ACLS SCENARIOS QUESTIONS AND
VERIFIED ANSWERS|100%
CORRECT|GRADE A+ 2024
In your code testing, what must you remember to verbalize after arriving at the scene but prior to
approaching the patient? - ANSWER must verbalize using "universal precautions", aka gloves, etc
In your code testing, you should start every protocol by verbalizing what THREE commands? - ANSWER
that you want:
1. Oxygen placed on the patient
2. Monitors placed
3. An IV placed
What are the TEN possible ACLS Scenarios that we need to prepare for? - ANSWER 1. Respiratory Arrest
2. Bradycardia
-Sinus Bradycardia, escape ventricular rhythm, 2nd & 3rd AV blocks
3. Supraventricular tachycardia
-"Regular" rhythms
-SVT, sinus tachycardia, junctional tachycardia, atrial flutter
-Irregular rhythms
-Afib, atrial flutter
4. Monomorphic Vtach
4a. With pulse
4b. Without pulse
5. Vfib
-Same algorithm as for pulseless Vtach
6. Polymorphic Vtach
-(Torsades de Pointes)
7. Asystole & PEA
8. Acute Coronary Syndrome (ACS)
,9. Acute Stroke
10. ROSC
What are the FOUR steps in the ACLS Breathing Protocol, for a patient in Respiratory Arrest? - ANSWER
1. R (Check Responsiveness)
-Patient is unresponsive
2. A (Activate EMS)/call for help
3. C (Circulation; check pulse and breathing)
-No more than 5-10 seconds; recheck every 2 minutes
4a. If there is no pulse, or you are unsure of whether or not there is a pulse, begin compressions
4b. If there is no breathing but there is a pulse (or you are unsure of whether or not there is a pulse),
give 2 rescue breaths
-Each breath over 1 second
What are the FIVE steps in the Respiratory Arrest Protocol? - ANSWER 1. R (check Responsiveness)
-Patient is not responding
2. A (Activate EMS/call for help)
3. C (Circulation; check pulse and breathing)
Patient has pulse, but is not breathing
4. Give 2 rescue breaths before starting CPR, and continue giving 10-12 rescue breaths per minute
(1 breath every 5-6 seconds)
5. Re-check pulse every 2 minutes
What is the Narcan Protocol for suspected opioid intoxication? What is the ACLS IM and Intranasal dose
for Narcan? How often can you repeated administration? - ANSWER 1. "In situations where the patient
has a pulse but is not breathing normally or is only gasping, the AHA considers the intramuscular or
intranasal administration of naloxone to be reasonable when the EMS provider suspects opioid
intoxication. If the suspected opioid overdose patient is in cardiac arrest, EMS providers can also
administer the medication after initiating CPR."
2.
2a. IM dose = 0.4mg
,2b. Intranasal dose = 2mg
3. Can repeat the doses after 4 minutes
What are the FIVE rhythms that fall under the Bradycardia Algorithm? - ANSWER 1. Sinus bradycardia
2. Mobitz Type I & II block
3. Complete (3rd degree) heart block
4. Afib with slow ventricular response
5. Ventricular or junctional escape rhythm
When dealing with a Respiratory Arrest Scenario, what are the FOUR(ish) steps for the Breathing
Protocol? - ANSWER 1. R (Check Responsiveness)
-Patient is unresponsive
2. A (Activate EMS)/call for help
3. C (Circulation; check pulse and breathing)
-No more than 5-10 seconds; recheck every 2 minutes
4a. If there is no pulse, or you are unsure of whether or not there is a pulse, begin compressions
4b. If there is no breathing but there is a pulse (or you are unsure of whether or not there is a pulse),
give 2 rescue breaths
-Each breath over 1 second
****Review the Notes i made in the powerpoint because there are a few scenarios/possible test/quiz
questions I wrote down that he talked about in class**** - ANSWER
What are the THREE Bradycardia Therapies (general, not specific)? - ANSWER 1. Drugs
2. Transcutaneous Pacing
3. Transvenous Pacing
What THREE ACLS drugs can be used to treat Bradycardia? - ANSWER 1. Epinephrine
2. Atropine
3. Dopamine
, What is the Preferred method of pacing in Emergent Unstable Bradycardia? Explain why, and the pro's
and con's of this technique? - ANSWER 1. Transcutaneous pacing is the preferred method
2. It is the easiest and quickest form of pacing to initiate
3. This doesn't produce as effective capture as transvenous pacing, but it can be initiated within seconds
by any ACLS provider
What pacing method would you utilize in a patient with Stable Bradycardia? Why? - ANSWER 1.
Transvenous pacing is preferred in Stable Bradycardia patients
2. This technique is used only for stable bradycardia because it takes longer to initiate, and requires
expert placement with fluoroscopy, but it produces more effective capture
3. So basically this is impractical for an emergency (it's only an option for stable bradycardia)
What pacing method would you utilize in a patient with Unstable Bradycardia? Why? - ANSWER 1.
Transcutaneous pacing is the preferred method
2. It is the easiest and quickest form of pacing to initiate
What are the FIVE steps to performing Transcutaneous Pacing? - ANSWER 1. Place the pad on the
patient, preferably in a posterior, left anterior fashion
2. Turn the knob to "Pacer"
3. Select the HR you want to pace with
-Rate knob (right knob)
4. Turn the current (mA) up until you observe capture
-mA knob (left knob)
5. Set the maintenance threshold 10% above pacing threshold
-For example, if capture is observed at 50mA, set the maintenance threshold to 55mA
What are the FOUR Disadvantages of Transcutaneous Pacing? - ANSWER 1. Only shows a ventricular ECG
waveform
-Can't pace the atria and ventricles independently
2. Not as effective capture as transvenous pacing
VERIFIED ANSWERS|100%
CORRECT|GRADE A+ 2024
In your code testing, what must you remember to verbalize after arriving at the scene but prior to
approaching the patient? - ANSWER must verbalize using "universal precautions", aka gloves, etc
In your code testing, you should start every protocol by verbalizing what THREE commands? - ANSWER
that you want:
1. Oxygen placed on the patient
2. Monitors placed
3. An IV placed
What are the TEN possible ACLS Scenarios that we need to prepare for? - ANSWER 1. Respiratory Arrest
2. Bradycardia
-Sinus Bradycardia, escape ventricular rhythm, 2nd & 3rd AV blocks
3. Supraventricular tachycardia
-"Regular" rhythms
-SVT, sinus tachycardia, junctional tachycardia, atrial flutter
-Irregular rhythms
-Afib, atrial flutter
4. Monomorphic Vtach
4a. With pulse
4b. Without pulse
5. Vfib
-Same algorithm as for pulseless Vtach
6. Polymorphic Vtach
-(Torsades de Pointes)
7. Asystole & PEA
8. Acute Coronary Syndrome (ACS)
,9. Acute Stroke
10. ROSC
What are the FOUR steps in the ACLS Breathing Protocol, for a patient in Respiratory Arrest? - ANSWER
1. R (Check Responsiveness)
-Patient is unresponsive
2. A (Activate EMS)/call for help
3. C (Circulation; check pulse and breathing)
-No more than 5-10 seconds; recheck every 2 minutes
4a. If there is no pulse, or you are unsure of whether or not there is a pulse, begin compressions
4b. If there is no breathing but there is a pulse (or you are unsure of whether or not there is a pulse),
give 2 rescue breaths
-Each breath over 1 second
What are the FIVE steps in the Respiratory Arrest Protocol? - ANSWER 1. R (check Responsiveness)
-Patient is not responding
2. A (Activate EMS/call for help)
3. C (Circulation; check pulse and breathing)
Patient has pulse, but is not breathing
4. Give 2 rescue breaths before starting CPR, and continue giving 10-12 rescue breaths per minute
(1 breath every 5-6 seconds)
5. Re-check pulse every 2 minutes
What is the Narcan Protocol for suspected opioid intoxication? What is the ACLS IM and Intranasal dose
for Narcan? How often can you repeated administration? - ANSWER 1. "In situations where the patient
has a pulse but is not breathing normally or is only gasping, the AHA considers the intramuscular or
intranasal administration of naloxone to be reasonable when the EMS provider suspects opioid
intoxication. If the suspected opioid overdose patient is in cardiac arrest, EMS providers can also
administer the medication after initiating CPR."
2.
2a. IM dose = 0.4mg
,2b. Intranasal dose = 2mg
3. Can repeat the doses after 4 minutes
What are the FIVE rhythms that fall under the Bradycardia Algorithm? - ANSWER 1. Sinus bradycardia
2. Mobitz Type I & II block
3. Complete (3rd degree) heart block
4. Afib with slow ventricular response
5. Ventricular or junctional escape rhythm
When dealing with a Respiratory Arrest Scenario, what are the FOUR(ish) steps for the Breathing
Protocol? - ANSWER 1. R (Check Responsiveness)
-Patient is unresponsive
2. A (Activate EMS)/call for help
3. C (Circulation; check pulse and breathing)
-No more than 5-10 seconds; recheck every 2 minutes
4a. If there is no pulse, or you are unsure of whether or not there is a pulse, begin compressions
4b. If there is no breathing but there is a pulse (or you are unsure of whether or not there is a pulse),
give 2 rescue breaths
-Each breath over 1 second
****Review the Notes i made in the powerpoint because there are a few scenarios/possible test/quiz
questions I wrote down that he talked about in class**** - ANSWER
What are the THREE Bradycardia Therapies (general, not specific)? - ANSWER 1. Drugs
2. Transcutaneous Pacing
3. Transvenous Pacing
What THREE ACLS drugs can be used to treat Bradycardia? - ANSWER 1. Epinephrine
2. Atropine
3. Dopamine
, What is the Preferred method of pacing in Emergent Unstable Bradycardia? Explain why, and the pro's
and con's of this technique? - ANSWER 1. Transcutaneous pacing is the preferred method
2. It is the easiest and quickest form of pacing to initiate
3. This doesn't produce as effective capture as transvenous pacing, but it can be initiated within seconds
by any ACLS provider
What pacing method would you utilize in a patient with Stable Bradycardia? Why? - ANSWER 1.
Transvenous pacing is preferred in Stable Bradycardia patients
2. This technique is used only for stable bradycardia because it takes longer to initiate, and requires
expert placement with fluoroscopy, but it produces more effective capture
3. So basically this is impractical for an emergency (it's only an option for stable bradycardia)
What pacing method would you utilize in a patient with Unstable Bradycardia? Why? - ANSWER 1.
Transcutaneous pacing is the preferred method
2. It is the easiest and quickest form of pacing to initiate
What are the FIVE steps to performing Transcutaneous Pacing? - ANSWER 1. Place the pad on the
patient, preferably in a posterior, left anterior fashion
2. Turn the knob to "Pacer"
3. Select the HR you want to pace with
-Rate knob (right knob)
4. Turn the current (mA) up until you observe capture
-mA knob (left knob)
5. Set the maintenance threshold 10% above pacing threshold
-For example, if capture is observed at 50mA, set the maintenance threshold to 55mA
What are the FOUR Disadvantages of Transcutaneous Pacing? - ANSWER 1. Only shows a ventricular ECG
waveform
-Can't pace the atria and ventricles independently
2. Not as effective capture as transvenous pacing
