Advanced Life Support

Question 1

Describe ventricular fibrillation (VF)

Answer 1

Chaotic, uncoordinated electrical activity

Question 2

In cardiac arrest what is the rhythm?

Answer 2

Pulseless electrical activity (PEA)

Although the rhythm shows 3rd degree heart block the fact that the patient is in cardiac arrest makes it pulseless electrical activity (PEA)

Question 3

Describe pulseless electrical activity

Answer 3

Any rhythm that would be expected to have a pulse that doesn’t.

Classically shown as NSR but can be any (non-shockable) rhythm with a QRS.

Question 4

When should adrenaline be administered on the shockable side of the algorithm?

Answer 4

After the 3rd shock

Question 5

What is the correct depth for chest compressions?

Answer 5

5-6cm

Question 6

When should we interrupt our 2 minutes of CPR?

Answer 6

Only if the patient shows PHYSICAL signs of life

Question 7

In cardiac arrest what is the rhythm?

Answer 7

Ventricular fibrilation (VF) - fine

Question 8

What is the correct rate for chest compressions?

Answer 8

100-120 per minute

Question 9

If after 2 minutes of CPR you paused for a rhythm check and saw this what would you do next and why?

Answer 9

Its VT so briefly check for a pulse (to make sure its pVT) and if no pulse immedately shock and restart CPR 30:2 for 2 minutes

Question 10

In cardiac arrest what is the rhythm?

Answer 10

Ventricular fibrilation (VF)

Question 11

What is the ration of compressions to ventilation?

Answer 11

30:2

Question 12

In cardiac arrest what is the rhythm?

Answer 12

Pulesless electircal activity (PEA)

Although the rhythm is normal sinus rhythm the fact that the patient is in cardiac arrest makes it pulseless electical activity (PEA)

Question 13

If after 2 minutes of CPR you paused for a rhythm check and saw this what would you do next and why?

Answer 13

Check for a pulse to confirm whether there was a return of circulation or if we were in PEA

Question 14

After delivery of a shock what is the first thing that should be done?

Answer 14

Immediately restarting CPR 30:2 for 2 min

Question 15

When should amiodarone be administered?

Answer 15

After the 3rd shock (straight after the adrenaline) A further 1/2 dose can be given after the 5th shock

Question 16

What is the dose of amiodarone in cardiac arrest?

Answer 16

300mg IV/IO

Question 17

Describe ventricular tachycardia (VT)

Answer 17

Rapid broad-complex rhythm

Question 18

If immdiately after a shock you saw this rhythm what would you do?

Answer 18

Continue CPR 30:2 for 2 minutes and then check for a pulse

It is not a sign of life it is only a change in rhythm

Question 19

In cardiac arrest what is the rhythm?

Answer 19

Torsades de pointes (TdP)

Treat as pVT/VF

Question 20

What are the shockable cardiac arrest rhythms?

Answer 20

Ventricular fibrillation (VF) Pulseless ventricular tachycardia (pVT)

Question 21

In cardiac arrest what is the rhythm?

Answer 21

Asystole

Question 22

When should adrenaline be administered on the non-shockable side of the algorithm?

Answer 22

As soon as vascular access is available

Question 23

If after 2 minutes of CPR you paused for a rhythm check and saw this what would you do next and why?

Answer 23

Its asystole so immediately resart CPR 30:2 for 2 min

No nee for a pulse check as aystole will never have a pulse

Question 24

Describe asystole

Answer 24

Absence of ventricular activity (QRS complex)

Question 25

In cardiac arrest what is the rhythm?

Answer 25

Pulseless ventricular tachycardia (pVT)

Question 26

In cardiac arrest what is the rhythm?

Answer 26

Asystole

P waves persisting but no QRS

Question 27

What is the dose of adrenaline in cardiac arrest?

Answer 27

1mg IV/IO (10ml of 1:10,000)

Question 28

What are the non-shockable cardiac arrest rhythms?

Answer 28

Asystole Pulseless electrical activity

Question 29

If after 2 minutes of CPR you paused for a rhythm check and saw this what would you do next and why?

Answer 29

It’s VF so shock and then immediately restart CPR 30:2 for 2 min.

No need for a pulse check as VF will never have one

Question 30

How frequently should adrenaline be administered after the initial dose?

Answer 30

Every 3-5 minutes (every alternate 2 minute loop)