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What is different about the algorithm for PEA compared to VF/pVT? -
ANSWER> no shocks are administered, only epinephrine is given (not
antiarrythmics)
What should be checked first when a patient suddenly "flat-lines" on the monitor -
ANSWER> the patient's leads are connected to the monitor that is being used
Survival in asystole is very poor, even if everything is done. However, in what
scenarios is a patient more likely to survive asystole. - ANSWER> setting of
witnessed arrest, younger age, noncardiac cause for arrest, and short interval from
collapse to basic to advanced life support
What is a rhythm that could look very similar to asystole that may be shockable,
even though it is still not a very survivable rhythm - ANSWER> fine VF
Dosing of epinephrine in the setting of VF/pVT and asystole/PEA - ANSWER> 1
mg every 3-5 minutes
Dosing of amiodarone (first and second dose) in the setting of cardiac arrest -
ANSWER> 300mg first dose
150mg second dose after 3-5 min
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,Dosing of lidocaine (first and second dose) in the setting of cardiac arrest -
ANSWER> 1-1.5mg/kg first dose
0.5-0.75 mg/kg second dose, repeat in 5-10 min
When would CPR NOT be started in the setting of a cardiac arrest? - ANSWER>
patient has signs of irreversible death such as rigor mortis, decapitation, or
dependent lividity OR if there is a threat to the safety of providers OR valid DNR
status
Times when epinephrine is administered - ANSWER> -cardiac arrest, VF,
pulseless VT unresponsive to initial shocks, asystole, and PEA
-symptomatic bradycardia after atropine has failed (unless it is a higher degree
block)
-severe hypotension due to shock
-anaphylaxis, severe allergic reactions
What are some special circumstances in which prolonged resuscitation is
appropriate? - ANSWER> hypothermia, drowning, drug overdose, pediatric
patients who primarily have respiratory arrest rather than cardiac arrest or other
potentially reversible causes of arrest
Factors that are typically considered when terminating resuscitation in hospital -
ANSWER> -time from collapse to CPR
-time from collapse to defibrillation
-prearrest state
-initial arrest arrhythmia
-response to resuscitation
-duration of resuscitation
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,Resuscitation efforts out-of-hospital are continued until... - ANSWER> -ROSC
-transfer of care to senior officials
-presence. of reliable criteria indicating irreversible death
-exhaustion prevents continuation
-valid DNR is presented
-online authorization from medical control physician or by prior medical protocol
for termination of life support
80% of in-patient cardiac arrests had abnormal vital signs up to _____ hours prior
to arrest - ANSWER> 8
3 core measurements of Ustein Guidelines - ANSWER> 1. rate of bystander CPR
2. time to defibrillation
3. survival to hospital discharge
After a person is found down and it is confirmed that they are unresponsive, how
long should a carotid pulse be checked? - ANSWER> 5-10 seconds
How often should providers switch performing compressions? - ANSWER> 2 min
If a pulse returns during resuscitation (respiratory arrest alone), and rescue breaths
are administered, how often should rescue breaths be performed? - ANSWER> 5-
6 seconds
In what patients should it be assumed that a spinal injury is present until ruled out?
- ANSWER> anyone with head or facial injury
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, If a patient has a spinal injury (or is assumed to have a spinal injury) how should
their airway be opened? - ANSWER> jaw thrust without head extension (unless
this is not effective, because "dead is dead")
a member of team should stabilize the head in neutral position during airway
manipulation
Most common reason for upper airway obstruction in an unconscious patient -
ANSWER> loss of tone in the muscles (tongue most common)
If a patient was coughing prior to losing consciousness, what should be suspected
as the cause of collapse, and what should be done? - ANSWER> suspect FB and
open airway wide- if FB is seen, remove it with finger. If no object is seen, begin
CPR and each time respirations are given, open mouth wide and look again for
foreign object and remove if seen
How much air is given in order to make the chest rise over 1 second? -
ANSWER> 600mL
If possible, a patient receiving bag mask ventilation should be connected to oxygen
concentration of what and receive a minimal flow rate of how many liters? -
ANSWER> oxygen concentration >40% and minimal flow rate of 10-12 liters per
minute
This type of airway is used if the patient is at risk for developing obstruction from
tongue/muscle relaxation.
It is only used in unconscious patients
It can be used concurrently with bag mask, can be used during suctioning of mouth
and throat, and can be used in intubated patients to keep them from biting the tube
- ANSWER> OPA
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