ALS/ACLS - Team Response Scenario - Maurice Van
Essen [2021]
On rapid assessment, Mr. van Essen is responsive and his airway is patent. He
appears pale and distressed. He is diaphoretic. Select the tools to use during the
primary assessment to gather more information about Mr. van Essen's clinical
condition.
1. Pulse Oximetry
2. Cardiac Monitoring
3. Stethoscope
4. Blood pressure monitoring
What is your interpretation of the rhythm on the cardiac monitor? First, identify
the rhythm.
Mr. van Essen has a narrow-complex supraventricular tachycardia and the rhythm is
regular.
Mr. van Essen's primary assessment findings are as follows:Blood pressure:
105/70 mmHgPulse: 182 bpmRespirations: 24 breaths/minTemperature:
98.6°FPulse oximetry: 96%Lung sounds: clearBased on Mr. van Essen's clinical
presentation and these assessment findings, is his condition stable or unstable?
Stable
Which intervention would be an appropriate next step in caring for Mr. van
Essen?
12-Lead ECG
The 12-lead ECG confirms a narrow-complex supraventricular tachycardia with a
regular rhythm. Based on Mr. van Essen's current condition, what is the
appropriate next action?
Attempt vagal maneuvers.
Following the vagal maneuver, the team reassesses Mr. van Essen and notes the
following:Blood pressure: 105/70 mmHgPulse: 178 bpmRespirations: 24
breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung sounds: clearRhythm:
unchangedWhat should the team do next?
Initiate pharmacologic therapy
What is the correct medication to prepare?
Adenosine
What is the initial dose of adenosine?
6 mg by rapid IV push, followed by a 10 to 20 mL normal saline flush
After administering the initial dose of adenosine, the team reassesses Mr. van
Essen and notes the following:Blood pressure: 105/70 mmHgPulse: 178
bpmRespirations: 24 breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung
sounds: clearRhythm: unchangedGiven these assessment findings, what is the
appropriate next intervention?
If the first dose of adenosine does not convert the rhythm, administer 12 mg of
adenosine followed by a 10- to 20-mL normal saline flush.
Mr. van Essen receives two additional doses of adenosine (12 mg) but the
supraventricular tachycardia persists. Mr. van Essen's blood pressure is
Essen [2021]
On rapid assessment, Mr. van Essen is responsive and his airway is patent. He
appears pale and distressed. He is diaphoretic. Select the tools to use during the
primary assessment to gather more information about Mr. van Essen's clinical
condition.
1. Pulse Oximetry
2. Cardiac Monitoring
3. Stethoscope
4. Blood pressure monitoring
What is your interpretation of the rhythm on the cardiac monitor? First, identify
the rhythm.
Mr. van Essen has a narrow-complex supraventricular tachycardia and the rhythm is
regular.
Mr. van Essen's primary assessment findings are as follows:Blood pressure:
105/70 mmHgPulse: 182 bpmRespirations: 24 breaths/minTemperature:
98.6°FPulse oximetry: 96%Lung sounds: clearBased on Mr. van Essen's clinical
presentation and these assessment findings, is his condition stable or unstable?
Stable
Which intervention would be an appropriate next step in caring for Mr. van
Essen?
12-Lead ECG
The 12-lead ECG confirms a narrow-complex supraventricular tachycardia with a
regular rhythm. Based on Mr. van Essen's current condition, what is the
appropriate next action?
Attempt vagal maneuvers.
Following the vagal maneuver, the team reassesses Mr. van Essen and notes the
following:Blood pressure: 105/70 mmHgPulse: 178 bpmRespirations: 24
breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung sounds: clearRhythm:
unchangedWhat should the team do next?
Initiate pharmacologic therapy
What is the correct medication to prepare?
Adenosine
What is the initial dose of adenosine?
6 mg by rapid IV push, followed by a 10 to 20 mL normal saline flush
After administering the initial dose of adenosine, the team reassesses Mr. van
Essen and notes the following:Blood pressure: 105/70 mmHgPulse: 178
bpmRespirations: 24 breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung
sounds: clearRhythm: unchangedGiven these assessment findings, what is the
appropriate next intervention?
If the first dose of adenosine does not convert the rhythm, administer 12 mg of
adenosine followed by a 10- to 20-mL normal saline flush.
Mr. van Essen receives two additional doses of adenosine (12 mg) but the
supraventricular tachycardia persists. Mr. van Essen's blood pressure is
