Electrical Therapies and Defibrillation Flashcards
7 cards from real ACLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Electrical Therapies and Defibrillation flashcards as text
What is the recommended initial energy for synchronized cardioversion of unstable atrial flutter using a biphasic device?
Answer: 50–100 J
Atrial flutter typically responds to lower cardioversion energies; ACLS recommends starting at 50–100 J biphasic for unstable flutter.
A patient in pulseless VT is refractory after two defibrillation attempts. What is the recommended next action regarding energy?
Answer: Use manufacturer-recommended escalating doses or maximum dose for subsequent shocks
For refractory VF/pVT, subsequent shocks should use manufacturer-recommended escalating energy or the maximum device dose to improve defibrillation success.
Which condition requires immediate unsynchronized defibrillation rather than synchronized cardioversion?
Answer: Polymorphic VT (irregular) with a pulse and hemodynamic instability
Polymorphic VT is treated like VF with unsynchronized high-energy shocks because the irregular rhythm makes synchronization difficult and dangerous.
During transcutaneous pacing for a patient with symptomatic bradycardia, what initial pacing rate is recommended?
Answer: 60–80 beats per minute
Transcutaneous pacing is typically initiated at 60–80 beats per minute, which provides adequate cardiac output without causing excessive tachycardia.
How is electrical capture confirmed during transcutaneous pacing?
Answer: Wide QRS complexes follow each pacing spike AND a pulse is palpable
Electrical capture is confirmed by wide QRS complexes following each pacing spike AND mechanical capture by palpating a pulse corresponding to the paced rate.
When placing defibrillator pads on a patient with an implanted pacemaker or ICD, how should the pads be positioned?
Answer: At least 1 inch (2.5 cm) away from the implanted device
Pads should be placed at least 1 inch (2.5 cm) from the implanted device to avoid energy shunting and damage to the device or myocardium.
A patient in unstable SVT requires synchronized cardioversion but the device keeps firing randomly. What is the most likely cause?
Answer: The ECG lead is detecting artifact instead of R-waves, preventing sync
If synchronization fails, poor lead contact or artifact may prevent the device from detecting R-waves; checking lead placement and selecting the best ECG lead resolves this.