AHA ACLS Exam Practice and Study Questions and
Answers
An effective system of care comprises all of these elements:
Structure, process, system, and patient outcomes.
Taxonomy of Systems of Care:
SPSO: Structure, Process, System, Patient Outcome.
Post-Cardiac Arrest Syndrome:
Includes post-arrest brain injury, post-arrest myocardial dysfunction, systemic ischemia or
reperfusion response, and persistent acute and chronic pathology that may have precipitated
the cardiac arrest.
Providers should titrate post-arrest phase inspired O2 to the lowest possible level to achieve
an arterial SPO2 of:
94% or greater
Normocarbia
Partial pressure of end-tidal carbon dioxide [PETCO2] of 30-40 mmHg or PaCO2 of 35-45 mmHg)
may be a reasonable goal unless patient factors prompt more individualized treatment.
Mild hypocapnia might be useful as a temporary measure when treating:
cerebral edema
The optimal post-cardiac arrest blood pressure remains unknown; however a mean arterial
pressure of what is a reasonable goal?
65 mmHg
,Average survival rate of IHCA:
24%
In a recent study, nearly 80% of hospitalized patients with cardiorespiratory arrest had
abnormal vital signs documented for up to how many hours prior to the actual arrest?
8 hours
More than half of IHCA are the result of:
respiratory failure or hypovolemic shock
The majority of IHCA are foreshadowed by changes in physiology, such as:
tachypnea, tachycardia, and hypotension.
Components of a rapid response system:
-Event detection and response triggering arm.
-A planned response arm, such as the RRT.
-Quality monitoring.
-Administrative support
Examples of physiologic criteria to determine when to call a RRT:
-Threatened airway
-Respiratory rate less than 6/min or more than 30/min
-Heart rate less than 40/min or greater than 140/min.
-Systolic BP < 90 mmHg
-Symptomatic hypertension
-Unexpected decrease in LOC
-Unexplained agitation
-Seizure
,-Significant fall in urine output
-Subjective concern about the pt
Term to define team leaders who may become trapped in a specific treatment or diagnostic
approach-
Fixation error
In one human study, ROSC did not occur unless a CPP of what was obtained during CPR?
15 mmHg or greater
If hypoxia is presumed the cause of the cardiac arrest (such as in a drowning patient):
2 minutes of CPR prior to activating the emergency response team should be delivered.
H's:
Hypovolemia, Hypoxia, Hydrogen Ion (acidosis), Hypo-/hyperkalemia, Hypothermia
T's:
Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), Thrombosis
(coronary).
Common cause of PEA:
Hypovolemia
Hypovolemia, a common cause of PEA, produces classic physiologic response of:
a rapid, narrow-complex tachycardia (sinus tachycardia), and typically produces increased
diastolic and decreased systolic pressures.
Common non-traumatic causes of hypovolemia include:
occult hemorrhage and severe dehydration
, Massive or saddle PE obstructs flow to the pulmonary vasculature and causes:
acute right heart failure
Certain drug overdoses and toxic exposures may lead to:
peripheral vascular dilation and/or myocardial dysfunction with resultant hypotension.
Myocardial dysfunction and arrhythmias may be reversible in certain drug overdoses using
limited interventions. These interventions have one thing in common: they buy time.
Treatments that can provide this level of support include:
-Prolonged basic CPR in special resuscitation situations.
-Extracorporeal CPR
-Intra-aortic balloon pumping
-Renal dialysis
-Intravenous lipid emulsion
-Specific drug antidotes (digoxin immune Fab, glucagon, bicarbonate)
-Transcutaneous pacing
-Correction of severe electrolyte disturbances (potassium, magnesium, calcium, acidosis)
-Specific adjunctive agents
Average respiratory rate for an adult:
12-16 BPM
Normal tidal volume to maintain normal oxygenation and elimination of CO2.
8-10 mL/kg
Tachypnea
Respiratory rate > 20 BPM
Bradypnea
Answers
An effective system of care comprises all of these elements:
Structure, process, system, and patient outcomes.
Taxonomy of Systems of Care:
SPSO: Structure, Process, System, Patient Outcome.
Post-Cardiac Arrest Syndrome:
Includes post-arrest brain injury, post-arrest myocardial dysfunction, systemic ischemia or
reperfusion response, and persistent acute and chronic pathology that may have precipitated
the cardiac arrest.
Providers should titrate post-arrest phase inspired O2 to the lowest possible level to achieve
an arterial SPO2 of:
94% or greater
Normocarbia
Partial pressure of end-tidal carbon dioxide [PETCO2] of 30-40 mmHg or PaCO2 of 35-45 mmHg)
may be a reasonable goal unless patient factors prompt more individualized treatment.
Mild hypocapnia might be useful as a temporary measure when treating:
cerebral edema
The optimal post-cardiac arrest blood pressure remains unknown; however a mean arterial
pressure of what is a reasonable goal?
65 mmHg
,Average survival rate of IHCA:
24%
In a recent study, nearly 80% of hospitalized patients with cardiorespiratory arrest had
abnormal vital signs documented for up to how many hours prior to the actual arrest?
8 hours
More than half of IHCA are the result of:
respiratory failure or hypovolemic shock
The majority of IHCA are foreshadowed by changes in physiology, such as:
tachypnea, tachycardia, and hypotension.
Components of a rapid response system:
-Event detection and response triggering arm.
-A planned response arm, such as the RRT.
-Quality monitoring.
-Administrative support
Examples of physiologic criteria to determine when to call a RRT:
-Threatened airway
-Respiratory rate less than 6/min or more than 30/min
-Heart rate less than 40/min or greater than 140/min.
-Systolic BP < 90 mmHg
-Symptomatic hypertension
-Unexpected decrease in LOC
-Unexplained agitation
-Seizure
,-Significant fall in urine output
-Subjective concern about the pt
Term to define team leaders who may become trapped in a specific treatment or diagnostic
approach-
Fixation error
In one human study, ROSC did not occur unless a CPP of what was obtained during CPR?
15 mmHg or greater
If hypoxia is presumed the cause of the cardiac arrest (such as in a drowning patient):
2 minutes of CPR prior to activating the emergency response team should be delivered.
H's:
Hypovolemia, Hypoxia, Hydrogen Ion (acidosis), Hypo-/hyperkalemia, Hypothermia
T's:
Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), Thrombosis
(coronary).
Common cause of PEA:
Hypovolemia
Hypovolemia, a common cause of PEA, produces classic physiologic response of:
a rapid, narrow-complex tachycardia (sinus tachycardia), and typically produces increased
diastolic and decreased systolic pressures.
Common non-traumatic causes of hypovolemia include:
occult hemorrhage and severe dehydration
, Massive or saddle PE obstructs flow to the pulmonary vasculature and causes:
acute right heart failure
Certain drug overdoses and toxic exposures may lead to:
peripheral vascular dilation and/or myocardial dysfunction with resultant hypotension.
Myocardial dysfunction and arrhythmias may be reversible in certain drug overdoses using
limited interventions. These interventions have one thing in common: they buy time.
Treatments that can provide this level of support include:
-Prolonged basic CPR in special resuscitation situations.
-Extracorporeal CPR
-Intra-aortic balloon pumping
-Renal dialysis
-Intravenous lipid emulsion
-Specific drug antidotes (digoxin immune Fab, glucagon, bicarbonate)
-Transcutaneous pacing
-Correction of severe electrolyte disturbances (potassium, magnesium, calcium, acidosis)
-Specific adjunctive agents
Average respiratory rate for an adult:
12-16 BPM
Normal tidal volume to maintain normal oxygenation and elimination of CO2.
8-10 mL/kg
Tachypnea
Respiratory rate > 20 BPM
Bradypnea
