ACLS 2

Question 1

Acidosis differential

Answer 1

Current thought – there’s a differential here, but the patient is probably already acidotic from coding, so thinking about this won’t change management…

Question 2

hyperkalemia treatment

Answer 2

sodium bicarbonate (IV), glucose+insulin, calcium chloride (IV), Kayexalate, dialysis, and possibly albuterol

Question 3

to remember with potassium infusion

Answer 3

never give undiluted IV potassium

Question 4

most common street drug causing pulseless arrest

Answer 4

cocaine

Question 5

cocaine toxicity on ECG

Answer 5

QT prolongation

Question 6

how are you going to examine someone for tamponade

Answer 6

1) look at neck for jugular vein distention (JVD)
2) assess pulses – no pulse or difficulty palpating a pulse
3) muffled heart sounds due to fluid inside the pericardium

Question 7

Simplified/more realistic version of H’s and T’s

Answer 7

1) Did this patient bleed out heavily?
2) Does this patient of lung disease or did that airway close somehow? Leading to tension pneumo?
3) Does this patient have underlying heart disease/CAD and have a massive MI?

Question 8

Physical exam assessment of cardiac arrest?

Answer 8

• reduced breath sounds on one side suggesting tension pneumo?

Question 9

physical signs of tension pneumo?

Answer 9

Physical signs include JVD, tracheal deviation, unequal breath sounds, difficulty with ventilation, and no pulse felt with CPR.