Cardiovascular Disorder

Question 1

“CAB”

Answer 1

circulation, airway, breathing

Question 2

Depth:

Answer 2

5-6 cm (2-2.3 in)

Question 3

Rate:

Answer 3

100-120 bpm

Question 4

When providing positive pressure ventilation, target respirations at a rate of _______ bpm.

Answer 4

8-12

Question 5

Defibrillation should be performed immediately upon the diagnosis of a shockable ___________

Answer 5

ventricular rhythm

Question 6

___________should be performed in the pulseless patient while the defibrillator and monitor are being set up, but as soon as a shockable rhythm is noted on the monitor, defibrillate!

Answer 6

Chest compressions

Question 7

Continue to reassess the rhythm every 2 min after this, and __________ for shockable rhythms.

Answer 7

defibrillate

Question 8

The minimum energy for the first shock is typically at least _______. For pulsed biphasic waveforms, begin at 120-150 J.

Answer 8

150 J

Question 9

Increase ________ if needed, and provide 2 min of compressions between defibrillations.

Answer 9

energy

Question 10

Administer ___________ IV/intraosseous (IO) as soon as feasible. Redose with 1 mg epinephrine every other cycle of CPR.

Answer 10

epinephrine 1 mg

Question 11

Administer __________ IV/IO for resistant ventricular dysrhythmias.

Answer 11

amiodarone 300 mg

Question 12

________ is characterized by loss of
consciousness
apnea
and the absence of a palpable pulse, resulting from an insufficient cardiac output to deliver oxygen to vital organs.

Answer 12

Cardiac arrest

Question 13

____________ (ie, deep, slow breaths at a rate of 1-2/min) frequently occur in the first minutes of cardiac arrest and should not be mistaken as a sign of cardiac activity!

Answer 13

Agonal respirations

Question 14

Resuscitation should focus on two simultaneous goals:

Answer 14

(1) restoration of circulation and

(2) identification and correction of the underlying etiology of cardiopulmonary collapse.

Question 15

Approximately 20% of initial rhythms in out-of-hospital cardiac arrest are ________ (ventricular fibrillation [VF] and pulseless ventricular tachycardia [VT]). Coronary artery disease, structural heart disease, and genetic or stimulant-related etiologies are the most common cardiogenic presentations.

Answer 15

shockable

Question 16

Cardiac arrest is the loss of functional cardiac mechanical activity combined with an absence of _________It is the final common pathway of all life-threatening disease, rendering detection of the precipitating etiology difficult.

Answer 16

systemic circulation.

Question 17

Reversible causes of carcinogenic shock

Hypovolemia

Answer 17

Hemorrhage, dehydration, shock

Question 18

Reversible causes of carcinogenic shock

Hypoxia

Answer 18

Medications/drugs, COPD, OSA, drowning

Question 19

Reversible causes of carcinogenic shock

Hydrogen ion

Answer 19

Acidosis, metabolic, DKA, AKA

Question 20

Reversible causes of carcinogenic shock

Hypo/hyperkalemia (hypomagnesemia)

Answer 20

Malnourishment, AKI, ESRD, medications

Question 21

Reversible causes of carcinogenic shock

Hypothermia

Answer 21

Sedatives, trauma, drowning

Question 22

Reversible causes of carcinogenic shock

Tension pneumothorax

Answer 22

CPR-related, COPD, spontaneous

Question 23

Reversible causes of carcinogenic shock

Tamponade, cardiac

Answer 23

Type A dissection, cancer, iatrogenic

Question 24

Reversible causes of carcinogenic shock

Toxins

Answer 24

Opioids, CCB, BB, TCA, CO, CN

Question 25

Reversible causes of carcinogenic shock

Thrombosis, pulmonary

Answer 25

Cancer, immobility, OCP/pregnancy

Question 26

Reversible causes of carcinogenic shock

Thrombosis, cardiac

Answer 26

CAD, coronary artery dissection, prolonged QT

Question 27

Up to 80% of cases involve coronary artery disease (CAD) or a structural cardiac defect, which are more common in the ________

Answer 27

elderly.

Question 28

cardiac arrest PE

Answer 28

Patient is pulseless, unconscious, and unresponsive.

Question 29

Agonal breathing (slow, deep breathing) may be present and does not automatically preclude ________

Answer 29

pulselessness.

Question 30

________ and defibrillation are appropriate for a patient with cardiac arrest and agonal respiration.

Answer 30

Chest compressions

Question 31

Detection of _______ is associated with improved clinical outcomes.

Answer 31

agonal breathing

Question 32

Cardiac Arrest

asses for :

Answer 32

• Evidence of trauma or other environmental injury
  
  • Signs of bleeding
  • Abdominal distention or palpable mass
  • Implanted medical devices and catheters
  • Recent surgical incisions
  • Sudden, severe hypothermia

Question 33

If intubation is not immediately available, ventilate with a bag-mask and a HEPA filter using the 2-person technique to obtain a firm seal at _______ per minute

Answer 33

10 breaths

Question 34

Defer advanced airway maneuvers until later in the _________ or after return of spontaneous circulation unless basic airway maneuvers are insufficient to secure the airway, provide respirations, or prevent aspiration.

Answer 34

resuscitation

Question 35

Changes in quantitative end-tidal CO2 can guide resuscitative interventions.

Sustained normal or near-normal ________ values suggest acceptable circulation from chest compressions.

Answer 35

(≥20 mm Hg)

Question 36

Changes in quantitative end-tidal CO2 can guide resuscitative interventions.

A sudden increase suggests return of spontaneous ______

Answer 36

circulation.

Question 37

Changes in quantitative end-tidal CO2 can guide resuscitative interventions.

A sudden decrease suggests _______

Answer 37

loss of airway patency.

Question 38

Changes in quantitative end-tidal CO2 can guide resuscitative interventions.

A gradual decrease suggests _______

Answer 38

inadequate circulation (eg, compressor fatigue over time, uncontrolled hemorrhage).

Question 39

Suggested initial mechanical ventilator settings:

Answer 39

• Volume assist-control
• Tidal volume: 6 mL/kg
• Peak flow: 30 L/min
• Peak pressure limit: 100 cm H2O※
• Respiratory rate: 10; positive
• expiratory pressure: 0; fraction of inspired O2: 100%

Question 40

Prioritize timely epinephrine administration especially in cases with ___________

Answer 40

non-shockable rhythms.

Question 41

Administer _________ for persistent VF or pulseless VT after 2-3 defibrillation attempts.

Answer 41

antidysrhythmics

Question 42

Refractory ventricular dysrhythmias

Treatment:

Answer 42

Amiodarone 5 mg/kg (up to 300 mg) IV bolus or lidocaine 1-1.5 mg/kg (up to 100 mg) IV bolus may be given to stabilize the myocardium and is particularly useful in patients with witnessed arrests.

A second dose of amiodarone (up to 150 mg) IV bolus or lidocaine 0.5-0.75 mg/kg IV bolus may be given for persistent VF or pulseless VT.

Question 43

Double Sequential Defibrillation

1=> _________
2=> Apply pads in anterior–posterior and base–apex positioning.
3=> Limited data support this intervention.
4=> Exercise caution due to potential defibrillator damage.

Answer 43

Utilize identical models and pads.

Question 44

Double Sequential Defibrillation

1=> Utilize identical models and pads.
2=> _________
3=> Limited data support this intervention.
4=> Exercise caution due to potential defibrillator damage.

Answer 44

Apply pads in anterior–posterior and base–apex positioning.

Question 45

Double Sequential Defibrillation

1=> Utilize identical models and pads.
2=> Apply pads in anterior–posterior and base–apex positioning.
3=> Limited data support this intervention.
4=> ________

Answer 45

Exercise caution due to potential defibrillator damage.

Question 46

Subjects must meet all 3 criteria for resuscitation to be terminated prior to transportation to a hospital:

Answer 46

1=> Unwitnessed by EMS or bystander
2=> No automated external defibrillator or defibrillator shock delivered
3=> No return of spontaneous circulation despite resuscitation attempts

Question 47

n the ED or other hospital-based settings, multiple parameters are considered in the decision to terminate resuscitation.

Parameters include:

Answer 47

case-specific features, such as elapsed duration of resuscitation
initial cardiac rhythm
sustained end-tidal CO2 <10 mm Hg
identification of an irreversible etiology
unresponsiveness to resuscitative interventions, and patient-specific features, such as age, comorbidities, and advanced directives.

Question 48

The ALS Termination of Resuscitation Guidelines (TOR) carries the lowest risk (0.01%) of premature termination when all 4 of the following criteria are me

Answer 48

Arrest not witnessed
No bystander compressions
No return of spontaneous circulation before transport
No shock delivered before transport

Question 49

After ________of resuscitation, end-tidal CO2 values of ≤10 mm Hg are strongly associated with unsuccessful resuscitation.

Answer 49

20 min