Mixed Deck — All ECC Topics Flashcards

A project coordinator is planning a Train-the-Trainer (TTT) program for Heartsaver instructors. How many practice teaching opportunities should each trainee instructor ideally complete before independent certification?

Answer: At least one observed teaching practicum with structured feedback from an experienced instructor

AHA guidelines require instructor candidates to be observed teaching and receive structured feedback before they are certified to teach independently.

A hospital's IHCA (in-hospital cardiac arrest) team wants to compare its survival rate to national benchmarks. The most appropriate national benchmark source is:

Answer: Get With The Guidelines–Resuscitation (GWTG-R) registry national data

The American Heart Association's GWTG-Resuscitation registry provides the largest national IHCA dataset with risk-adjusted benchmarks specifically for in-hospital cardiac arrest outcomes.

The 'pit crew' CPR model emphasizes which key principle?

Answer: Pre-assigned roles executed with choreographed precision to minimize interruptions

The pit crew model assigns each team member a predefined role executed simultaneously with precision, analogous to a NASCAR pit stop, to minimize CPR interruptions and time to defibrillation.

A patient has a heart rate of 150 bpm with a narrow complex tachycardia on the monitor. The rhythm has no identifiable P waves. Which rhythm is most likely?

Answer: Atrial fibrillation

Atrial fibrillation characteristically presents with an irregularly irregular rhythm, no discernible P waves, and a rate typically between 100-180 bpm.

A patient in refractory cardiogenic shock following ROSC is not responding to vasopressors. Which mechanical circulatory support device is most commonly considered in this scenario?

Answer: Extracorporeal membrane oxygenation (ECMO)

VA-ECMO (venoarterial extracorporeal membrane oxygenation) provides full cardiopulmonary support and is the preferred device for refractory cardiogenic shock post-arrest when other measures fail.

A project team conducting an after-action review (AAR) of a cardiac arrest response identifies that chest compression fractions were consistently below 60%. Which planning change BEST addresses this finding?

Answer: Implementing structured role rotation training with CPR quality feedback devices to minimize hands-off time

Role rotation drills combined with real-time CPR quality feedback directly address the root cause of poor compression fraction by minimizing unnecessary interruptions.

During a code, a team member correctly identifies an error in medication dosing but the team leader ignores it. What should the team member do?

Answer: Use closed-loop communication and assertively re-state the concern

Closed-loop communication and assertiveness are professional obligations when patient safety is at risk, even when challenging authority.

Maintaining patient privacy during a resuscitation in a shared emergency department bay is an example of which HIPAA principle?

Answer: Privacy Rule compliance

The HIPAA Privacy Rule requires protecting individually identifiable health information even in emergency settings.

A post-cardiac surgery patient has a CVP of 18 mmHg, cardiac output of 2.2 L/min, and pulmonary capillary wedge pressure of 20 mmHg. Which intervention is most appropriate?

Answer: Initiation of inotropic support and vasopressors for cardiogenic shock

Elevated filling pressures bilaterally with low cardiac output defines cardiogenic shock, requiring inotropic support to improve contractility and perfusion.

What is the maximum recommended time for interrupting chest compressions to deliver ventilations with an advanced airway in place?

Answer: No interruption needed; ventilate every 6 seconds asynchronously

Once an advanced airway is secured, ventilations should be delivered every 6 seconds (10/min) asynchronously without pausing chest compressions.

In acute heart failure risk stratification, which tool integrates BNP, vital signs, and BUN to estimate 30-day mortality?

Answer: ADHERE risk tree

The ADHERE (Acute Decompensated Heart Failure National Registry) risk tree uses BUN, systolic BP, and creatinine to stratify in-hospital mortality.

Which antiarrhythmic drug is an acceptable alternative to amiodarone for shock-refractory VF/pulseless VT?

Answer: Lidocaine

Lidocaine (1–1.5 mg/kg IV/IO) is an acceptable alternative to amiodarone for shock-refractory VF or pulseless VT.

A nurse calls out that the IV line is not functioning during a code. Using closed-loop communication, what should happen next?

Answer: The team leader acknowledges the report and assigns someone to establish new access

Closed-loop communication requires the team leader to acknowledge the message and clearly direct a response to ensure the issue is addressed.

Which legal concept holds a hospital responsible for the negligent actions of its employed emergency physicians during a cardiac resuscitation?

Answer: Respondeat superior

Respondeat superior ('let the master answer') makes employers vicariously liable for torts committed by employees acting within the scope of their employment.

In a resuscitation debriefing, what is the PRIMARY educational goal?

Answer: To identify opportunities to improve team performance and patient care

Post-event debriefing is a learning tool designed to identify system and team performance gaps and reinforce best practices, not to assign blame.

What is the key role of blood pressure monitoring in emergency cardiovascular care?

Answer: To determine circulatory stability

Blood pressure is a vital indicator of the body's circulatory status, reflecting the force with which blood is pumped through the arteries. Monitoring blood pressure in emergency cardiovascular care helps assess if the patient's circulatory system is stable enough to perfuse organs, or if there's a risk of shock or other critical conditions.

What does professional liability insurance protect a ECC practitioner against?

Answer: Financial loss from claims of negligence, errors, or omissions in professional services

Professional liability insurance (errors and omissions coverage) protects practitioners from the financial consequences of claims alleging negligence, mistakes, or failure to perform professional duties, covering legal defense costs and settlements.

An oropharyngeal airway (OPA) is sized correctly when it extends from the:

Answer: Corner of the mouth to the earlobe

The OPA should be sized by measuring from the corner of the mouth to the earlobe (or center of mouth to angle of jaw), ensuring correct length to lift the tongue off the pharynx.

During an ACLS scenario, the team leader asks the respiratory therapist to prepare for intubation but receives no verbal acknowledgment. What should the team leader do?

Answer: Repeat the directive and specifically address the therapist by name

Repeating a directive and addressing the individual by name ensures acknowledgment and confirms role assignment, which is essential for closed-loop communication.

In ECC practice, what is the purpose of a standard operating procedure (SOP)?

Answer: To document step-by-step instructions for routine tasks to ensure consistency and quality

SOPs provide standardized, detailed instructions for routine operations, ensuring consistency, quality, efficiency, and safety regardless of which qualified individual performs the task.