cases of complete asystole