ADVANCED LIFE SUPPORT PRACTICE EXAM | QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS GRADED A+ |
LATEST EDITION
Principles of high quality CPR
Ways to ensure the delivery of high quality CPR
- Allow the chest to recoil fully
- Compress to a depth of at least 2 in but not more than 2.4 in
- Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
How to insert an oropharyngeal airway.
how to insert nasopharyngeal airway
Considerations when an advanced airway is in place
Proper placement of electrodes for monitoring of HR, rhythm, and obtaining
12 and 15-lead ECG
Procedure for defibrillation
Procedure for synchronized cardioversion
Procedure for transcutaneous pacing
Procedure for obtaining intraosseous (IO) access
How to interpret EtCO2 during resuscitation ventilation?
30-45 what it is normally
15-20 during a resuscitation
Below 10 could be a problem with rate or quality of compressions
Spike is often the first sign of ROSC
Four components of communication
,Sender, message, receiver, feedback (closed loop communication)
Debriefing
Review, Analyze, Reflect, Summarize
Team leader responsibilities
- Assigns team roles
- Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
Team member responsibilities
- Have the knowledge and skills to perform their assigned role
- Communicate with the team leader if they feel they are lacking the above,
identify something the team leader may have overlooked, recognize a
dangerous situation or need for urgent action
- Stay in their assigned role but assist others as needed, as long as they are
able to maintain their own responsibilities
Six-Person High-Performance Resuscitation Team
Includes three CPR/defibrillator roles, and three leadership/supportive roles
1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or
interruptions to chest compressions)
,Example of a debrief review
A 15-year-old patient who had been brought to the emergency department for
evaluation of an earlier episode of syncope went into witnessed ventricular
fibrillation. Compressions were started, defibrillator pads were applied and
an initial shock of 120 J was delivered. An OPA was inserted and high-flow
oxygen was initiated. After 2 minutes of CPR and a rhythm check, the patient
was observed to still be in ventricular fibrillation; a second shock of 150 J was
delivered, CPR was resumed, 1 mg of epinephrine was administered and
capnography monitoring was established. After approximately 1 more minute
of CPR, the patient achieved ROSC.
What should be prioritized during ventricular fibrillation - defibrillation or
ventilations?
Defibrillation is the most effective therapy for the treatment of vfib
A systematic approach to assessment includes a ____, ____, and ____
assessment.
Rapid, primary, secondary
- Initial impression
- Responsiveness
- Breathing
- Pulse
Are components of a _____ assessmetn
Rapid
- Airway
- Breathing
- Circulation
- Disability
- Exposure
are components of a _____ assessment
Primary
, A broader assessment to narrow the list of differential diagnoses and discover
underlying causes is a _____ assessment
secondary (focused history, physical examination, diagnostic testing)
An OPA can only be used on a(n) ________ patient
unconscious
What could be adverse effects of an NPA too short or too long?
Too short, may not relieve obstruction. Too long, may stimulate vagal
response/bradycardia, increase risk for aspiration, or damage epiglottis or
vocal chords.
APPLY LUBRICANT TO PATIENT'S NOSTRIL AND BEVEL before
inserting NPA
Which nostril do you start with NPA, because it is typically larger and more
straight?
Right
Assessing breathing
- Rate and rhythm
- Chest rise and cyanosis
- Presence or absence of breath sounds
- Bilateral equality
- Establish capnography to monitor the adequacy of ventilation (ETCO2
values 35-45 confirm adequacy of ventilation)
- Establish pulse oximetry
To minimize complications when using a BVM, depress the bag...
slowly over 1 second, and only about halfway (400mL to 700mL tidal volume for
an adult)
Assessing circulation
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS GRADED A+ |
LATEST EDITION
Principles of high quality CPR
Ways to ensure the delivery of high quality CPR
- Allow the chest to recoil fully
- Compress to a depth of at least 2 in but not more than 2.4 in
- Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
How to insert an oropharyngeal airway.
how to insert nasopharyngeal airway
Considerations when an advanced airway is in place
Proper placement of electrodes for monitoring of HR, rhythm, and obtaining
12 and 15-lead ECG
Procedure for defibrillation
Procedure for synchronized cardioversion
Procedure for transcutaneous pacing
Procedure for obtaining intraosseous (IO) access
How to interpret EtCO2 during resuscitation ventilation?
30-45 what it is normally
15-20 during a resuscitation
Below 10 could be a problem with rate or quality of compressions
Spike is often the first sign of ROSC
Four components of communication
,Sender, message, receiver, feedback (closed loop communication)
Debriefing
Review, Analyze, Reflect, Summarize
Team leader responsibilities
- Assigns team roles
- Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
Team member responsibilities
- Have the knowledge and skills to perform their assigned role
- Communicate with the team leader if they feel they are lacking the above,
identify something the team leader may have overlooked, recognize a
dangerous situation or need for urgent action
- Stay in their assigned role but assist others as needed, as long as they are
able to maintain their own responsibilities
Six-Person High-Performance Resuscitation Team
Includes three CPR/defibrillator roles, and three leadership/supportive roles
1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or
interruptions to chest compressions)
,Example of a debrief review
A 15-year-old patient who had been brought to the emergency department for
evaluation of an earlier episode of syncope went into witnessed ventricular
fibrillation. Compressions were started, defibrillator pads were applied and
an initial shock of 120 J was delivered. An OPA was inserted and high-flow
oxygen was initiated. After 2 minutes of CPR and a rhythm check, the patient
was observed to still be in ventricular fibrillation; a second shock of 150 J was
delivered, CPR was resumed, 1 mg of epinephrine was administered and
capnography monitoring was established. After approximately 1 more minute
of CPR, the patient achieved ROSC.
What should be prioritized during ventricular fibrillation - defibrillation or
ventilations?
Defibrillation is the most effective therapy for the treatment of vfib
A systematic approach to assessment includes a ____, ____, and ____
assessment.
Rapid, primary, secondary
- Initial impression
- Responsiveness
- Breathing
- Pulse
Are components of a _____ assessmetn
Rapid
- Airway
- Breathing
- Circulation
- Disability
- Exposure
are components of a _____ assessment
Primary
, A broader assessment to narrow the list of differential diagnoses and discover
underlying causes is a _____ assessment
secondary (focused history, physical examination, diagnostic testing)
An OPA can only be used on a(n) ________ patient
unconscious
What could be adverse effects of an NPA too short or too long?
Too short, may not relieve obstruction. Too long, may stimulate vagal
response/bradycardia, increase risk for aspiration, or damage epiglottis or
vocal chords.
APPLY LUBRICANT TO PATIENT'S NOSTRIL AND BEVEL before
inserting NPA
Which nostril do you start with NPA, because it is typically larger and more
straight?
Right
Assessing breathing
- Rate and rhythm
- Chest rise and cyanosis
- Presence or absence of breath sounds
- Bilateral equality
- Establish capnography to monitor the adequacy of ventilation (ETCO2
values 35-45 confirm adequacy of ventilation)
- Establish pulse oximetry
To minimize complications when using a BVM, depress the bag...
slowly over 1 second, and only about halfway (400mL to 700mL tidal volume for
an adult)
Assessing circulation
