ACLS MEGACODE QUESTIONS AND ANSWERS 2025

A 40 year old man arrives at the ER accompanied by his family. He is complaining of palpitations after working outside for several hours. The assessment is as follows: SKIN: Hydrated, pale, warm and dry CVS: Strong peripheral pulses and a BP of 125/80 CNS: Fully intact RESP: RR is 22, no resp. difficulties, lungs CTA You place o2 at 2L by NC on the patient and start an IV. The monitor shows a narrow complex SVT (160). What is your next intervention? - ANSWER attempt vagal maneuvers You have performed vagal maneuvers. The patient has shows no change on the monitor. What is your next step? - ANSWER Give adenosine 6mg rapid IV push. If no conversion, give 12mg rapid IV push You give 6mg Adenosine rapid IV push with no effect. 12mg Adenosine rapid IV push is then given. The patient develops severe chest pain. You see a change in the rhythm. The BP (not obtainable), and weak pulse. The patient also has LOC changes. Your next step should be? - ANSWER perform immediate synchronized cardioversion *Synchronized cardioversion is indicated for unstable ventricular tachycardia with a pulse. 100 J is given for regular wide complex ventricular tachycardia. After synchronized cardioversion is unsuccessful, the pt. continues to deteriorate. The patient is now unconscious with pusleless ventricular tachycardia. Below is what you see on the monitor: - ANSWER Give one unsynchronized shock (120-200 J)