HEARTCODE ACLS EXAM SCRIPT 2025 QUESTIONS WITH
SOLUTIONS GUARANTEE A+
✔✔if persistent tachycardia does not present with symptoms what do you need to
consider - ✔✔wide QRS?
greater than 0.12 seconds
✔✔If persistent tachycardia without symptoms DOES have a wide QRS what to do you
do? - ✔✔IV access and 12 lead if available
6mg adenosine followed by NS flush only IF regular and monomorphic
consider anti-arrhythmic infusion:
- 20-50mg/min procainamide (max 17mg/kg)
- 150mg amiodarone over 10 minutes
- 100mg sotalol over 5 minutes
✔✔which anti-arrhythmic drugs can be used if prolonged QT - ✔✔only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours
✔✔if persistent tachycardia without symptoms and without wide QRS what do you do -
✔✔IV access and 12 lead EKG if available
vagal maneuvers
6mg adenosine followed by NS flush only IF regular
Beta blocker or calcium channel blocker
✔✔patient comes in with symptoms of ACS what do you do first - ✔✔chew 325mg
aspirin
O2
nitro
morphine
get 12 lead EKG
IV access
✔✔IF ACS patient has EKG showing ST elevation and symptoms are less than 12
hours then what - ✔✔re-perfusion
door to balloon 90 minutes
door to needle 30 minutes
, ✔✔If ACS patient has EKG showing non ST elevation MI or high risk unstable angina
then what - ✔✔early invasive strategy?
adjunctive treatment?
-nitroglycerin
-heparin
-beta blockers
-clopidogrel
-glycoprotein IIb / IIIa inhibitor
✔✔what are the contraindications to fibrinolytics in ACS treatment - ✔✔systolic > 180
diastolic > 100
right arm left arm systolic difference > 15
history of structural central nervous system disease
recent head/facial trauma
stroke more than 3 hours or less then 3 months ago
recent trauma, surgery or bleed
any history of intracranial hemorrhage
bleeding, clotting problem or on blood thinners
serious systemic disease
✔✔adenosine - ✔✔used in tachy
6mg bolus followed by 20mL normal saline
12mg can be used after 1-2 minutes
✔✔amiodirone - ✔✔In VF/VT arrest AFTER trying CPR shock and epi/vasopressin:
300mg then 150mg
In life threatening arrhythmias:
150mg over 10 minute infusion, every 10 minutes as needed
✔✔atropine sulfate - ✔✔use as first line defense in sinus bradycardia
0.5mg every 3-5 minutes as needed MAX is 3mg ( think alive gets 0.5)
do not use if hypothermia
✔✔dopamine - ✔✔2nd line drug for symptomatic bradycardia
use for hypotension with signs of shock
2-20 mcg/kg per minute
✔✔epinephrine - ✔✔in cardiac arrest:
1mg every 3-5 minutes
SOLUTIONS GUARANTEE A+
✔✔if persistent tachycardia does not present with symptoms what do you need to
consider - ✔✔wide QRS?
greater than 0.12 seconds
✔✔If persistent tachycardia without symptoms DOES have a wide QRS what to do you
do? - ✔✔IV access and 12 lead if available
6mg adenosine followed by NS flush only IF regular and monomorphic
consider anti-arrhythmic infusion:
- 20-50mg/min procainamide (max 17mg/kg)
- 150mg amiodarone over 10 minutes
- 100mg sotalol over 5 minutes
✔✔which anti-arrhythmic drugs can be used if prolonged QT - ✔✔only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours
✔✔if persistent tachycardia without symptoms and without wide QRS what do you do -
✔✔IV access and 12 lead EKG if available
vagal maneuvers
6mg adenosine followed by NS flush only IF regular
Beta blocker or calcium channel blocker
✔✔patient comes in with symptoms of ACS what do you do first - ✔✔chew 325mg
aspirin
O2
nitro
morphine
get 12 lead EKG
IV access
✔✔IF ACS patient has EKG showing ST elevation and symptoms are less than 12
hours then what - ✔✔re-perfusion
door to balloon 90 minutes
door to needle 30 minutes
, ✔✔If ACS patient has EKG showing non ST elevation MI or high risk unstable angina
then what - ✔✔early invasive strategy?
adjunctive treatment?
-nitroglycerin
-heparin
-beta blockers
-clopidogrel
-glycoprotein IIb / IIIa inhibitor
✔✔what are the contraindications to fibrinolytics in ACS treatment - ✔✔systolic > 180
diastolic > 100
right arm left arm systolic difference > 15
history of structural central nervous system disease
recent head/facial trauma
stroke more than 3 hours or less then 3 months ago
recent trauma, surgery or bleed
any history of intracranial hemorrhage
bleeding, clotting problem or on blood thinners
serious systemic disease
✔✔adenosine - ✔✔used in tachy
6mg bolus followed by 20mL normal saline
12mg can be used after 1-2 minutes
✔✔amiodirone - ✔✔In VF/VT arrest AFTER trying CPR shock and epi/vasopressin:
300mg then 150mg
In life threatening arrhythmias:
150mg over 10 minute infusion, every 10 minutes as needed
✔✔atropine sulfate - ✔✔use as first line defense in sinus bradycardia
0.5mg every 3-5 minutes as needed MAX is 3mg ( think alive gets 0.5)
do not use if hypothermia
✔✔dopamine - ✔✔2nd line drug for symptomatic bradycardia
use for hypotension with signs of shock
2-20 mcg/kg per minute
✔✔epinephrine - ✔✔in cardiac arrest:
1mg every 3-5 minutes
