American Red Cross ALS, ALS -
American Red Cross/ Latest Update
Atropine 0.5mg - CORRECT ANSWERS-While treating a patient with dizziness, a blood
pressure of 68/30 mm Hg, and cool, clammy skin, you see this lead II ECG rhythm:
What is the first intervention ?
Cincinnati Prehospital Stroke Scale assessment - CORRECT ANSWERS-A 68-year-old
woman experienced a sudden onset of right arm weakness. EMS personnel measure a
blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory rate
of 14 breaths/min, and a pulse oximetry reading of 97%. The lead II ECG displays sinus
rhythm. What is the most appropriate action for the EMS team to perform next?
Head CT scan - CORRECT ANSWERS-EMS is transporting a patient with a positive
prehospital stroke assessment. Upon arrival in the emergency department, the initial
blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12
breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG
displays sinus rhythm. The blood glucose level is within normal limits. What intervention
should you perform next?
8-10 breaths per minute - CORRECT ANSWERS-What is the proper ventilation rate for
a patient in cardiac arrest who has an advanced airway in place?
Obtain a 12 lead ECG. - CORRECT ANSWERS-A 62-year-old man in the emergency
department says that his heart is beating fast. He says he has no chest pain or
shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the
respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What
intervention should you perform next?
Synchronized cardioversion - CORRECT ANSWERS-You are evaluating a 48-year-old
man with crushing substernal chest pain. The patient is pale, diaphoretic, cool to the
touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the
heart rate is 190/min, the respiratory rate is 18 breaths/min, and the pulse oximeter is
unable to obtain a reading because there is no radial pulse. The lead II ECG displays a
regular wide-complex tachycardia. What intervention should you perform next?
Determine whether pulses are present. - CORRECT ANSWERS-What is the initial
priority for an unconscious patient with any tachycardia on the monitor?
Unstable supraventricular tachycardia - CORRECT ANSWERS-Which rhythm requires
synchronized cardioversion?
,12mg - CORRECT ANSWERS-What is the recommended second dose of adenosine
for patients in refractory but stable narrow-complex tachycardia?
35-40mm Hg - CORRECT ANSWERS-What is the usual post-cardiac arrest target
range for PETCO2 when ventilating a patient who achieves return of spontaneous
circulation (ROSC)?
Start chest compressions of at least 100 per min. - CORRECT ANSWERS-You find an
unresponsive pt. who is not breathing. After activating the emergency response system,
you determine there is no pulse. What is your next action?
Obtaining a 12 lead ECG. - CORRECT ANSWERS-You are evaluating a 58-year-old
man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the
nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%.
What assessment step is most important now?
Peripheral IV - CORRECT ANSWERS-What is the preferred method of access for epi
administration during cardiac arrest in most pts?
Begin chest compressions. - CORRECT ANSWERS-An AED does not promptly analyze
a rythm. What is your next step?
Administer 1mg of epinephrine - CORRECT ANSWERS-You have completed 2 minutes
of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no
pulse. Another member of your team resumes chest compressions, and an IV is in
place. What management step is your next priority?
Resume compressions - CORRECT ANSWERS-During a pause in CPR, you see this
lead II ECG rhythm on the monitor. The patient has no pulse. What is the next action?
Prolonged interruptions in chest compressions. - CORRECT ANSWERS-What is a
common but sometimes fatal mistake in cardiac arrest management?
Allowing complete chest recoil - CORRECT ANSWERS-Which action is a componant of
high-quality chest comressions?
Providing quality compressions immediately before a defibrillation attempt. - CORRECT
ANSWERS-Which action increases the chance of successful conversion of ventricular
fibrillation?
Sinus rythm without a pulse - CORRECT ANSWERS-Which situation BEST describes
pulseless electrical activity?
Provide continuous chest compressions without pauses and 10 ventilations per minute.
- CORRECT ANSWERS-What is the BEST strategy for performing high-quality CPR on
a patient with an advanced airway in place?
,Chest compressions may not be effective. - CORRECT ANSWERS-Three minutes after
witnessing a cardiac arrest, one member of your team inserts an endotracheal tube
while another performs continuous chest compressions. During subsequent ventilation,
you notice the presence of a waveform on the capnography screen and a PETCO2 level
of 8 mm Hg. What is the significance of this finding?
allows for monitoring of CPR quality. - CORRECT ANSWERS-The use of quantitative
capnography in intubated patients
Consider terminating resuscitate efforts after consulting medical control. - CORRECT
ANSWERS-For the past 25 minutes, an EMS crew has attempted resuscitation of a
patient who originally presented in ventricular fibrillation. After the first shock, the ECG
screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid
bolus, and high-quality CPR. What is your next treatment?
Be sure oxygen is not blowing over the patient's chest during the shock. - CORRECT
ANSWERS-Which is a safe and effective practice within the defibrillation sequence?
Begin chest compressions. - CORRECT ANSWERS-During your assessment, your
patient suddenly loses consciousness. After calling for help and determining that the
patient is not breathing, you are unsure whether the patient has a pulse. What is your
next action?
Hands-free pads allow for a more rapid defibrillation. - CORRECT ANSWERS-What is
an advantage of using hands-free defibrillation pads instead of defibrillation paddles?
Continue CPR while charging the defibrillator. - CORRECT ANSWERS-What action is
recommended to help minimize interruptions in chest compressions during CPR?
Early defibrillation - CORRECT ANSWERS-Which action is included in the BLS survey?
Amioderone 300mg - CORRECT ANSWERS-Which drug and dose are recommended
for the management of a patient in refractory ventricular fibrillation?
10 seconds or less - CORRECT ANSWERS-What is the appropriate interval for an
interruption in chest compressions?
PETCO2 ≥10 mm Hg - CORRECT ANSWERS-Which of the following is a sign of
effective CPR?
Identifying and treating early clinical deterioration. - CORRECT ANSWERS-What is the
primary purpose of a medical emergency team (MET) or rapid response team (RRT)?
, Switch providers about every 2 minutes or every 5 compression cycles. - CORRECT
ANSWERS-Which action improves the quality of chest compressions delivered during a
resuscitation attempt?
1 breath every 5-6 seconds - CORRECT ANSWERS-What is the appropriate ventilation
strategy for an adult in respiratory arrest with a pulse rate of 80/min?
Atropine 0.5mg - CORRECT ANSWERS-A patient presents to the emergency
department with new onset of dizziness and fatigue. On examination, the patient's heart
rate is 35/min, the blood pressure is 70/50 mm Hg, the respiratory rate is 22
breaths/min, and the oxygen saturation is 95%. What is the appropriate first
medication?
2 to 10 mcg/kg per minute - CORRECT ANSWERS-A patient with dizziness and
shortness of breath with a sinus bradycardia of 40/min. The initial atropine dose was
ineffective, and your monitor/defibrillator is not equipped with a transcutaneous
pacemaker. What is the appropriate dose of dopamine for this patient?
Vagal manuever. - CORRECT ANSWERS-A patient has sudden onset of dizziness. The
patient's heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18
breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown
below:
Adenosine 6mg IV push - CORRECT ANSWERS-A monitored patient in the ICU
developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The
patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg, and the pulse
oximetry reading is 98%. There is vascular access at the left internal jugular vein, and
the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a
supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate
has not responded to vagal maneuvers. What is the next recommended intervention?
Divert the patient to a hospital 15 minutes away with CT capabilities. - CORRECT
ANSWERS-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?
Evidence of rigor mortis. - CORRECT ANSWERS-Choose an appropriate indication to
stop or withhold resuscitative efforts.
Obtain a 12 lead ECG. - CORRECT ANSWERS-A 49-year-old woman arrives in the
emergency department with persistent epigastric pain. She had been taking oral
antacids for the past 6 hours because she thought she had heartburn. The initial blood
pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the
most appropriate intervention to perform next?
