Mixed Deck — All ACLS Topics Flashcards

Which EEG pattern in a post-cardiac arrest patient is most strongly associated with poor neurological prognosis?

Answer: Burst suppression with identical bursts (generalized suppression pattern)

Burst suppression with identical bursts (suppression-burst ratio >50%) is a malignant EEG pattern indicating severe cortical injury post-arrest.

Which of the following should you evaluate according to the BLS Survey?

Answer: Responsiveness, Activate EMS and get AED, Circulation, Defibrillation

The BLS Survey, according to AHA guidelines, focuses on immediate life-saving actions for cardiac arrest. It involves quickly assessing for responsiveness, activating the emergency medical services (EMS) and retrieving an AED, initiating high-quality chest compressions to ensure circulation, and performing early defibrillation if a shockable rhythm is present. This sequence prioritizes rapid assessment and intervention.

Which of the following DOES NOT constitute an essential component of a dynamic resuscitation team?

Answer: The team has multiple leaders.

An essential component of a dynamic and effective resuscitation team is having a single, clear team leader who directs actions, assigns roles, and ensures smooth communication. Multiple leaders can lead to confusion, conflicting instructions, and disorganization, hindering efficient patient care during a critical event. Clear roles, closed-loop communication, and knowing one's limitations are all vital for team success.

For a stable narrow-complex tachycardia that does not respond to vagal maneuvers, what is the first drug of choice?

Answer: Adenosine 6 mg rapid IV push

Adenosine 6 mg rapid IV push is the first pharmacological treatment for stable regular narrow-complex SVT.

A bag valve mask is used to ventilate an adult patient who is in respiratory arrest and has a pulse:

Answer: 10 to 12 times per minute

For an adult patient in respiratory arrest who still has a pulse, the recommended ventilation rate using a bag-valve-mask is one breath every 5 to 6 seconds, which equates to 10 to 12 breaths per minute. This rate provides adequate oxygenation and ventilation without causing hyperventilation, which can negatively impact cardiac output and cerebral blood flow.

Which blood pressure threshold must be achieved and maintained BEFORE administering IV alteplase for acute ischemic stroke?

Answer: < 185/110 mmHg

BP must be < 185/110 mmHg before alteplase administration and maintained < 180/105 mmHg for at least 24 hours afterward.

What is the purpose of end-tidal CO2 (ETCO2) monitoring during cardiac arrest?

Answer: To confirm correct endotracheal tube placement and assess CPR quality

ETCO2 confirms ETT placement and reflects cardiac output during CPR — values above 10 mmHg suggest effective compressions.

The TIMI risk score for NSTEMI/UA is used to guide treatment intensity. Which of the following is NOT a component of the TIMI risk score?

Answer: Female sex

Female sex is not a component of the TIMI risk score; the score includes age, CAD risk factors, known CAD, ST changes, elevated markers, and recent aspirin use.

A patient has pulseless electrical activity (PEA) from suspected tension pneumothorax. What drug should be given while preparing needle decompression?

Answer: Epinephrine 1 mg IV immediately

Epinephrine 1 mg IV/IO every 3–5 minutes is given per ACLS protocol for PEA while reversible causes like tension pneumothorax are corrected.

Which of the following is a 'T' in the ACLS H's and T's mnemonic for reversible causes of cardiac arrest?

Answer: Thrombosis (pulmonary or coronary)

Thrombosis (pulmonary embolism or coronary occlusion) is one of the reversible T's to consider during cardiac arrest.

After giving atropine for symptomatic bradycardia with no improvement, the provider initiates dopamine at 5 mcg/kg/min. The patient's heart rate rises to 72 bpm and BP improves. What should be done next?

Answer: Arrange for expert consultation and possible transvenous pacing

A patient stabilized on a dopamine infusion still requires expert consultation to determine the need for transvenous pacing or other definitive treatment.

Bradyarrhythmia is characterized by:

Answer: any rhythm disorder with a heart rate of less than 60 beats per minute

By definition, bradycardia (or bradyarrhythmia) refers to any heart rhythm disorder where the heart rate is less than 60 beats per minute. While symptomatic bradycardia often involves rates below 50 bpm, the general definition of bradycardia starts at <60 bpm, indicating a slower-than-normal heart rate.

The Cincinnati Prehospital Stroke Scale (CPSS) assesses three findings. Which set is correct?

Answer: Facial droop, arm drift, speech abnormality

The CPSS evaluates facial droop, arm drift, and speech abnormality — any one abnormal finding indicates high stroke probability.

In the ACLS tachycardia algorithm, what heart rate threshold generally prompts evaluation for treatment?

Answer: Greater than 150 bpm

The ACLS tachycardia algorithm is typically initiated when heart rate exceeds 150 bpm, as rates below this rarely cause hemodynamic compromise.

A patient is found unresponsive. A bystander says the patient collapsed 3 minutes ago. You have an AED available. What should you do?

Answer: Attach the AED and follow its prompts immediately

Early defibrillation is critical for shockable rhythms; attach the AED and use it as quickly as possible while CPR continues.

A patient receives epinephrine 1 mg IV for cardiac arrest. When should the next dose be given?

Answer: Every 3–5 minutes

Epinephrine 1 mg IV/IO is repeated every 3–5 minutes during cardiac arrest.

What does the concept of 'self-fulfilling prophecy' refer to in post-cardiac arrest prognostication?

Answer: Withdrawal of care based on premature poor prognosis leading to the predicted death

Self-fulfilling prophecy occurs when early withdrawal of life-sustaining therapy, based on inaccurate or premature prognostication, causes the predicted death rather than the underlying injury.

A 70-year-old patient on digoxin presents with bradycardia and nausea. Digoxin toxicity is suspected. Which intervention is MOST specific to this cause?

Answer: Digoxin-specific antibody fragments (Digibind)

Digoxin-specific antibody fragments (Digibind/DigiFab) are the definitive antidote for life-threatening digoxin toxicity.

In a patient with pulseless VT, a synchronized shock is attempted but the defibrillator cannot synchronize. What should you do?

Answer: Deliver an unsynchronized shock immediately

If the defibrillator cannot synchronize on a VT waveform and the patient is pulseless, deliver an unsynchronized (defibrillation) shock immediately.

What is the treatment for pulseless electrical activity?

Answer: Epinephrine

The primary pharmacologic treatment for pulseless electrical activity (PEA) in the ACLS algorithm is epinephrine. Epinephrine's vasoconstrictive effects help to increase coronary and cerebral perfusion pressure during CPR, improving the chances of return of spontaneous circulation. While identifying and treating reversible causes is crucial, epinephrine is administered concurrently.