SHARP ESO UPDATED PRACTICE EXAM QUESTIONS
AND ANSWERS GUARANTEE A+
✔✔Pulseless Electrical Activity (PEA) - ✔✔1. PEA is the presence of electrical activity
(other than V-Fib or ventricular tachycardia (V TACH) that fails to generate a detectable
pulse.
2. PEA is often associated with clinical states that can be reversed when identified early
and treated appropriately.
✔✔Treat PEA with: - ✔✔a. CPR (2 minutes) and assess for possible causes:
i. Hs and Ts(H: hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia,
hypoglycemia, hypothermia
T: toxins; tamponade; thrombosis; trauma; tension pneumothorax
b. O2 at 15L ambu bag (10 breaths/min.)
c. Epinephrine 1mg IVP/IO, (use epinephrine 0.1mg/ml), repeat every 3-5 minutes
d. Repeat CPR and Epinephrine administration if no signs of ROSC
e. If hypovolemia known or suspected:
Infuse 250ml NS. Repeat in 5 minutes if no clinical improvement. If LR already infusing-
may use LR.
f. STAT chest x-ray (CXR)
✔✔3 types of Ventricular Tachycardia: - ✔✔1. Stable
2. Unstable
3. Pulseless
✔✔Ventricular Tachycardia (VT) (V-TACH) - ✔✔Defined as three or more beats of
ventricular origine in succession at a rate greater than 100 bpm. The rhythm is usually
regular and may be monomorphic (QRS have same shape) or polymorphic (QRS with
varying shapes). Atrioventricular dissociation usually is present. P waves may be
recognized but are not usually associated with the QRS complexes.
✔✔Stable V TACH - ✔✔-Patient is consious
-SBP more than 90
-No unstable signs or symptoms
✔✔Treat Stable VT with: - ✔✔a. Call physician for orders
b. O2 at minimum 4L/min. and adjust per patient status
c. Obtain 12 lead ECG
d. Draw serum potassium and magnesium
✔✔Unstable VT: - ✔✔-Patient must be symptomatic, exhibiting one or more of the
'unstable' symptoms related to tachycardia
-The patient should be immediately cardioverted
-If time permits and patient is awake and responsive:
Provide sedation with midazolam (Versed) prior to cardioversion
, ✔✔Treat unstable VT with: - ✔✔a. O2 at minimum 10L/min. NRBM
b. If ventricular rate is more than 150, synchronized cardioversion at 200 joules.
c. If patient awake and responsive, give Midazolam (Versed) 0.5mg IVP/IO prior to
cardioversion.
-May repeat to a total of 1mg to achieve sedation
d. Draw serum potassium and magnesium
✔✔Flumazenil (Romazicon) - ✔✔0.2 mg IVP over 15 seconds is the reversal agent for
benzodiazepines
✔✔Ventricular Fibrillation - ✔✔Characterized by disorganized ventricular depolarization
that is irregular and unable to generate any cardiac output (BP). Check pulse to verify
rhythm.
✔✔Coarse and fine V Fib - ✔✔Used to describe the amplitude of the rhythm
✔✔Coarse VFib - ✔✔Usually indicates a recent onset of V-Fib that may be corrected
with immediate defibrillation
✔✔Fine VFib - ✔✔Indicates a more prolonged VFib that is approaching asystole.
Successful resuscitation is more difficult at this stage
✔✔Treat VFib/ Pulseless VTach with: - ✔✔Note: No stacked shocks for VFib/Pulseless
VTach and immediate defibrillation if witnessed arrest and defibrillator is available
a. CPR 2 minutes or until defibrillator arrives
b. O2 at 15L/min. ambu bag (10 breaths/min.)
c. Defibrillate: Biphasic: 200 joules
d. Resume CPR immediately for 2 minutes
e. Epinephrine 1mg IVP/IO (Use epinephrine 0.1mg/ml), repeat every 3-5 mintues,
continue CPR
f. Defibrillate: Biphasic: 200 joules
g. Resume CPR immediately for 2 minutes
h. Amiodarone 300mg IVP/ IO, continue CPR
i. Defibrillate: Biphasic 200 joules
j. Resume CPR immediately for 2 minutes
k. Epinephrine 1mg IV/IO
l. Defibrillate: Biphasic 200 joules
m. Amiodarone 150mg IV/IO
n. Resume CPR immediately for 2 minutes
o. If rhythm persists, repeat, and continue alternating CPR, Epinephrine, and
defibrillation
✔✔Chest pain - ✔✔The most common presentation of an acute coronary syndrome (ex:
unstable angina; non-Q wave MI; Q-wave MI
AND ANSWERS GUARANTEE A+
✔✔Pulseless Electrical Activity (PEA) - ✔✔1. PEA is the presence of electrical activity
(other than V-Fib or ventricular tachycardia (V TACH) that fails to generate a detectable
pulse.
2. PEA is often associated with clinical states that can be reversed when identified early
and treated appropriately.
✔✔Treat PEA with: - ✔✔a. CPR (2 minutes) and assess for possible causes:
i. Hs and Ts(H: hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia,
hypoglycemia, hypothermia
T: toxins; tamponade; thrombosis; trauma; tension pneumothorax
b. O2 at 15L ambu bag (10 breaths/min.)
c. Epinephrine 1mg IVP/IO, (use epinephrine 0.1mg/ml), repeat every 3-5 minutes
d. Repeat CPR and Epinephrine administration if no signs of ROSC
e. If hypovolemia known or suspected:
Infuse 250ml NS. Repeat in 5 minutes if no clinical improvement. If LR already infusing-
may use LR.
f. STAT chest x-ray (CXR)
✔✔3 types of Ventricular Tachycardia: - ✔✔1. Stable
2. Unstable
3. Pulseless
✔✔Ventricular Tachycardia (VT) (V-TACH) - ✔✔Defined as three or more beats of
ventricular origine in succession at a rate greater than 100 bpm. The rhythm is usually
regular and may be monomorphic (QRS have same shape) or polymorphic (QRS with
varying shapes). Atrioventricular dissociation usually is present. P waves may be
recognized but are not usually associated with the QRS complexes.
✔✔Stable V TACH - ✔✔-Patient is consious
-SBP more than 90
-No unstable signs or symptoms
✔✔Treat Stable VT with: - ✔✔a. Call physician for orders
b. O2 at minimum 4L/min. and adjust per patient status
c. Obtain 12 lead ECG
d. Draw serum potassium and magnesium
✔✔Unstable VT: - ✔✔-Patient must be symptomatic, exhibiting one or more of the
'unstable' symptoms related to tachycardia
-The patient should be immediately cardioverted
-If time permits and patient is awake and responsive:
Provide sedation with midazolam (Versed) prior to cardioversion
, ✔✔Treat unstable VT with: - ✔✔a. O2 at minimum 10L/min. NRBM
b. If ventricular rate is more than 150, synchronized cardioversion at 200 joules.
c. If patient awake and responsive, give Midazolam (Versed) 0.5mg IVP/IO prior to
cardioversion.
-May repeat to a total of 1mg to achieve sedation
d. Draw serum potassium and magnesium
✔✔Flumazenil (Romazicon) - ✔✔0.2 mg IVP over 15 seconds is the reversal agent for
benzodiazepines
✔✔Ventricular Fibrillation - ✔✔Characterized by disorganized ventricular depolarization
that is irregular and unable to generate any cardiac output (BP). Check pulse to verify
rhythm.
✔✔Coarse and fine V Fib - ✔✔Used to describe the amplitude of the rhythm
✔✔Coarse VFib - ✔✔Usually indicates a recent onset of V-Fib that may be corrected
with immediate defibrillation
✔✔Fine VFib - ✔✔Indicates a more prolonged VFib that is approaching asystole.
Successful resuscitation is more difficult at this stage
✔✔Treat VFib/ Pulseless VTach with: - ✔✔Note: No stacked shocks for VFib/Pulseless
VTach and immediate defibrillation if witnessed arrest and defibrillator is available
a. CPR 2 minutes or until defibrillator arrives
b. O2 at 15L/min. ambu bag (10 breaths/min.)
c. Defibrillate: Biphasic: 200 joules
d. Resume CPR immediately for 2 minutes
e. Epinephrine 1mg IVP/IO (Use epinephrine 0.1mg/ml), repeat every 3-5 mintues,
continue CPR
f. Defibrillate: Biphasic: 200 joules
g. Resume CPR immediately for 2 minutes
h. Amiodarone 300mg IVP/ IO, continue CPR
i. Defibrillate: Biphasic 200 joules
j. Resume CPR immediately for 2 minutes
k. Epinephrine 1mg IV/IO
l. Defibrillate: Biphasic 200 joules
m. Amiodarone 150mg IV/IO
n. Resume CPR immediately for 2 minutes
o. If rhythm persists, repeat, and continue alternating CPR, Epinephrine, and
defibrillation
✔✔Chest pain - ✔✔The most common presentation of an acute coronary syndrome (ex:
unstable angina; non-Q wave MI; Q-wave MI
