Advanced Life Support Exam Questions With Insightful
Answers.
What is the chain of survival? - accurate answers-Interventions that
contribute to a successful outcome:
1. Early recognition and call for help
2. Early CPR
3. Early defibrillation
4. Post-resuscitation care
How early is early defibrillation? - accurate answers-Within 3-5 minutes of
collapse
How much do survival rates drop by each minute of delay in defibrillating? -
accurate answers-10-20% drop in survival rates (from 50-70%)
What are the 4Hs and 4Ts? - accurate answers-Reversible causes of cardiac
arrest:
- Hypoxia
- Hypovolaemia
- Hypo/hyperkalaemia/metabolic
- Hypothermia
- Thrombosis (coronary or pulmonary)
- Toxins
- Tamponade
- Tension pneumothorax
What scanner can be used to identify some of the reversible causes of cardiac
arrest?
What causes can it identify in a trained professional? - accurate answers-
Ultrasound
Tamponade, PE, regional wall motion abnormality (ischaemia), aortic
dissection, hypovolaemia and pneumothorax
How often do you give adrenaline in the ALS algorithm? - accurate answers-
Every 3-5 minutes
,How often do you give amiodarone in the ALS algorithm? - accurate answers-
After 3 shocks and again only if VF/pVT persists after 5 defibrillation attempts
at lower dose of 150mg
What is ECMO? - accurate answers-A portable extracorporeal membrane
oxygenation (ECMO) device is used as an adjunct to standard CPR to perform
extracorporeal cardiopulmonary resuscitation (commonly known as ECPR). It
is a method of cardiopulmonary resuscitation (CPR) that passes the patient's
blood through a machine in a process to oxygenate the blood supply and
pump blood around the body. A patient who is deemed to be in cardiac arrest
refractory to CPR has percutaneous catheters inserted into the femoral vein
and artery. Theoretically, the application of ECPR allows for the return of
cerebral perfusion in a more sustainable manner than with external
compressions alone
What is involved in post-resuscitation care? - accurate answers-ABCDE
approach
Aim SATS 94-98% and normal pCO2
Continue to identify and treat cause
Manage temperature
What might be needed if thrombosis is presumed the cause of the arrest? -
accurate answers-Coronary angiography and PCI
What does situational awareness involve communicating? - accurate answers-
1. The facts
- Location, info from staff about events leading up to arrest, actions already
taken, who patient is,
2. The roles in the arrest
3. What are the potential causes of cardiac arrest?
4. What immediate steps are needed?
5. What are the next steps?
What are the main decisions needed to be made during a cardiac arrest? -
accurate answers-Rhythm identification
The choice of shock energy
The likely cause of arrest
Appropriate treatment including drugs and airway management
When to stop
,Mneumonic:
RECTS
What are the main things to do after ROSC in post-resuscitation care (x5) -
accurate answers-ABCDE
Aim SATS 94-96%
ECG
Identify and treat cause
Targeted temperature management
What should the team leader do throughout leading (x4)? - accurate answers-
Voice their thoughts and plans of action to the whole team, explaining any
deviations from guidelines
Delegate tasks clearly to a specific person
Be aware of limitations and consult teams for advice
What should the team leader use the 2 minutes of compressions for? -
accurate answers-Plan tasks for the next rhythm check e.g airway
interventions, role changes, medications to give, causes of arrest
What is the TEAM tool?
What are the three key areas a leader should be focusing on? - accurate
answers-Team Emergency Assessment Measure - for teaching and discussion
in scenario teaching
1. Leadership: expectations of each team member, maintaining a global
perspective (monitoring process, hands off, plans ahead, checks safety e.g. for
shocks)
2. Teamwork
3. Task management: prioritising main tasks (compressions, drugs, airway
and shocks) and following guidelines
What is SBARD - accurate answers-An agreed method of handover
Situation
Background
Assessment
Recommendation
agreed Decision
, What is the chain of prevention? - accurate answers-Prevents and detects
patient deterioration and cardiac arrest
Education (of ABCDE)
Monitoring
Recognition
Call for help
Response
What is the highest NEWS2? - accurate answers-20
What is the minimum monitoring for NEWS2 of 3 in a single parameter? -
accurate answers-Every hour
What is the minimum monitoring for NEWS2 between 5 and 6? - accurate
answers-1 hourly
What is the minimum monitoring for NEWS2 of 7 or more? - accurate
answers-Continuous
What in the A of ABCDE causes cardiac arrest? - accurate answers-Complete
Airway obstruction (physical blockage or due to central nervous depression)
> hypoxia
> cerebral oedema
> exhaustion
> hypoxic brain injury
> cardiac arrest
What are the main causes of central nervous depression of airway patency
and reflexes? - accurate answers-Head Injury
Intracerebral disease
Hypercapnia
Metabolic disorders e.g. DM
Drugs including alcohol, opioids, anaesthetics
What can cause physical airway obstruction? - accurate answers-- Foreign
body
- Blood, vomitus or secretions
- Direct trauma
- Laryngeal nerve damage
Answers.
What is the chain of survival? - accurate answers-Interventions that
contribute to a successful outcome:
1. Early recognition and call for help
2. Early CPR
3. Early defibrillation
4. Post-resuscitation care
How early is early defibrillation? - accurate answers-Within 3-5 minutes of
collapse
How much do survival rates drop by each minute of delay in defibrillating? -
accurate answers-10-20% drop in survival rates (from 50-70%)
What are the 4Hs and 4Ts? - accurate answers-Reversible causes of cardiac
arrest:
- Hypoxia
- Hypovolaemia
- Hypo/hyperkalaemia/metabolic
- Hypothermia
- Thrombosis (coronary or pulmonary)
- Toxins
- Tamponade
- Tension pneumothorax
What scanner can be used to identify some of the reversible causes of cardiac
arrest?
What causes can it identify in a trained professional? - accurate answers-
Ultrasound
Tamponade, PE, regional wall motion abnormality (ischaemia), aortic
dissection, hypovolaemia and pneumothorax
How often do you give adrenaline in the ALS algorithm? - accurate answers-
Every 3-5 minutes
,How often do you give amiodarone in the ALS algorithm? - accurate answers-
After 3 shocks and again only if VF/pVT persists after 5 defibrillation attempts
at lower dose of 150mg
What is ECMO? - accurate answers-A portable extracorporeal membrane
oxygenation (ECMO) device is used as an adjunct to standard CPR to perform
extracorporeal cardiopulmonary resuscitation (commonly known as ECPR). It
is a method of cardiopulmonary resuscitation (CPR) that passes the patient's
blood through a machine in a process to oxygenate the blood supply and
pump blood around the body. A patient who is deemed to be in cardiac arrest
refractory to CPR has percutaneous catheters inserted into the femoral vein
and artery. Theoretically, the application of ECPR allows for the return of
cerebral perfusion in a more sustainable manner than with external
compressions alone
What is involved in post-resuscitation care? - accurate answers-ABCDE
approach
Aim SATS 94-98% and normal pCO2
Continue to identify and treat cause
Manage temperature
What might be needed if thrombosis is presumed the cause of the arrest? -
accurate answers-Coronary angiography and PCI
What does situational awareness involve communicating? - accurate answers-
1. The facts
- Location, info from staff about events leading up to arrest, actions already
taken, who patient is,
2. The roles in the arrest
3. What are the potential causes of cardiac arrest?
4. What immediate steps are needed?
5. What are the next steps?
What are the main decisions needed to be made during a cardiac arrest? -
accurate answers-Rhythm identification
The choice of shock energy
The likely cause of arrest
Appropriate treatment including drugs and airway management
When to stop
,Mneumonic:
RECTS
What are the main things to do after ROSC in post-resuscitation care (x5) -
accurate answers-ABCDE
Aim SATS 94-96%
ECG
Identify and treat cause
Targeted temperature management
What should the team leader do throughout leading (x4)? - accurate answers-
Voice their thoughts and plans of action to the whole team, explaining any
deviations from guidelines
Delegate tasks clearly to a specific person
Be aware of limitations and consult teams for advice
What should the team leader use the 2 minutes of compressions for? -
accurate answers-Plan tasks for the next rhythm check e.g airway
interventions, role changes, medications to give, causes of arrest
What is the TEAM tool?
What are the three key areas a leader should be focusing on? - accurate
answers-Team Emergency Assessment Measure - for teaching and discussion
in scenario teaching
1. Leadership: expectations of each team member, maintaining a global
perspective (monitoring process, hands off, plans ahead, checks safety e.g. for
shocks)
2. Teamwork
3. Task management: prioritising main tasks (compressions, drugs, airway
and shocks) and following guidelines
What is SBARD - accurate answers-An agreed method of handover
Situation
Background
Assessment
Recommendation
agreed Decision
, What is the chain of prevention? - accurate answers-Prevents and detects
patient deterioration and cardiac arrest
Education (of ABCDE)
Monitoring
Recognition
Call for help
Response
What is the highest NEWS2? - accurate answers-20
What is the minimum monitoring for NEWS2 of 3 in a single parameter? -
accurate answers-Every hour
What is the minimum monitoring for NEWS2 between 5 and 6? - accurate
answers-1 hourly
What is the minimum monitoring for NEWS2 of 7 or more? - accurate
answers-Continuous
What in the A of ABCDE causes cardiac arrest? - accurate answers-Complete
Airway obstruction (physical blockage or due to central nervous depression)
> hypoxia
> cerebral oedema
> exhaustion
> hypoxic brain injury
> cardiac arrest
What are the main causes of central nervous depression of airway patency
and reflexes? - accurate answers-Head Injury
Intracerebral disease
Hypercapnia
Metabolic disorders e.g. DM
Drugs including alcohol, opioids, anaesthetics
What can cause physical airway obstruction? - accurate answers-- Foreign
body
- Blood, vomitus or secretions
- Direct trauma
- Laryngeal nerve damage
