EMed-ACLS EXAM REVIEW QUESTIONS WITH CORRECT ANSWERS

EMed-ACLS EXAM REVIEW QUESTIONS WITH CORRECT ANSWERS Management Targets for Post-Cardiac Arrest Care (A) Early Haemodynamic Optimisation 1. MAP 2. CVP 3. ScvO2 4. Urine output (B) Oxygenation 1. SaO2 (C) Ventilation 1. PaCO2 - Answer-(A) Early haemodynamic optimisation - to maximise tissue perfusion & repay oxygen debt 1. MAP = 65-100mmHg 2. CVP = 8-12mmHg 3. ScvO2 > 70% 4. Urine output > 1ml/kg/hour (B) Oxygenation 1. SaO2 94-98% - Post-ROSC ventilation with 100% O2 in the first hour was a/w worse neuro outcomes compared to immediate adjustment of FiO2 to targeted SaO2 levels, possibly due to generation of excess oxygen free radicals (C) Ventilation 1. PaCO2 = 40mmHg (normocarbia) - If therapeutic hypothermia is employed, the reduced metabolism may result in reduced ventilatory needs 2. End-tidal CO2 35-45mmHg 3. Low tidal volumes 6-8ml/kg body weight - to avoid increased intra-thoracic pressures Management of Post-Cardiac Arrest Care - Answer-(A) Ventilatory support - guided by ABG 1. Mech ventilation - Maintain SpO2 94-98% a) Hypoventilated => anoxic brain injury b) Hyperventilation => decreased cerebral blood flow => worsen brain injury