Advanced Life Support (ALS) Exam Updated
Actual Question and Answer (2026/2027) |
Grade A+ Verified
• Shockable rhythms in cardiac arrest -✓✓ Ventricular fibrillation (VF) and
pulseless ventricular tachycardia (pVT).
• Non-shockable rhythms in cardiac arrest -✓✓ Pulseless electrical activity (PEA)
and asystole.
• 4Hs in cardiac arrest -✓✓ Hypoxia, Hypovolaemia, Hypo-/Hyperkalaemia (and
metabolic disorders), Hypothermia.
• 4Ts in cardiac arrest -✓✓ Tension pneumothorax, Tamponade (cardiac), Toxins,
Thrombosis (coronary or pulmonary).
• Target temperature range for post-cardiac arrest temperature management -✓✓
32-36°C for at least 24 hours.
• Target oxygen saturation post-arrest -✓✓ 94-98%.
• First-line treatment for symptomatic bradycardia -✓✓ Atropine 500 mcg IV.
• Three broad categories of tachycardia in ALS -✓✓ Narrow-complex regular (e.g.,
SVT), Narrow-complex irregular (e.g., AF), Broad-complex (e.g., VT).
,• First drug given in a shockable rhythm cardiac arrest -✓✓ Adrenaline 1mg IV
after the second shock, followed by amiodarone 300mg IV.
• Frequency of adrenaline during CPR in a non-shockable rhythm -✓✓ Every 3-5
minutes (every other cycle of CPR).
• Recommended chest compression depth for high-quality CPR -✓✓ 5-6 cm.
• Compression-to-ventilation ratio in a patient without an advanced airway -✓✓
30:2.
• First-line treatment for cardiac arrest due to hyperkalaemia -✓✓ Calcium chloride
or calcium gluconate IV.
• Preferred airway management in cardiac arrest -✓✓ Initially a bag-valve-mask
(BVM), but early advanced airway (ET tube or supraglottic device) if trained.
• Recommended sequence when dealing with refractory VF/pVT after three shocks
-✓✓ Continue high-quality CPR, consider antiarrhythmic drugs (e.g., amiodarone,
lidocaine), and check for reversible causes.
• Repeat dose of amiodarone if VF persists after initial dose -✓✓ A repeat dose of
150 mg IV may be administered if VF persists.
• PEA -✓✓ PEA shows electrical activity on the monitor without a palpable pulse.
• Asystole -✓✓ Asystole shows no electrical activity.
,• Torsades de Pointes -✓✓ It is a polymorphic ventricular tachycardia often due to
prolonged QT interval, requiring treatment with magnesium sulfate.
• Bag-mask ventilation to advanced airway transition -✓✓ After 2 minutes of CPR,
if trained personnel are available to secure an advanced airway without significant
interruption.
• Factors influencing airway choice -✓✓ Operator experience, ease of placement,
potential interruption to chest compressions, and patient anatomy.
• Target mean arterial pressure (MAP) in post-cardiac arrest care -✓✓ Aim for a
MAP of at least 65 mmHg to ensure adequate cerebral perfusion.
• Role of capnography during CPR -✓✓ It monitors ventilation, confirms effective
chest compressions, and aids in detecting return of spontaneous circulation
(ROSC).
• Key elements of effective communication during resuscitation -✓✓ Clear role
allocation, closed-loop communication, regular updates, and situational awareness.
• Debriefing in resuscitation -✓✓ It allows team members to reflect on what went
well, identify areas for improvement, and reinforce learning points.
• Dose of magnesium sulfate for Torsades de Pointes -✓✓ 2g IV over 5-20 minutes
is recommended.
, • Lidocaine use in cardiac arrest management -✓✓ As an alternative to amiodarone
in shock-refractory VF/pVT if amiodarone is contraindicated or unavailable.
• Hypothermia effects on resuscitation -✓✓ It depresses cardiac function and may
mask cardiac arrest; rewarming is essential in management.
• Modifications for pediatric resuscitation -✓✓ Lower compression depth (one-
third the anterior-posterior diameter of the chest) and age-appropriate drug dosing.
• DNAR discussions initiation -✓✓ When prognosis is poor, after consultation
with seniors, and ideally with involvement of the patient or family.
• How often should rescuers performing CPR be changed, assuming there are
enough rescuers available? -✓✓ Every 2 minutes.
• What is the correct hand position for chest compressions during CPR? -✓✓ The
middle of the lower half of the sternum.
• What breathing pattern is commonly observed in the early phases of cardiac
arrest? -✓✓ Occasional gasps.
• When should pulse checks be performed during resuscitation? -✓✓ Pulse checks
should only be performed when organized electrical activity compatible with a
pulse is observed.
• How often should adrenaline be repeated during cardiac arrest? -✓✓ Adrenaline
should be repeated every 3-5 minutes, irrespective of the cardiac arrest rhythm.
Actual Question and Answer (2026/2027) |
Grade A+ Verified
• Shockable rhythms in cardiac arrest -✓✓ Ventricular fibrillation (VF) and
pulseless ventricular tachycardia (pVT).
• Non-shockable rhythms in cardiac arrest -✓✓ Pulseless electrical activity (PEA)
and asystole.
• 4Hs in cardiac arrest -✓✓ Hypoxia, Hypovolaemia, Hypo-/Hyperkalaemia (and
metabolic disorders), Hypothermia.
• 4Ts in cardiac arrest -✓✓ Tension pneumothorax, Tamponade (cardiac), Toxins,
Thrombosis (coronary or pulmonary).
• Target temperature range for post-cardiac arrest temperature management -✓✓
32-36°C for at least 24 hours.
• Target oxygen saturation post-arrest -✓✓ 94-98%.
• First-line treatment for symptomatic bradycardia -✓✓ Atropine 500 mcg IV.
• Three broad categories of tachycardia in ALS -✓✓ Narrow-complex regular (e.g.,
SVT), Narrow-complex irregular (e.g., AF), Broad-complex (e.g., VT).
,• First drug given in a shockable rhythm cardiac arrest -✓✓ Adrenaline 1mg IV
after the second shock, followed by amiodarone 300mg IV.
• Frequency of adrenaline during CPR in a non-shockable rhythm -✓✓ Every 3-5
minutes (every other cycle of CPR).
• Recommended chest compression depth for high-quality CPR -✓✓ 5-6 cm.
• Compression-to-ventilation ratio in a patient without an advanced airway -✓✓
30:2.
• First-line treatment for cardiac arrest due to hyperkalaemia -✓✓ Calcium chloride
or calcium gluconate IV.
• Preferred airway management in cardiac arrest -✓✓ Initially a bag-valve-mask
(BVM), but early advanced airway (ET tube or supraglottic device) if trained.
• Recommended sequence when dealing with refractory VF/pVT after three shocks
-✓✓ Continue high-quality CPR, consider antiarrhythmic drugs (e.g., amiodarone,
lidocaine), and check for reversible causes.
• Repeat dose of amiodarone if VF persists after initial dose -✓✓ A repeat dose of
150 mg IV may be administered if VF persists.
• PEA -✓✓ PEA shows electrical activity on the monitor without a palpable pulse.
• Asystole -✓✓ Asystole shows no electrical activity.
,• Torsades de Pointes -✓✓ It is a polymorphic ventricular tachycardia often due to
prolonged QT interval, requiring treatment with magnesium sulfate.
• Bag-mask ventilation to advanced airway transition -✓✓ After 2 minutes of CPR,
if trained personnel are available to secure an advanced airway without significant
interruption.
• Factors influencing airway choice -✓✓ Operator experience, ease of placement,
potential interruption to chest compressions, and patient anatomy.
• Target mean arterial pressure (MAP) in post-cardiac arrest care -✓✓ Aim for a
MAP of at least 65 mmHg to ensure adequate cerebral perfusion.
• Role of capnography during CPR -✓✓ It monitors ventilation, confirms effective
chest compressions, and aids in detecting return of spontaneous circulation
(ROSC).
• Key elements of effective communication during resuscitation -✓✓ Clear role
allocation, closed-loop communication, regular updates, and situational awareness.
• Debriefing in resuscitation -✓✓ It allows team members to reflect on what went
well, identify areas for improvement, and reinforce learning points.
• Dose of magnesium sulfate for Torsades de Pointes -✓✓ 2g IV over 5-20 minutes
is recommended.
, • Lidocaine use in cardiac arrest management -✓✓ As an alternative to amiodarone
in shock-refractory VF/pVT if amiodarone is contraindicated or unavailable.
• Hypothermia effects on resuscitation -✓✓ It depresses cardiac function and may
mask cardiac arrest; rewarming is essential in management.
• Modifications for pediatric resuscitation -✓✓ Lower compression depth (one-
third the anterior-posterior diameter of the chest) and age-appropriate drug dosing.
• DNAR discussions initiation -✓✓ When prognosis is poor, after consultation
with seniors, and ideally with involvement of the patient or family.
• How often should rescuers performing CPR be changed, assuming there are
enough rescuers available? -✓✓ Every 2 minutes.
• What is the correct hand position for chest compressions during CPR? -✓✓ The
middle of the lower half of the sternum.
• What breathing pattern is commonly observed in the early phases of cardiac
arrest? -✓✓ Occasional gasps.
• When should pulse checks be performed during resuscitation? -✓✓ Pulse checks
should only be performed when organized electrical activity compatible with a
pulse is observed.
• How often should adrenaline be repeated during cardiac arrest? -✓✓ Adrenaline
should be repeated every 3-5 minutes, irrespective of the cardiac arrest rhythm.
