(RECOVER) MODULE 1 INITIATING ALS
EXAM QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
,Initiating Advanced Life Support (ALS) - Answer: BLS or Basic Life Support, which restores blood flow
and oxygen delivery to the tissues, is the most important part of CPR. Once BLS is started, adjunctive
advanced life support therapies may help increase the likelihood of achieving ROSC (return of
spontaneous circulation). In Module 1, we'll discuss the three steps of initiating ALS: (1) attaching and
interpreting monitoring equipment, (2) establishing vascular access, and (3) administering reversal
agents. We'll also talk about fluid therapy during CPR and the use of corticosteroids. Finally, we'll review
the indications for open-chest CPR and how to do it.
This module is part of the CPR: Advanced Life Support course.This module contains the following four
lessons: - Answer: Lesson 1: Monitoring
Lesson 2: Access for Drug Administration
Lesson 3: Initial Drug Therapies
Lesson 4: Open-Chest CPR
The Electrocardiogram
Once basic life support has been started, our next priority in a patient with cardiopulmonary arrest is to
initiate advanced life support, as shown in the CPR algorithm below.
There are 3 steps to start advanced life support: - Answer: Initiate monitoring (ECG and End Tidal CO2)
Obtain vascular access
Administer reversal agents
The Importance of the Electrocardiogram (ECG)
The ECG rhythm diagnosis is the primary decision point in the ALS portion of the CPR algorithm. ECG
monitoring is an essential aspect of ALS. It is therefore important that attachment of ECG leads be a
priority after BLS has been started. In addition, all responders should be comfortable with basic
assessment of the ECG rhythm and diagnosis of the four primary CPA rhythms. - Answer: ECG rhythm
diagnosis is the primary ALS decision point.
ECG leads should be attached as soon as possible after BLS is initiated.
All responders should be comfortable with ECG rhythm diagnosis.
Keeping Your Electrocardiogram (ECG) Equipment Ready - Answer: ECG equipment should be kept in a
"ready state" with leads attached, an with alligator clips or adhesive electrode patches and contact gel
available. In addition, all team members should be familiar with operation of the monitor and how to
rapidly place the leads in the correct locations on the patient.
, Equipment in "ready state": - Answer: ECG monitor with leads attached
Clips or stick-on electrode patches readily available
Gel to improve contact
All team members should know how to use the monitor and attach the leads
Benefits of Properly Maintained Equipment - Answer: When the ECG is kept in a ready state at all times,
the equipment can be efficiently attached to a patient in the event of a crisis such as cardiopulmonary
arrest.
Consequences of Improperly Maintained Equipment - Answer: When the ECG monitor is not regularly
checked to ensure that all required equipment is available, it is likely to lead to delays in obtaining a
rhythm diagnosis in a crisis.
Attaching ECG Leads - Answer: For monitoring during CPR, a 3-lead ECG electrode configuration is
usually adequate.
Lead Placement
For the 3-lead system, ECG electrodes are generally placed on the right forelimb, the left forelimb, and
the left hindlimb. - Answer: In the U.S., the leads are most commonly color coded, as follows: white =
right forelimb; black = left forelimb; red = left hindlimb.
Ideally, leads are placed in the proper locations, but if you cannot remember where they are supposed
to go, simply place the leads on three different limbs and you will obtain an ECG tracing that will be
sufficient for CPR.
Connection with the Patient
There are a number of ECG electrode styles available, but in dogs and cats, alligator clamp electrodes or
disposable, pre-gelled adhesive electrodes are used most commonly.
For alligator clamp electrodes, a coupling material is needed to provide a low resistance contact through
the fur to the skin. - Answer: Pre-gelled adhesive electrodes are preferred during CPR. They can be
placed on the foot pads of the appropriate limbs and quickly taped into place using white medical tape.
EXAM QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
,Initiating Advanced Life Support (ALS) - Answer: BLS or Basic Life Support, which restores blood flow
and oxygen delivery to the tissues, is the most important part of CPR. Once BLS is started, adjunctive
advanced life support therapies may help increase the likelihood of achieving ROSC (return of
spontaneous circulation). In Module 1, we'll discuss the three steps of initiating ALS: (1) attaching and
interpreting monitoring equipment, (2) establishing vascular access, and (3) administering reversal
agents. We'll also talk about fluid therapy during CPR and the use of corticosteroids. Finally, we'll review
the indications for open-chest CPR and how to do it.
This module is part of the CPR: Advanced Life Support course.This module contains the following four
lessons: - Answer: Lesson 1: Monitoring
Lesson 2: Access for Drug Administration
Lesson 3: Initial Drug Therapies
Lesson 4: Open-Chest CPR
The Electrocardiogram
Once basic life support has been started, our next priority in a patient with cardiopulmonary arrest is to
initiate advanced life support, as shown in the CPR algorithm below.
There are 3 steps to start advanced life support: - Answer: Initiate monitoring (ECG and End Tidal CO2)
Obtain vascular access
Administer reversal agents
The Importance of the Electrocardiogram (ECG)
The ECG rhythm diagnosis is the primary decision point in the ALS portion of the CPR algorithm. ECG
monitoring is an essential aspect of ALS. It is therefore important that attachment of ECG leads be a
priority after BLS has been started. In addition, all responders should be comfortable with basic
assessment of the ECG rhythm and diagnosis of the four primary CPA rhythms. - Answer: ECG rhythm
diagnosis is the primary ALS decision point.
ECG leads should be attached as soon as possible after BLS is initiated.
All responders should be comfortable with ECG rhythm diagnosis.
Keeping Your Electrocardiogram (ECG) Equipment Ready - Answer: ECG equipment should be kept in a
"ready state" with leads attached, an with alligator clips or adhesive electrode patches and contact gel
available. In addition, all team members should be familiar with operation of the monitor and how to
rapidly place the leads in the correct locations on the patient.
, Equipment in "ready state": - Answer: ECG monitor with leads attached
Clips or stick-on electrode patches readily available
Gel to improve contact
All team members should know how to use the monitor and attach the leads
Benefits of Properly Maintained Equipment - Answer: When the ECG is kept in a ready state at all times,
the equipment can be efficiently attached to a patient in the event of a crisis such as cardiopulmonary
arrest.
Consequences of Improperly Maintained Equipment - Answer: When the ECG monitor is not regularly
checked to ensure that all required equipment is available, it is likely to lead to delays in obtaining a
rhythm diagnosis in a crisis.
Attaching ECG Leads - Answer: For monitoring during CPR, a 3-lead ECG electrode configuration is
usually adequate.
Lead Placement
For the 3-lead system, ECG electrodes are generally placed on the right forelimb, the left forelimb, and
the left hindlimb. - Answer: In the U.S., the leads are most commonly color coded, as follows: white =
right forelimb; black = left forelimb; red = left hindlimb.
Ideally, leads are placed in the proper locations, but if you cannot remember where they are supposed
to go, simply place the leads on three different limbs and you will obtain an ECG tracing that will be
sufficient for CPR.
Connection with the Patient
There are a number of ECG electrode styles available, but in dogs and cats, alligator clamp electrodes or
disposable, pre-gelled adhesive electrodes are used most commonly.
For alligator clamp electrodes, a coupling material is needed to provide a low resistance contact through
the fur to the skin. - Answer: Pre-gelled adhesive electrodes are preferred during CPR. They can be
placed on the foot pads of the appropriate limbs and quickly taped into place using white medical tape.
