VF/Pulseless VT

Question 1

What are the two shockable rhythms?

Answer 1

VF and pulseless VT

Question 2

First step in adult cardiac arrest

Answer 2

Shout for help/activate emergency response

Question 3

After activating emergency response… (3)

Answer 3

Start CPR
Give oxygen
Attach monitor/defibrillator

Question 4

After starting CPR has started, check if they are in a shockable rhythm. If yes…

Answer 4

Shock

Question 5

What are the two types of shock energy and what dose is given with each?

Answer 5

Biphasic - Manufacturer recommendation (120-200 J)

Monophasic - 360 J

Question 6

What if the manufacturer recommendation is not known for defibrillator dose?

Answer 6

Use maximum available.

Question 7

After initial shock… (2 things)

Answer 7

Immediately start CPR (2 minutes)

IV/IO access

Question 8

After 5 cycles of CPR, next step is to…

Answer 8

Conduct a rhythm check

Question 9

The pause in chest compressions to check the rhythm should not exceed _______

Answer 9

10 seconds

Question 10

If a nonshockable rhythm is present and the rhythm is organized (regular and narrow complexes), a team member should…

Answer 10

try to palpate a pulse

Question 11

If there is any doubt about the presence of a pulse…

Answer 11

immediately resume CPR

Question 12

If the rhythm is organized and there is a palpable pulse…

Answer 12

proceed to post-cardiac arrest care

Question 13

When IV/IO access is available…

Answer 13

give a vasopressor during CPR

Question 14

The two vasopressors that can be administered are…

Answer 14

Epinephrine

Vasopressin

Question 15

Dose and timing of two vasopressors

Answer 15

Epinephrine - 1 mg IV/IO - repeat every 3 to 5 minutes

Vasopressin - 40 units IV/IO - may substitute for the first or second dose of epinephrine

Question 16

What are the three antiarrhythmics to consider?

Answer 16

Amiodarone
Lidocaine
Magnesium sulfate

Question 17

What is the dose given of Amiodarone?

Answer 17

300 mg IV/IO bolus, then consider an additional 150 mg IV/IO once

Question 18

What is the dose given of Lidocaine? What is the maximum dose? When should Lidocaine be used?

Answer 18

1 to 1.5 mg/kg IV/IO first dose, then 0.5 to 0.75 mg/kg IV/IO at 5- to 10-minute intervals to a maximum dose of 3 mg/kg

Lidocaine should be used if Amiodarone is unavailable

Question 19

When should Magnesium sulfate be used?

Answer 19

Only for torsades de pointes

Question 20

What is the dose of Magnesium sulfate?

Answer 20

Loading dose 1 to 2 g IV/IO diluted in 10 mL of D5W given as IV/IO bolus, typically over 5 to 20 minutes

Question 21

What are the two main things monitored by quantitative waveform capnography?

Answer 21

Optimize chest compressions

Detect ROSC during chest compressions

Question 22

What is the main determinant of PETCO2 during CPR?

Answer 22

Blood delivery to the lungs

Question 23

Persistently low PETCO2 values below _____ during CPR suggest ROSC is unlikely

Answer 23

10 mm Hg

Question 24

If PETCO2 abruptly increases to a normal value of ____ to ____, it is likely to consider this an indicator of ROSC

Answer 24

35 to 40 mm Hg

Question 25

Coronary Perfusion Pressure or Arterial Relaxation Pressure correlate with _____ and ______

Answer 25

Myocardial blood flow and ROSC

Question 26

If the arterial relaxation pressure is below _______ it is reasonable to try to improve __________ or _________

Answer 26

20 mm Hg chest compressions vasopressor therapy

Question 27

Normal range for central venous oxygen saturation is ____ to ____. If SCVO2 is less than _____ it is reasonable to try to improve chest compressions and vasopressor therapy

Answer 27

60% to 80% <30%