Post-Cardiac Arrest Care 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 Post-Cardiac Arrest Care flashcards as text
A post-cardiac arrest patient maintained at 33°C develops QTc prolongation to 520 ms. What is the priority action?
Answer: Review and discontinue QT-prolonging medications while continuing TTM
Hypothermia itself prolongs QTc; review for concurrent QT-prolonging drugs (antiarrhythmics, antibiotics) that compound the risk, and discontinue them while maintaining TTM.
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.
Which of the following is the most appropriate initial tidal volume setting for mechanical ventilation in a post-cardiac arrest patient?
Answer: 6–8 mL/kg of predicted body weight
Lung-protective ventilation using 6–8 mL/kg of predicted body weight reduces ventilator-induced lung injury in post-arrest patients.
A post-arrest patient has return of spontaneous circulation but remains hypotensive despite adequate volume resuscitation. Bedside echocardiography shows severely reduced left ventricular ejection fraction. The MOST appropriate next step is:
Answer: Add dobutamine to norepinephrine for inotropic support
Post-arrest myocardial stunning with severely reduced EF requires inotropic support; dobutamine added to a vasopressor addresses both cardiac output and vascular tone.
According to ACLS guidelines, at what point should fever (>37.7°C) be actively treated following the TTM maintenance phase?
Answer: Immediately and for at least 72 hours post-arrest
Active fever prevention is recommended for at least 72 hours post-ROSC because fever worsens neurological outcomes from increased cerebral metabolic demand.
Which clinical sign at 72 hours post-arrest, when combined with other predictors, is associated with poor neurological prognosis?
Answer: Absent pupillary light reflex bilaterally
Bilaterally absent pupillary light reflexes at 72 hours are a strong multimodal indicator of poor neurological prognosis after cardiac arrest.
A patient presents after out-of-hospital cardiac arrest with ROSC. Family states the arrest occurred due to a drug overdose (opioids). Regarding TTM and coronary angiography, which statement is MOST accurate?
Answer: TTM is still recommended if comatose; emergent angiography is not indicated without ECG evidence of ischemia
TTM remains indicated for comatose post-arrest patients regardless of cause; however, emergent angiography is reserved for those with ECG evidence of acute coronary syndrome, not all post-arrest patients.