Advanced Life Support

Question 1

How many survive with resuscitation outside of the hopsital?

Answer 1

9%

Question 2

How many survive in hospital following resuscitation?

Answer 2

24%

Question 3

What are the two biggest causes of death in the UK?

Answer 3

Dementia

Ischaemic Heart Disease

Question 4

What are the shockable and non-shockable rhythms?

Answer 4

Shockable: (25%)

• Ventricualr Fibrillation
• Ventricular Tachycardia

Non-shockable: (75%)

• Asystole (50%)
• Pulseless Electrical Activity (PEA) (25%)

Question 5

What is ROSC?

Answer 5

Return of Spontaneous Circulation

- Occurs in 30% of patients following resuscitation

Question 6

What is the incidence of cardiac arrest in hospital?

Answer 6

1 in 1000

Question 7

In which season does cardiac arrest peak?

Answer 7

Winter

Question 8

What are the 4 steps in the Chain of Survival?

Answer 8

1) Early recognition/call for help
2) Early CPR
3) Early defibrillation
4) Post-resuscitation care

Question 9

How effective is CPR?

Answer 9

It doubles the chances of survival as it prolongs the oxygenation of the brain and heart

Question 10

What is the ratio of CPR to ventillation?

Answer 10

30 : 2

Question 11

How often do you give adrenaline?

Answer 11

Every 3-5 minutes

Question 12

When do you give amiodarone?

Answer 12

After 3 shocks

Question 13

After ROSC what is the target SpO2?

Answer 13

94 - 98%

Question 14

What is the difference between technical and non-tecnhical skills?

Answer 14

Technical: How to administer CPR, O2 etc.

Non-technical: Leadership, Communication, Teamwork etc.

Question 15

Give two examples of reversible causes of cardiac arrest

Answer 15

Hypoxia
Hypovolemia
Hypo/Hyperkalaemia
Hypo/Hyperthermia
Pulmonary thrombosis
Coronary thrombosis
Tamponade
Tension Pneumothorax
Toxins

Question 16

What are SBAR and RSVP?

Answer 16

Situation 
Background
Assessment
Recommendation
Decisions

Reason
Story
Vital signs
Plan

Question 17

True or false, most cardiac arrests occur without warning?

Answer 17

False. In 80% of cases there is gradual deterioration in clinical signs hours before the cardiac arrest.

Question 18

How often should NEWS be monitored?

Answer 18

If score is 0 then minumum 12 hrly
If total 1-4 then 4-6 hrly 
If 3 in any single parameter then minimum 1 hrly
Total 5-6 then 1 hrly
Total 7+ continuous monitoring

Question 19

Give an example of what you would monitor in ABCDE?

Answer 19

A - Talking / Clear breathing / On Air, O2?
B - SpO2 / Resp Rate 
C - Pulse / Blood pressure
D - Glucose / Consciousness / Pupils
E - Temperature / Rashes / Bleeding

Question 20

What does NEWS stand for?

Answer 20

National Early Warning Score

Question 21

Give two causes of airway obstruction

Answer 21

Foreign Body
Vomit
Blood
Direct trauma
Epiglottitis
Bronchospasm
Laryngospasm

Question 22

At what resp rate would you escalate to a Medical Emergeny Team (MET)?

Answer 22

< 5 per min

> 36 per min

Question 23

At what pulse rates would you escalate to a Medical Emergency Team (MET)?

Answer 23

< 40 per min

> 140 per min

Question 24

At what systolic pressure would you escalate to a Medical Emergency Team (MET)?

Answer 24

< 90 mmHg

Question 25

What disability factors would cause you to escalate to a Medical Emergency Team (MET)?

Answer 25

Sudden drop in >2 points on GCS

Repeated or prolonged seizures