Cardiac Arrest Exam Questions with
Complete Solutions
Systemic Approach - Answer-1. Initial impression
a. unconscious or conscious patient (appearance)
o Unconscious patient- BLS assessment
o Conscious patient- primary assessment and secondary assessment.
**Scene safety first, then...initial impression. Provider visually checks while approaching
pt.
BLS Assessment - Answer-CAB
o Check responsiveness
o Shout for help, activate emergency response system, get AED (or send someone)
o Assess for breathing and pulse
o If no pulse, start CPR beginning with compressions
Check for shockable rhythm as soon as AED/defibrillator arrives
o If pulse but no breathing, start rescue breathing
**In an unconscious patient, perform BLS assessment first**
Agonal Breathing/Gasps - Answer-**Not moving any air, they are not actually breathing.
Resuscitation and CPR should continue even if agonal breathing is present. Agonal
breathing is common after cardiac arrest.**
• May be present in first few minutes after sudden cardiac arrest
• It is NOT normal breathing! It is a sign of cardiac arrest!
• The mouth may be open and the jaw, head, or neck may move with gasps. Can
appear forceful or weak, usually at a slow rate. No air is moving!!
** in a conscious patient, do primary assessment first. In unconscious patient- primary
assessment follows BLS assessment/ interventions**
Airway - Answer-• Is the airway patent?
• Is an advanced airway indicated?
• Is proper placement of airway device confirmed?
• Is tube secured and placement reconfirmed frequently?
Breathing - Answer-• Are ventilation and oxygenation adequate?
• Are quantitative waveform capnography and oxyhemoglobin saturation monitored?
, Circulation - Answer-• Are chest compressions effective?
• What is the cardiac rhythm?
• Is defibrillation or cardioversion indicated?
• Has IV/IO access been established?
• Is ROSC present? (ROSC- return of spontaneous circulation)
• Is the patient with a pulse unstable?
• Are medications needed for rhythm or blood pressure?
• Does the patient need volume/fluid for resuscitation?
Disability - Answer-• Check for neurologic function
• Quickly assess for responsiveness, level of consciousness, pupil dilation
• AVPU (alert, responds to verbal stimuli, pain stimuli, unresponsive)
Exposure - Answer-• Remove clothing to perform a physical examination, looking for
obvious signs of trauma, bleeding, burns, unusual markings, or medical alert bracelets
o Figure out why this happened. Possible cause of why the patient has gone into
cardiac arrest.
Secondary Assessment - Answer-• History (SAMPLE) (situation and s/sx, allergies,
medications, past medical history, last oral intake, events leading up to the present
injury.
• Identifying and treating underlying causes: Five Hs and Five Ts
**The focus is on a differential diagnosis - why did this person have this cardiac arrest at
this time?**
Priorities During Cardiac Arrest - Answer-• High quality CPR and early defibrillation
• Advanced airway and drugs are secondary
• Identifying and treating underlying cause in another priority after CPR/defib
Components and indicators of high-quality CPR - Answer-1. Components:
o Quality chest compressions
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