ALS PCS

Question 1

Medical Cardiac Arrest- Primary Clinical Considerations

Answer 1

In the following settings, consider very early transport after a minimum of one analysis (and defibrillation if indicated) once an egress plan is organized:
1. pregnancy presumed ≥ 20 weeks gestation (fundus above umbilicus, ensure manual displacement of uterus to left)
2. hypothermia
3. airway obstruction
4. non-opioid drug overdose/toxicology
5. other known reversible causes of arrest not addressed
For patients in Refractory VF or pulseless VT, transport of the patient should begin after the third consecutive shock. Refractory VF or pulseless VT is defined for the purpose of this directive, as persistent VF or pulseless VT after 3 consecutive shocks.

Question 2

Medical Cardiac Arrest Conditions- CPR

Answer 2

LOA- altered
Other- performed in 2 minute intervals

Question 3

Medical Cardiac Arrest Conditions- Manual Defibrillation

Answer 3

Age- ≥ 24 hours
LOA- altered
Other- VF or pulseless VT

Question 4

Medical Cardiac Arrest Conditions- AED or SAED Defibrillation

Answer 4

Age- ≥ 24 hours
LOA- altered
Other- defibrillation indicated, if not using manual defibrillation

Question 5

Medical Cardiac Arrest Conditions- EPINEPHrine

Answer 5

Age- ≥ 24 hours
LOA- altered
Other- anaphylaxis suspected as a causative event

Question 6

Medical Cardiac Arrest Conditions- Medical TOR

Answer 6

Age- ≥ 16 years
LOA- altered
Other- arrest not witnessed by a paramedic AND no ROSC 20 minutes of resuscitation AND no defibrillation delivered

Question 7

Medical Cardiac Arrest Contraindications- CPR

Answer 7

• Obviously dead as per the BLS PCC
• Meet conditions of the BLS PCS DNR standard

Question 8

Medical Cardiac Arrest Contraindications- Manual Defibrillation

Answer 8

• Rhythms other than VF or pulseless VT

Question 9

Medical Cardiac Arrest Contraindications- AED or SAED Defibrillation

Answer 9

• Non-shockable rhythm

Question 10

Medical Cardiac Arrest Contraindications- EPINEPHrine

Answer 10

• Allergy or sensitivity to NSAIDS

Question 11

Medical Cardiac Arrest Contraindications- Medical TOR

Answer 11

• Known reversible cause of the arrest unable to be addressed
• Pregnancy presumed to be ≥ 20 weeks gestation
• Suspected hypothermia
• Airway obstruction
• Non-opioid drug overdose/toxicology

Question 12

Medical Cardiac Arrest Treatment- Manual Defibrillation

Answer 12

Age (≥ 24 hours to < 8 years)
Dose: 1 defibrillation
Initial Dose: 2J/kg
Subsequent Dose(s): 4J/kg
Dosing Interval: 2 mins
Max # of Doses: N/A

Age ( ≥ 8 years)
Dose: 1 defibrillation
Initial Dose: As per RBHP/manufacturer
Subsequent Dose(s): As per RBHP/manufacturer
Dosing interval: 2 mins
Max # of Doses: N/A

Question 13

Medical Cardiac Arrest Treatment- AED or SAED Defibrillation

Answer 13

Age (≥ 24 hours to < 8 years)
Dose: 1 defibrillation with or without pediatric attenuator cable
Max Single Dose: As per RBHP/manufacturer
Dosing Interval: 2 mins
Max # of Doses: N/A

Age ( ≥ 8 years)
Dose: 1 defibrillation
Max Single Dose: As per RBHP/manufacturer
Dosing Interval: 2 mins
Max # of Doses: N/A

Question 14

Medical Cardiac Arrest Treatment- EPINEPHrine

Answer 14

Route: IM
Concentration: 1mg/mL = 1:1,000
Dose: 0.01mg/kg*
Max Single Dose: 0.5mg
Dosing Interval: N/A
Max # of Doses: 1
The dose may be rounded to nearest 0.05mg

Question 15

Trauma Cardiac Arrest Conditions- CPR

Answer 15

LOA- altered
Other- performed in 2 minute intervals

Question 16

Trauma Cardiac Arrest Conditions- Manual Defibrillation

Answer 16

Age- ≥ 24 hours
LOA- altered
Other- VF or Pulseless VT

Question 17

Trauma Cardiac Arrest Conditions- AED or SAED

Answer 17

Age- ≥ 24 hours
LOA- altered
Other- Defibrillation indicated